Background

Cutaneous squamous cell carcinoma (cSCC) represents the most serious form of keratinocyte cancers due to its metastatic potential. Studies on nationwide incidence and disease-specific survival rates of metastatic cSCC (mcSCC) are lacking.

Objective

To investigate the cumulative incidence and disease-specific survival of mcSCC patients in the Dutch population and assess patient-based risk factors.

Methods

We conducted a nationwide cancer registry study including all patients with a first cSCC in 2007/2008, using data from the Netherlands Cancer Registry (NCR), the nationwide network and registry of histopathology and cytopathology, and Statistics Netherlands. Cumulative incidence and Kaplan-Meier curves were calculated and time-dependent Cox proportional hazards regression analyses were used.

Results

From the 11,137 patients, 1.9% (n=217) developed metastasis. Median time to metastasis was 1.5 years [IQR, 0.6-3.8]. Risk factors were age (adjusted hazard ratio (aHR) 1.03, 95% confidence interval (CI) 1.02-1.05), male sex (aHR 1.7, 95%CI 1.3-2.3) and immunosuppression (aHR organ transplant recipient 5.0, 95%CI 2.5-10.0; aHR hematologic malignancy 2.7, 95%CI 1.6-4.6). The 5-year disease-specific survival for mcSCC patients was 79.1%.

Limitations

Only histopathologically confirmed mcSCCs were included.

Conclusion

About 2% of cSCCs metastasize with a higher risk for males, increasing age and immunocompromised patients. Disease-specific survival for mcSCC patients is high.

中文翻译：

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转移性皮肤鳞状细胞癌的累积发病率和疾病特异性生存期：一项全国性癌症登记研究

背景

皮肤鳞状细胞癌 (cSCC) 代表最严重的角质形成细胞癌形式，因为它具有转移潜力。缺乏关于转移性 cSCC (mcSCC) 的全国发病率和疾病特异性生存率的研究。

客观的

调查荷兰人群中 mcSCC 患者的累积发病率和疾病特异性生存率，并评估基于患者的危险因素。

方法

我们使用来自荷兰癌症登记处 (NCR)、全国组织病理学和细胞病理学网络和登记处以及荷兰统计局的数据，进行了一项全国性癌症登记研究，包括 2007/2008 年首次出现 cSCC 的所有患者。计算累积发病率和 Kaplan-Meier 曲线，并使用时间依赖性 Cox 比例风险回归分析。

结果

在 11,137 名患者中，1.9% (n=217) 发生了转移。中位转移时间为 1.5 年 [IQR，0.6-3.8]。风险因素是年龄（调整后的风险比 (aHR) 1.03, 95% 置信区间 (CI) 1.02-1.05）、男性（aHR 1.7, 95%CI 1.3-2.3）和免疫抑制（aHR 器官移植受者 5.0, 95%CI 2.5-10.0；aHR 恶性血液病 2.7, 95%CI 1.6-4.6)。mcSCC 患者的 5 年疾病特异性生存率为 79.1%。

限制

仅包括经组织病理学证实的 mcSCC。

结论

大约 2% 的 cSCC 发生转移，男性、年龄增加和免疫功能低下患者的风险更高。mcSCC 患者的疾病特异性存活率很高。