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The thickness of squamous cell carcinoma (SCC) of the skin is directly related to the risk of recurrences. These results were recently published in Lancet Oncology.

There are three main types of cancers that originate in the skin: basal cell carcinoma; squamous cell carcinoma; and melanoma. These different categories of skin cancer indicate the types of skin cells in which the cancer originates. Melanoma is the least common type of skin cancer but by far the most deadly.

The American Cancer Society estimates that approximately 200,000 to 300,000 cases of squamous cell skin cancer occur each year in the United States. However, only approximately 1,000 to 2,000 people die from both squamous and basal cell cancers combined. Most of the individuals who die from squamous cell carcinoma are elderly and do not have a functioning immune system and/or have not received treatment until the disease is too advanced.

Patients diagnosed with squamous cell carcinoma are most often treated with the surgical removal of the cancer. The optimal time for surgery is when the cancer is small so that cosmetic or structural impact is minimized.

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Researchers from Germany recently conducted a study to explore potential factors associated with an increased risk of developing recurrences among patients with squamous cell skin cancer. This study included 615 patients with squamous cell skin cancer who were treated between 1990 and 2001. The median follow-up was 43 months.

  • Patients with a tumor thickness of 2 millimeters or less had no metastatic cancers (spread to distant sites in the body).
  • Patients with a tumor thickness between 2.1 and 6.0 mm had a 4% risk of developing metastatic cancers.
  • Patients with a tumor thickness greater than 6.0 mm had a 16% chance of developing metastatic cancer.
  • Risk of metastasis was also increased among patients with suppressed immune systems, a large diameter of the cancer, and cancer located on the ear.

The researchers concluded that increased thickness of squamous cell carcinoma of the skin, as well as a suppressed immune system and cancer on the ear, increases the risk of distant spread of cancer. Patients diagnosed with squamous cell carcinoma of the skin may wish to speak with their physician about determining the risk of a cancer recurrence as well as a follow-up screening schedule.

Reference: Brantsch KD, Meisner C, Schonfisch B, et al. Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study. Lancet Oncology [early online publication]. July 9, 2008.