Cleveland Clinic Cancer Center (Taussig) Outcomes
Head and Neck Cancer
Implications of Satellitosis or In-Transit Metastasis in Cutaneous Squamous Cell Carcinoma a Prognostic Omission in Cancer Staging Systems
2010-2020
Unlike Merkel cell carcinoma and melanoma, satellitosis or in-transit metastasis (S-ITM) is not incorporated into the current cutaneous squamous cell carcinoma (CSCC) staging systems. It is important to determine if the clinical outcomes of S-ITM are relevant to prognosis for patients with CSCC. Our objective was to evaluate the association of S-ITM with clinical outcomes in patients with CSCC and to determine its prognostic implications.
Cumulative Incidence of Cutaneous Squamous Cell Carcinoma
2010-2020
| Number at Risk | 0 Months | 12 Months | 24 Months | 36 Months | 48 Months | 60 Months |
|---|---|---|---|---|---|---|
| Bone invasion | 36 | 28 | 19 | 14 | 8 | 4 |
| Nodal | 70 | 31 | 19 | 15 | 13 | 10 |
| S-ITM | 72 | 28 | 19 | 12 | 8 | 7 |
| T3 | 341 | 229 | 167 | 113 | 87 | 60 |
S-ITM, satellitosis or in-transit metastasis; T3, tumor stage III.
Cancer staging per the American Joint Committee on Cancer’s AJCC Cancer Staging Manual, 8th edition.
Probability of Disease-Specific Survival
2010-2020
| Number at Risk | 0 Months | 12 Months | 24 Months | 36 Months | 48 Months | 60 Months |
|---|---|---|---|---|---|---|
| Bone invasion | 34 | 30 | 21 | 17 | 12 | 5 |
| Nodal | 64 | 40 | 26 | 19 | 14 | 11 |
| S-ITM | 70 | 38 | 27 | 15 | 8 | 8 |
| T3 | 319 | 240 | 182 | 122 | 95 | 70 |
| M1 | 18 | 3 | 2 | 0 | 0 | 0 |
M1,metastasis stage I; S-ITM, satellitosis or in-transit metastasis; T3, tumor stage III.
Cancer staging per the American Joint Committee on Cancer’s AJCC Cancer Staging Manual, 8th edition.
This multi-institutional cohort study found that patients with CSCC and S-ITM appear to have clinical outcomes comparable to those of patients who are node-positive, and an increased risk of recurrence and worse survival compared with patients who have T3 and T4 disease. These outcomes are similar to those observed for Merkel cell carcinoma and melanoma. Given that S-ITM may be a powerful prognostic factor, it should be incorporated into clinical staging systems.
