Low incidence of metastasis and recurrence from cutaneous squamous cell carcinoma found in a UK population: Do we need to adjust our thinking on this rare but potentially fatal event?

Background and Methods Cutaneous squamous cell carcinoma (cSCC) is the commonest skin cancer with metastatic potential, however, reported rates of metastasis varies greatly. All cases of primary cSCC on the Isle of Wight between 2005 and 2014 were identified and retrospectively followed for recurrence and/or metastasis. Primary outcome was to identify the rate of metastasis/recurrence from cSCC. Secondary outcomes included associated risk factors for metastasis/recurrence, death from cSCC, and time from diagnosis of primary cSCC to event. Results A total of 1122 patients with 1495 tumors were identified within the study period. A total of 18 metastasized and 40 recurred, an overall incidence of 1.2% and 2.7%, respectively. Eight patients died from their disease. Conclusions Risk of metastasis from cSCC in the UK general population is likely to be in the order of 1.2%. Where metastasis occurs this is often within 2 years. Recurrence rates are higher following curette and cautery. Discussion If treated adequately both recurrence and metastasis from cSCC is a rare event. Not all cSCC cases need follow‐up instead time should be spent educating patients around signs of recurrence/metastasis then discharged, relieving burden on secondary care. Multi‐disciplinary teaming meetings are expensive and should be limited to complex cases.