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Stage IV cutaneous squamous cell carcinoma: treatment outcomes in a series of 42 patients
Author(s) -
Chapalain M.,
Baroudjian B.,
Dupont A.,
Lhote R.,
Lambert J.,
Bagot M.,
Lebbe C.,
BassetSeguin N.
Publication year - 2020
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.16007
Subject(s) - medicine , stage (stratigraphy) , incidence (geometry) , cetuximab , oncology , population , chemotherapy , adverse effect , radiation therapy , retrospective cohort study , gastroenterology , cancer , paleontology , physics , colorectal cancer , environmental health , optics , biology
Abstract Background The prevalence and incidence of cutaneous squamous cell carcinoma ( cSCC ) are increasing due to the ageing of the population and sun exposure. Advanced cSCC forms (locally advanced and/or locoregional metastatic and/or distant metastatic) account for approximately 3% of cSCC and can result in death. Objective Analysis of the clinical characteristics and treatment outcomes in stage IV cSCC with unresectable locoregional extension and/or the presence of metastases. Methods A retrospective study was conducted at a single‐centre university hospital for stage IV cSCC patients followed between 1 January 2008 and 31 December 2015. Descriptive analyses (demographic, anatomo‐clinical characteristics, treatment sequences, response to treatment and survival analysis) were performed. Results The study included 42 patients (median age = 75.5 years) with a diagnosis of stage IV cSCC who were treated with at least one line of chemotherapy and/or cetuximab. At the time of diagnosis, 85.7% of the patients had locoregional extension (19% of locally advanced and 67% of locoregional metastatic) and 14.3% had distant metastatic disease. Regarding treatment, 40% and 36% of patients received no more than 1 and 2 systemic treatment lines, respectively. The 4‐year overall survival was 6%, and the median follow‐up was 18.6 months. The objective response rate was 55% after the first line of treatment with a median progression‐free survival ( PFS ) of 6.18 months and 12% after the second line with a median PFS of 6.51 months. Grade 3 and 4 adverse events were observed for 33% of patients. Conclusion Our study confirms a very poor prognosis of stage IV cSCC and a poor response to conventional therapies, indicating that the stage IV cSCC patient population remains with unmet medical needs.