Oncologic outcomes for invasive squamous cell carcinoma with a clinically resolved biopsy site managed by watchful waiting: A retrospective cohort study.

Abstract

Treatment of cutaneous squamous cell carcinoma (cSCC) largely involves surgical excision. Few studies have examined oncologic outcomes of tumors managed by watchful waiting (WW) when the lesion appears resolved after the biopsy site has healed. To describe oncologic outcomes for patients diagnosed with cSCC that was determined clinically resolved at follow-up and subsequently managed by WW. This retrospective cohort included pathology proven cases of cSCC occurring from January 1st, 2013 to April 31st, 2023. Each required documented clinical resolution more than 4 weeks after biopsy, management by WW, and at least 12 months of follow-up. Of 148 tumors managed by WW, there were 2 cases of local recurrence, and no cases of nodal metastasis, distant metastasis, or disease specific death. Log-rank test found significant risk of recurrence in immunocompromised participants (Hazard ratio = 12.87, P = .0193) and those with rheumatologic disease (Hazard ratio = 16.18, P = .0075). Retrospective, single-center design. The recurrence rate in this cohort compares favorably to reported recurrence rates for surgically managed cSCC. In select cases, WW may be a reasonable management option for low-risk lesions that appear clinically resolved after healing of the biopsy site.