Prognostic determinants of early and late relapse in cutaneous squamous cell carcinoma: A multicenter retrospective cohort study.

Abstract

Cutaneous squamous cell carcinoma exhibits a significant disease burden due to local relapses and metastasis. Despite advances in prognosis, little evidence exists on prognostic factors of early and late relapse, which could provide more personalized management and follow-up schedules. We conducted a multicenter retrospective cohort study including 23,166 cases of cutaneous squamous cell carcinoma. Patients were categorized into those with early recurrence (≤4 months), late recurrence (>24 months), and no recurrence. Risk factors and tumor characteristics were analyzed to identify patterns associated with early and late relapses. Some risk factors show a different impact depending on the type of recurrence and its timing. Lymphovascular invasion (subdistribution hazard ratios [SHR] = 3.01) and large caliber and deep perineural invasion (SHR = 2.55) show a statistically significant association with early locorregional metastasis, losing impact with time. Poor differentiation shows impact early (SHR = 3.26) and late (SHR = 4.63), with less relevance from 4 to 24 months (SHR = 1.68). Other features keep a similar impact along the whole period. Retrospective cohort study. Lymphovascular invasion and large caliber and deep perineural invasion are risk factors associated with early locorregional metastasis and should encourage nodal staging at diagnosis. Poor differentiation keeps importance beyond 24 months, and longer follow-up might be recommended in patients with this feature.