Aggressive behaviour of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia (#705)
Aim: To describe the clinico-pathological features and prognosis of cutaneous squamous cell carcinoma (SCC) in patients with chronic lymphocytic leukemia (CLL)
Methods: Consecutive patients with CLL who were treated with curative intent for cutaneous SCC between July 2000 and July 2010 were identified through the institutional database. Chart review and telephone follow-up was undertaken to obtain clinical features and outcomes.
Results: Thirty-three patients (32 male, 1 female; median age 74) were identified. Primary tumour stage (AJCC 7th edition) at presentation was T1 27%, T2 52%, T3 0%, T4 3%, TX 15% and T0 3%. Six patients (18%) presented with nodal involvement, and two patients (6%) had in-transit metastases. The majority of patients were treated with surgery (91%), and 27% received adjuvant radiotherapy (median 50.4Gy). Three node-negative patients (9%) were treated with definitive radiotherapy. Surviving patients were followed for a median of 5.6 years following the completion of treatment. Three-year overall survival and recurrence-free survival was 41% (95% CI: 27-63%) and 25% (CI: 14-47%), respectively. Local recurrence occurred in 10 patients (30%), and regional recurrence in 16 patients (48%). Six patients (18%) developed distant metastatic disease. The three-year overall survival in the subgroup of patients with nodal metastases treated with curative intent (n=14) was 12% (95% CI: 2-69%).
Conclusion: Cutaneous SCC demonstrates aggressive behaviour in patients with underlying CLL. Outcomes with current standard treatment regimens are poor, highlighting the need for studies utilising novel management strategies.