Risk factors related to locoregional recurrence in squamous cell carcinoma of the skin.

Abstract

A retrospective analysis was performed to identify the risk factors associated with development of locoregional recurrent disease in patients with primary squamous cell carcinoma of the skin. Step-wise logistic regression analysis was used in this study, which consisted of 1,039 patients treated from January 1980 to December 1989 at Ankara Oncology Hospital. Locoregional recurrence occurred in 187 (18%) of these patients within a mean disease-free period of 15 months. Age, sex, anatomical location, size of lesion, lymph node, status at diagnosis, stage according to TNM classification, histopathologic grade, previous therapy, treatment modality, lesions arising from scar tissue (scar carcinoma), regional lymph node dissection, concomitant premalignant tumor of the skin, development secondary nonmelanotic skin carcinoma, and second malignancy were used as variables that could be correlated with locoregional recurrent disease. No correlation was found between development of recurrence and previous therapy, second nonmelanoma skin cancer, second malignancy, premalignant skin tumor, sex, or regional lymph node dissection. Although univariate analysis demonstrated that location, tumor size, patient's age, lymph node status, stage, histopathologic grade, scar carcinoma, and treatment modality were associated with an increased risk of locoregional recurrence, it was found that stage of the disease (P < 0.001), treatment modality (P < 0.01), tumor arising from scar tissue (P < 0.01), and histopathologic grade (P < 0.05) were statistically significant as risk factors of recurrence when a multivariate analysis was applied.