Rates Of Squamous Cell Carcinoma Research Articles

Epidemiology of Cervical Adenocarcinoma and Squamous Cell Carcinoma Among Women Living With Human Immunodeficiency Virus Compared With the General Population in the United States.

Although cervical cancer risk overall is elevated among women living with human immunodeficiency virus (HIV; WLH), it is unclear whether risks are similarly elevated across histologic subtypes. Data from the HIV/AIDS Cancer Match Study, a linkage of 12 US HIV and cancer registries during 1996 -2016, were used. Cervical cancers were categorized as adenocarcinoma (AC), squamous cell carcinoma (SCC), or other histologic subtype. Standardized incidence ratios compared rates of AC and SCC in WLH to those in general population. For WLH, risk factors for AC and SCC were evaluated using Poisson regression. Five-year survival was estimated by HIV status and histology. Overall, 62 615 cervical cancers were identified, including 609 in WLH. Compared with the general population, incidence of AC was 1.47 times higher (95% confidence interval [CI]: 1.03-2.05) and SCC was 3.62 times higher among WLH (95% CI: 3.31-3.94). Among WLH, there was no difference in AC rates by race/ethnicity or HIV transmission group, although SCC rates were lower among White women (vs Black) and higher among women who inject drugs (vs heterosexual transmission). Among WLH, 5-year overall survival was similar for AC (46.2%) and SCC (43.8%) but notably lower than for women not living with HIV. Among WLH, AC rates were modestly elevated, whereas SCC rates were greatly elevated compared with the general population. These findings suggest there may be differences in the impact of immunosuppression and HIV in the development of AC versus SCC, given their common etiology in human papillomavirus infection.

Anal cancer screening and prevention: a review for dermatologists.

The incidence of and mortality from anal cancer, predominantly squamous cell carcinoma (SCC), have been increasing since the 1980s, during an era when many common malignancies have seen decreases in mortality. Dermatologists may be more likely to see patients at an increased risk for anal SCC, such as those living with HIV, MSM and those presenting for management of anogenital warts, yet there is little guidance in the field on how to manage these patients. We underwent a project to review the evidence surrounding screening and prevention of anal SCC. HPV vaccination, the main preventative measure for anal SCC, is often underutilized and may not be effective for those most at risk. Screening methods currently include high-risk HPV and anal cytology testing, with high-resolution anoscopy (HRA) reserved for biopsy and confirmatory testing. High-risk HPV testing has been associated with high sensitivity for intraepithelial neoplasia, but low specificity in high-risk groups. Recent meta-analyses examining AIN detection using anal cytology estimate a similarly high sensitivity of 74-87%, with a relatively higher specificity (44-66%) for identifying high-grade AIN. HRA is the gold standard for diagnosis, but its accessibility and cost are deterrents from its use as a screening tool. Cervical cancer screening, initially adopted without significant evidence of its impact, has significantly decreased cervical cancer rates. The argument can be made that rates of anal SCC may also benefit from appropriate screening methods, particularly anal cytology. It is prudent for dermatologists to be aware of the methods available to them in the management of at-risk patients, the data supporting them, and the potential benefits of screening in order to counsel patients appropriately and address the increasing burden of disease.

High-risk human papilloma virus, precancerous lesions and cancer in anal condylomas.

Anal condylomas are associated with human papillomavirus (HPV) infection and are a risk factor for anal squamous cell carcinoma (SCC). To conduct a meta-analysis evaluating the prevalence of anal high-risk HPV, high-grade squamous intraepithelial lesions (HSIL) and SCC in patients with condylomas. The standardized incidence ratio (SIR) and the incidence rate of anal SCC were also calculated. Three electronic databases were searched until April 2020. Meta-analyses were performed using random effects models. Pooled prevalence estimate of high-risk HPV (HR-HPV) in anal condylomas was 40.2% (21.0-63.1) in immunocompromised and 16.4% (10.7-24.3) in nonimmunocompromised patients, with an odds ratio (OR) of 3.79 (1.51-9.52, P = 0.005) for immunocompromised patients. HR-HPV in condylomas with HSIL was 73.8% (39.1-92.5) and in non-HSIL cases was 17.7% (9.6-30.2), corresponding to an OR of 12.33 (2.97-51.21, P = 0.001) for those with HSIL. The prevalence of HSIL in condylomas was 24.0% (16.4-33.7) in immunocompromised and 11.8% (7.2-18.8) in nonimmunocompromised patients, with an OR of 2.51 (1.72-3.65, P < 0.001) for immunocompromised patients. The overall prevalence of anal SCC in anal condylomas was 0.3% (0.0-1.7). The SIR of anal SCC was 10.7 (8.5-13.5), 20.1 (14.4-28.2) in men and 7.7 (5.6-10.5) in women. The overall incidence rate of anal SCC was 6.5 per 100 000 person-years (3.6-11.7), 12.7 (9.1-17.8) in men and 4.7 (1.7-13) in women. Patients with a history of anal condylomas have a high risk of anal SCC, especially men. The prevalence of HR-HPV and HSIL in condylomas from immunocompromised patients is high. This information can change patient follow-up and treatment.

Incidence of HPV-related Anogenital Intraepithelial Neoplasia and Cancer in Men With Diabetes Compared With the General Population.

Diabetes may increase risk of human papillomavirus (HPV)-related precancer and cancer. We estimated incidence of penile and anal high-grade intraepithelial neoplasia (hgPeIN, hgAIN) and squamous cell carcinoma (SCC) in men with diabetes compared with the entire Danish male population without diabetes. In this registry-based cohort study, we included all men born 1916-2001 and residing in Denmark (n = 2,528,756). From nationwide registries, we retrieved individual-level information on diabetes, educational level, and diagnoses of hgPeIN, hgAIN, penile SCC, and anal SCC. We used Poisson regression models to estimate incidence of hgPeIN, hgAIN, penile SCC, and anal SCC as a function of diabetes status, attained age, calendar period, and education. We estimated incidence rate ratios (IRRs) of each outcome in men with diabetes compared with nondiabetic men, both for diabetes overall and separately for type 1 (T1D) and type 2 diabetes (T2D). Men with diabetes had increased incidence rate of penile SCC compared with nondiabetic men (IRR = 1.5, 95% CI = 1.2, 1.9). We saw similar trends for anal SCC, hgPeIN, and hgAIN. The combined incidence rate of penile and anal SCC was increased in men with T2D (IRR = 1.5, 95% CI = 1.3, 1.8), but not with T1D (IRR = 0.53, 95% CI = 0.20, 1.4) compared with men without diabetes. The incidence of penile and anal high-grade intraepithelial neoplasia and SCC in men with diabetes was increased compared with men without diabetes. For penile and anal SCCs, this was primarily due to an increased risk in men with T2D.

Radiooncological View on Therapy Outcome after Multidisciplinary Treatment of Sinonasal Tumors.

We report the outcome of a mono-institutional retrospective study of sinonasal carcinoma with the primary focus on GTV (gross tumor volume) and the effect of radiotherapy. 53 patients with sinonasal carcinoma and that of the nasal cavity, paranasal sinus or both except lymphoma were included. All patients were treated between 1999 and 2017. For tumor volume delineation, all pre-therapeutic images were fused to the planning CT (computed tomography). The median follow-up was 17 months [0.3-60], the median age 60 years, 35 males and 18 females were included. Squamous cell carcinoma (SCC) (60.4%) was the predominant histology, followed by adenocarcinoma (15.1%). The mean composite OS (overall survival) time was 33.3 ± 3.5 months. There was no significant difference in the 5 y composite OS between tumor localization or radiotherapy setting. The simultaneous integrated boost concept showed a trend towards improving five-year composite OS compared to the sequential boost concept. The only factor with a significant impact on the 5 y composite OS rate was the pre-therapeutic GTV (cutoff 75 cm3; p = 0.033). The GTV ≥ 100 cm3 has no effect on the 5 y composite OS rate for SCC. The pre-therapeutic GTV is a prognostic factor for five-year composite OS for the entire group of patients with sinonasal tumors, influencing the outcome after completion of all treatment strategies. The GTV seems to not influence five-year composite OS in SCC. For this rare tumor entity, an intensive, multidisciplinary discussion is essential to finding the best treatment option for the patient.

Clinical Management of Early-Stage Hypopharyngeal Squamous Cell Carcinoma: A Single-Institution Clinical Analysis.

Early detection of hypopharyngeal squamous cell carcinoma (SCC) is important for both an improved prognosis and less-invasive treatment. We retrospectively analyzed the detection rates of early hypopharyngeal SCCs according to the evaluation methods and the clinical management of early hypopharyngeal SCCs. Sixty-eight patients with early hypopharyngeal SCC who were diagnosed were reviewed. The number of early hypopharyngeal cancer patients with asymptomatic or synchronous or metachronous esophageal cancer examined by upper gastrointestinal endoscopy with narrow-band imaging (NBI) was significantly higher than those examined by laryngopharyngeal endoscopy with NBI. The 3-year disease-specific survival rates according to T classification were as follows: Tis, 100%; T1, 100%; T2, 79.8%; and overall, 91.2%, respectively. Early-stage hypopharyngeal SCC can be cured by minimally invasive transoral surgery or radiotherapy. Observation of the pharynx using NBI in patients with a history of head and neck cancer, esophageal cancer, gastric cancer, or pharyngeal discomfort is very important, and routinely examining the pharynx with NBI, even in patients undergoing endoscopy for screening purposes, is recommended.

Skin shop: long-term management and follow-up of narrowly and incompletely excised non-melanomatous skin cancer.

'Skin Shop' is a model of care at a high-volume tertiary centre that describes a registrar-lead skin cancer service under consultant supervision. Ninety-two percent of lesions are completely excised, 4.2% are narrowly excised and 3.2% are incompletely excised. Current international guidelines suggest re-excision of incompletely excised non-melanomatous skin cancer (NMSC); however, there is a lack of robust evidence to suggest how these lesions should be optimally managed. We describe how narrow and incompletely excised NMSC are managed in the 'Skin Shop' and present rates of recurrence. Retrospective analysis of all lesions excised between December 2014 and June 2019. Lesion type, histological margin, presence of high-risk features, management, presence of residual tumour in re-excision and follow-up duration were recorded. Rates of clinical recurrence were documented. From 5821 lesions excised, a total of 394 NMSC (245 basal cell carcinoma (BCC), 128 squamous cell carcinoma (SCC) and 21 Basosquamous cell carcinoma) were narrowly or incompletely excised. A total of 135 (34.3%) lesions were observed in clinic for recurrence, 133 (33.8%) lesions underwent re-excision, 81 (20.6%) lesions underwent GP surveillance and 14 (3.6%) lesions received radiotherapy. Mean specialist clinic follow-up was 12.4 months. Fourteen lesions recurred (3.5%, 10 BCC, 3 SCC, 1 basosquamous) of which 12 underwent re-excision. The risk of recurrence for narrow and incompletely excised BCC was 2.9% and 10%, respectively. The corresponding rates for SCC were 2.2% and 3.3%, respectively. Skin Shop is an effective model with low rates of narrow and incompletely excised NMSC. Risk of recurrence of these lesions is low with our current practice.

Assessing Impact of HPV Vaccination on Cervical Cancer Incidence among Women Aged 15-29 Years in the United States, 1999-2017: An Ecologic Study.

To date, the impact of the human papillomavirus (HPV) vaccine on invasive cervical cancers in the United States has not been documented due, in part, to the time needed for cancer to develop and to recent changes to cervical cancer screening guidelines and recommendations, which complicate data interpretation. We examined incidence rates of cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) among women aged 15-29 years diagnosed during 1999-2017 using population-based cancer registry data covering 97.8% of the U.S. Trends were stratified by age and histology. The annual percent change in cervical cancer incidence per year was calculated using joinpoint regression. During 1999-2017, SCC rates decreased 12.7% per year among women aged 15-20 years, 5.5% among women aged 21-24 years, and 2.3% among women aged 25-29 years. The declines in SCC rates were largest among women aged 15-20 years during 2010-2017, with a decrease of 22.5% per year. Overall, AC rates decreased 4.1% per year among women aged 15-20 years, 3.6% per year among women aged 21-24 years, and 1.6% per year among women aged 25-29 years. AC rates declined the most among women aged 15-20 years during 2006-2017, decreasing 9.4% per year. Since HPV vaccine introduction, both SCC and AC incidence rates declined among women aged 15-20 years, a group not typically screened for cervical cancer, which may suggest HPV vaccine impact. Timely vaccination and improved screening and follow-up among recommended age groups could result in further reductions in invasive cervical cancer.

Intralesional 5-Fluorouracil for Treatment of Non-Melanoma Skin Cancer: A Systematic Review

Surgical excision is the paradigm treatment option for non-melanoma skin cancer (NMSC), however intralesional fluorouracil (IL 5-FU) is an efficacious alternative and superior to other chemotherapy agents in NMSC. Yet, little summative data exists on the topic. To assess the efficacy of IL 5-FU in the treatment of NMSC. A systematic review was performed using PubMed, Embase and Web of Science databases. 19 studies were included. ANOVA test was used to compare the duration of lesion prior to therapy and resolution time following IL 5-FU treatment. A two-way proportion test was performed to compare the clearance rate between squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and keratoacanthoma (KA). There was no significant difference between the clearance rate of SCC and BCC after IL 5-FU therapy (87 % vs 91.4%, respectively; P=0.2); however, the clearance rate of both SCC and BCC was significantly greater than that of KA (74.5%; P&lt;0.007); 95% CI [2.56%&ndash;19.1%]. Lesion duration and resolution time did not significantly differ across SCC, BCC, and KA (P&gt;0.3). While majority of data is derived from individual cases, IL 5-FU achieved higher clearance rate in SCC and BCC groups than in KA group. J Drugs Dermatol. 2021;20(2):192-198. doi:10.36849/JDD.5518.

The environmental pollutant and tobacco smoke constituent dibenzo[def,p]chrysene is a co-factor for malignant progression of mouse oral papillomavirus infections

HPV infections in the oral cavity that progress to cancer are on the increase in the USA. Model systems to study co-factors for progression of these infections are lacking as HPVs are species-restricted and cannot grow in preclinical animal models. We have recently developed a mouse papillomavirus (MmuPV1) oral mucosal infection model that provides opportunities to test, for the first time, the hypothesis that tobacco carcinogens are co-factors that can impact the progression of oral papillomas to squamous cell carcinoma (SCC). Four cohorts of mice per sex were included: (1) infected with MmuPV1 and treated orally with DMSO-saline; (2) infected with MmuPV1 and treated orally with the tobacco carcinogen, dibenzo[def,p]chrysene (DBP); (3) uninfected and treated orally with DMSO-saline, and (4) uninfected and treated orally with DBP. Oral swabs were collected monthly for subsequent assessment of viral load. Oral tissues were collected for in situ viral DNA/RNA detection, viral protein staining, and pathological assessment for hyperplasia, papillomas and SCC at study termination. We observed increased rates of SCC in oral tissue infected with MmuPV1 and treated with DBP when compared to mice treated with DBP or virus individually, each of which showed minimal disease. Virally-infected epithelium showed strong levels of viral DNA/RNA and viral protein E4/L1 staining. In contrast, areas of SCC showed reduced viral DNA staining indicative of lower viral copy per nucleus but strong RNA signals. Several host markers (p120 ctn, p53, S100A9) were also examined in the mouse oral tissues; of particular significance, p120 ctn discriminated normal un-infected epithelium from SCC or papilloma epithelium. In summary, we have confirmed that our infection model is an excellent platform to assess the impact of co-factors including tobacco carcinogens for oral PV cancerous progression. Our findings can assist in the design of novel prevention/treatment strategies for HPV positive vs. HPV negative disease.

S1417 Painless Jaundice: A Case of Primary Pure Squamous Cell Carcinoma of the Gallbladder

INTRODUCTION: Gallbladder cancer is the most common malignant tumor of the biliary tract with the majority of cases are adenocarcinoma (AC). Pure squamous cell carcinoma (SCC) of the gallbladder (GB) is extremely rare and accounts for only around 0.5 - 3% of all GB cancers. The initial presentation of these cases varies significantly due to its rarity. We, therefore, present a case of painless jaundice due to SCC of the gallbladder. CASE DESCRIPTION/METHODS: The patient is a 78-year-old man who presented with a 3-day history of painless jaundice. Accompanied by dark urine and clay-colored stools. He denied notable weight loss, night sweats, nausea, or vomiting. Hepatic function panel was significant for ALT 686, AST 483, Alkaline Phosphatase 1183, total bilirubin 25.6, and direct bilirubin 20.6. MRCP revealed intrahepatic biliary dilatation, a 7 mm cystic structure at the level of the head of the pancreas, and diffuse gallbladder thickening. ERCP was attempted, however, aborted due to distorted anatomy secondary to distorted anatomy. Endoscopic ultrasound demonstrated an irregular hypoechoic mass of 45 mm × 40 mm at the level of the gallbladder. Fine needle aspiration was consistent with squamous cell carcinoma. On further evaluation by multidisciplinary committee, it demonstrated invasion into the duodenum therefore surgical resection was not feasible decided to proceed with palliative radiation. DISCUSSION: Most of the published literature on pure SCC of the gallbladder is based on case reports and case series. SCC of the GB is thought to be due to keratinization of the columnar lining of the GB due to chronic repeated irritants, like cholelithiasis. Therefore, populations more prone to developing stones are thought to be higher in incidence, with a known female predominance. We described the rare presentation of painless jaundice in an elderly male with locally invasive SCC of the GB. The survival rates of SCC of the GB are significantly lower (mean: 5 months) compared to AC of the GB (mean survival: 11.4 months). As most of these lesions are advanced at presentation, rendering them unresectable (70–90%), resulting in poor prognoses. A standard regimen of chemotherapy for squamous-cell gallbladder cancer does not exist and, the only definite curative measure is resection. Therefore, while encountering painless jaundice it is important to consider carcinomas of the GB, as earlier detection of these cancers can open greater opportunities for curative resection.Figure 1.: Irregular malignant cells with hyperchromatic nuclei and glassy keratinizing cytoplasm positive for p63 consistent with Squamous cell carcinoma.Figure 2.: Irregular malignant cells with hyperchromatic nuclei and glassy keratinizing cytoplasm positive for p63 consistent with Squamous cell carcinoma.Figure 3.: Endoscopic Ultrasound: 45 mm × 40 mm irregular mass with poorly defined borders at the level of the gallbladder.

Low recurrence rates for challenging squamous cell carcinomas using Mohs micrographic surgery with AE1/AE3 cytokeratin immunostaining

To the Editor: Local recurrence rates of high-risk cutaneous squamous cell carcinoma (SCC) are lower after Mohs micrographic surgery compared with conventional excision.1 Although local recurrence rates of primary cutaneous SCC after Mohs micrographic surgery are low,1,2 local recurrence can reach 15% or higher for tumors with high-risk factors.3 Adjuvant AE1/AE3 cytokeratin immunohistochemical stains ease visualization of SCC in challenging cases by helping to identify single-cell spread, neoplastic cells masked by inflammation, and perineural invasion.

LncRNA-MALAT1 is a promising biomarker for prognostic evaluation of tongue squamous cell carcinoma.

MALAT1 is recognized as an oncogenic lncRNA in various malignancies. Here, the authors aim to explore the association of MALAT1 expression and prognostic implication in tongue squamous cell carcinoma (SCC). The tongue tissues of 128 tongue SCC cases satisfying strict follow-up criteria and 28 normal cases were subjected to qRT-PCR assay for monitoring MALAT1 expression. Chi-square test was applied to explore the correlation between MALAT1 expression and clinicopathological features of tongue SCC. Kaplan-Meier analysis was used to calculate survival rates. Cox proportional hazard analysis was adopted to analyze the relationship between prognostic factors and patient survival. The expression of MALAT1 was upregulated in tongue SCC, compared to normal tongue tissues. The expression level of MALAT1 was correlated to differentiation and stage of tongue SCC, and high MALAT1 expression was associated with low disease-free survival and overall survival rates. Moreover, advanced tongue SCC patients with high MALAT1 level had lower disease-free survival and decreased overall survival rate than patients with low MALAT1 level. These results revealed that MALAT1 overexpression can be considered as a significant prognostic factor to independently predict the disease-free survival and overall survival rate of tongue SCC. The expression level of MALAT1 is closely related with progression of tongue SCC. Furthermore, MALAT1 can serve as an independent biomarker for prognostic evaluation of tongue SCC.

Skin cancer multiplicity in lung transplant recipients: a prospective population-based study.

Lung transplant recipients are at high risk of skin cancer, but precise annual incidence rates of treated skin cancers per patient are unknown. To perform a prospective assessment of the total burden of histologically confirmed squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) and associated factors in lung transplant recipients. A population-based cohort of 125 Queensland lung transplant recipients aged 18 years and over, recruited between 2013 and 2015, were followed to the end of 2016. All underwent dermatological skin examinations at baseline and annually thereafter and patients self-reported all interim treated skin cancers, which were verified against pathology databases. Standard skin cancer risk factors were obtained via questionnaire, and details of medications were acquired from hospital records. During a median follow-up time of 1·7 years, 29 (23%) and 30 (24%) lung transplant recipients with a median duration of immunosuppression of 3·3 years developed SCC and BCC, respectively. The general population age-standardized incidence rates of SCC and BCC were 201 and 171 per 1000 person-years, respectively (based on first primary SCC or BCC during follow-up); however, on accounting for multiple primary tumours, corresponding incidence rates were 447 and 281 per 1000 person-years. Risk of multiple SCCs increased around sixfold in those aged ≥ 60 years and in those with previous skin cancer, and increased around threefold in those treated with the antifungal medication voriconazole. Multiple BCC risk rose threefold from age 60 years and tenfold for patients with previous skin cancer. Lung transplant recipients have very high incidence of multiple primary skin cancers. Close surveillance and assiduous prevention measures are essential. Linked Comment:Proby and Harwood. Br J Dermatol 2020; 183:416-417.

Hematoporphyrin monomethyl ether-mediated sonodynamic therapy induces A-253 cell apoptosis.

It has been found that >90% of oral cancer patients suffer from squamous cell carcinoma (SCC). The 5-year survival rate of SCC is ~50%, despite the availability of different treatments. Sonodynamic therapy (SDT) has been developed as a novel therapy for cancer, resisting bacterial infection and inhibiting atherosclerotic plaque progression. The present study investigated the efficacy of hematoporphyrin monomethyl ether (HMME)-mediated SDT on the A-253 epidermoid cancer cell line. The cytotoxicity of HMME and the survival rate of cells following SDT were examined by the MTT assay. Apoptosis and necrosis of cells were detected using flow cytometry with Annexin V and propidium iodide (PI) staining, and fluorescence microscopy with Hoechst 33258 and PI staining. Intracellular reactive oxygen species (ROS) and Ca2+ levels were measured using a fluorescence microscope based on 2′,7′-dichlorofluorescein diacetate and fluo-3/acetoxymethylester, respectively. Results of the MTT assay demonstrated that a lower concentration (<10 µg/ml) of HMME had no significant effect on the A-253 cells, but SDT combined with ultrasonic treatment for 1 min and 10 µg/ml HMME decreased the cell survival rate by 27%. Flow cytometry analysis revealed that A-253 cells in the SDT group had a higher rate of late apoptosis compared with the control group. Furthermore, fluorescence quantitation of apoptotic A-253 cells demonstrated that the percentages of apoptotic cells were increased in the ultrasound and SDT group compared with those in the control group. In the present study, the ROS level in the SDT group was elevated compared with that in the control group. The Ca2+ levels were increased to 181.2 and 268.7% in the ultrasound and SDT groups, respectively, relative to the control group. Taken together, the findings of the present study demonstrated that HMME-SDT significantly induces the apoptosis of A-253 cells together with intracellular ROS generation and Ca2+ overload. Thus, HMME-SDT may be a promising treatment option for patients with SCC.

Trends in lung cancer incidence within the last 10 years: An Eastern Anatolian single center experience

Aim: Lung cancer is the most common cause of cancer-related deaths among men and women, and mortality and morbidity rates vary according to different histological groups. Therefore, histological type determination is extremely important. The purpose of the study is to investigate the histological subtypes of lung cancer cases within the last 10 years in one of the biggest centers of the Eastern Anatolian Region, considering the changes made in the 2015 updates in lung tumors by World Health Organization (WHO), and investigate the relationship between these histological sub-types and distribution according to year, gender and age. Methods: In this cross-sectional study, patients who were referred for lung biopsy between January 2010 and December 2019 and diagnosed with lung carcinoma were retrospectively analyzed. Results: Our study shows that the frequency of lung cancer, along with histological subtypes, has increased throughout the years. The most common lung cancer type, regardless of gender, is Squamous Cell Carcinoma (SCC), followed by Small Cell Lung Carcinoma (SCLC) and Adenocarcinoma. Adenocarcinoma and SHC were the most common subtypes among females and males, respectively. A significant relationship was observed between gender and histological type (P&lt;0.001).Conclusion: The data from our study suggest that the incidence of lung cancer increased throughout the years, similar to the data from our country and other developing countries around the world. In terms of subtypes, among developing countries, Adenocarcinoma rate increased while SCC rate decreased. In our study, the most common histological types increased at a similar rate. Adenocarcinoma was the most common lung cancer among females, similar to other developing countries. The most common lung cancer overall remained the same: SCC. This was considered an indication of the unchanged smoking habits of males.

Keratinocyte carcinoma in organ transplant recipients

Skin cancer commonly affects people who have received a solid organ transplant (heart, lung, liver and kidney). Transplant patients can get multiple skin cancers, some of which can grow very quickly. The commonest types of skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Immunosuppressant medication is used to prevent rejection of the transplanted organ. This alters the body's immune system, which in turn means that transplant patients are more prone to skin cancers that can grow rapidly. Over the last 20 years, newer immunosuppressants have been introduced which are thought to lessen the risk of skin cancer. Previous studies have shown a lower risk of SCC with the newer medication, but no study to date has looked at BCC rates. This study, from Ireland, aimed to find out if the rate of skin cancer in transplant patients has reduced over the last 20 years, spanning the introduction of newer immunosuppressive medications. The National Cancer Registry of Ireland registers all skin cancers for the Republic of Ireland. The authors looked at the rate of skin cancer in people who received a solid organ transplant and compared this to the rate of skin cancer in the general population. They found that the rate of SCC and BCC in patients who received an organ transplant has significantly reduced over the last two decades. This change in risk of skin cancer coincided with changes in immunosuppressant medication, along with focused education and regular skin cancer screening for transplant recipients.

2117 Anal Squamous Cell Carcinoma Presenting as a Rectal Mass

INTRODUCTION: Anal squamous cell carcinoma (SCC)typically presents as an anal mass. It rarely presentsin the rectumalone. Limited literature exists to discuss regarding optimal management for this unique presentation. We present a patient withanal SCC manifesting as a rectal mass and reviewher management. CASE DESCRIPTION/METHODS: A 73 year-old woman with esophageal reflux presented to our office with chronicrectal bleedingand constipation.She denied anal pain. Colonoscopy revealed a 1.2 cm massin the anterior rectum, 2 cm from the anal verge (Figure 1). Biopsies revealed focally invasive nonkeratinizing SCC (Figure 2). On rectal endoscopic ultrasound (EUS), the mass was confined to the anus andextended from the anorectal canal into the rectum (Figure 3). Submucosal invasion was noted, but not through the rectal muscularis propria. PET CT showed no perirectal invasion, lymphadenopathy, metastatic disease orother sources of primary SCC. Final staging was T2N0. She underwentchemoradiationwith5-fluorouricil and mitomycin. Surgery was deferred to preserve anal function.Her tumor showed a complete response after 6 weeks and she is currently being followed with routine surveillance. DISCUSSION: Anal SCC makes up2.6% of digestive system cancers in the United States, but its incidence is rising in men and women, possibly due to changes in sexual behavior and increasing rates of HPV exposure. Gastroenterologists should recognizeatypical presentations ofanal SCC, especially in high-risk populations: men who have sex with men, HIV positive patients, and women with high risk HPV. Rectal bleeding and altered bowel habits arethe most commonlyreported symptoms. Other symptoms include anal mass, pain, itching, and mucous discharge, but up to 20% of patients with anal cancer are asymptomatic. The absence of anal pain and external lesions as well as the rectal mass on in our patient suggested an alternative diagnosis. Given that management of rectal cancer has traditionally centered around resection, this emphasizes the utility of EUS to make the correct diagnosis and direct management. The management of this unique presentation of anal SCC has not been fully established, but our patient received standard chemoradiation with good results. Anal SCC has a range of presentations and can present as a rectal mass. Given that anal SCC rates are increasing, our case highlights the importance of disease screening, recognition, and prevention.

Recurrence rates of cutaneous SCC of the head and neck after surgery

Squamous cell carcinoma (SCC) is the second most common type of skin cancer in the UK, affecting 10,000 people in England and Wales alone. The risk factors include prolonged sun or tanning bed exposure, having fair skin, older age and having a family member who has had the condition. It is a slow growing cancer involving the outer layer of the skin but can spread to other areas of the body if untreated. SCCs are treated by removing them and this is usually through surgery, but in milder cases freezing and creams are sometimes used. This study was based in the Netherlands looking back at 579 patients with SCC, comparing the rates of cancer returning after undergoing two different forms of surgical treatment. 292 patients underwent standard excision, whereby the SCC and a small margin of skin was cut out and sent to the laboratory to confirm diagnosis and check that all of the cancer was removed. The other 380 patients underwent a newer, specialist procedure called Mohs micrographic surgery. This involves cutting the cancer out layer by layer, each time examining the sample under the microscope during the surgery to see how much cancer has been removed. While this is a much longer procedure, the aim is to preserve as much normal skin as possible, which is particularly important on the face for cosmetic reasons. The researchers followed up the group that underwent standard excision after 5‐7 years and found 8% of the SCCs had returned. In comparison, in the group who had Mohs surgery, only 3% of SCCs came back after 4‐9 years. In total, more SCCs came back in the group having standard excision. Adjusting for the size and depth of the cancer, it can be concluded that patients were three times less likely to have their SCC return if they had Mohs surgery in comparison to standard excision.

Differential Relapse Patterns for Non-small Cell Lung Cancer Subtypes Adenocarcinoma and Squamous Cell Carcinoma: Implications for Radiation Oncology

AimsCurative-intent (radical) radiotherapy aims to control local disease and cure non-small cell lung cancer (NSCLC). The predominant subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma (SCC). The radiotherapy paradigm offered to patients does not differ according to these two subtypes. Relapse patterns and disease control rates for adenocarcinoma and SCC treated with radical radiotherapy were determined. Materials and methodsA radical radiotherapy database covering the period from 2004 to June 2016 was examined to determine the first sites of relapse and the actuarial local and distant control rates. ResultsIn total, 537 patients with known pathological subtype were treated over the period. In 39 (7%), the site of first relapse was uncertain. Of the remainder, 203 (41%) had adenocarcinoma and 295 (59%) had SCC. At a median follow-up of 16.4 months, 58% had relapsed. There was a difference in relapse patterns (chi-squared test P < 0.0005), with a higher rate of first relapse locally in SCC (42% of all patients versus 24%) and a higher rate of first relapse in the brain for adenocarcinoma (14% versus 3%). The actuarial local control rate was worse for SCC (hazard ratio 0.6, 95% confidence interval 0.5–0.9, P = 0.002). The brain metastasis-free survival was worse for adenocarcinoma (hazard ratio 4.1, 95% confidence interval 2.2–7.5, P < 0.0001). ConclusionThere is a difference in relapse patterns between NSCLC histological subtypes, indicating that these are distinct entities. This may have implications for follow-up policy and strategies to improve disease control.