Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Aggressive behaviour of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia (#705)

Jonathan M Tomaszewski 1 , Haim Gavriel 2 3 , Emma Link 1 , Sholeh Boodhun 4 , Andrew Sizeland 1 , June Corry 1 5
  1. Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
  2. Assaf Harofeh Medical Center, Tel Aviv, Israel
  3. Tel Aviv University, Tel Aviv, Israel
  4. Alfred Hospital, Melbourne, Australia
  5. University of Melbourne, Melbourne, Australia

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.