The following is a summary of “Rate and Characteristics of Incompletely Excised Cutaneous Squamous Cell Carcinoma: A Dermatological Daily Practice Multicenter Prospective Cohort Study” published in the December 2022 issue of Dermatologic Surgery by Lee et al.

Recurrence, metastasis, and mortality rates are higher for squamous cell carcinoma (cSCC) patients undergoing incomplete excision. Aiming to quantify the frequency and profile of cutaneous squamous cell carcinoma (cSCC) that is not entirely removed after routine dermatologic surgery.

Prospective study of all consenting patients diagnosed with cSCC and treated with standard excision (SE) in 1 of the 6 Dermatology Departments in the Netherlands between 2015 and 2017. All cSCCs that could not be removed from the body were found by examining pathology reports. There were a total of 592 patients with 679 cSCCs, the vast majority of which (89%) were classified as low risk. Of the 4% (n=26) of cSCCs that were not entirely removed, the vast majority were high-risk tumors that had penetrated the deep excision margin.

In this prospective analysis, researchers found that the incidence of an incompletely excised cSCC was low (4%), even among a group dominated by low-risk cSCCs treated in a dermatological context. Instead, incomplete excision was most commonly found at the deep margins of high-risk cSCCs. Based on these findings, microscopic surgery should be considered for high-risk cSCC, and extra attention should be paid to the deep margin during SE.