Purpose: Non-melanoma skin cancer (NMSC) are the most common cancers in Australia and worldwide, occurring predominantly on sun exposed areas of the head and neck. Squamous cell carcinoma (SCC) is second most common NMSC after basal cell carcinoma, however SCC behaves more aggressively, and is more likely to metastasise to locoregional lymph nodes or distant sites (1). Surgical excision remains the mainstay of treatment, however the challenges of maintaining function and cosmesis without tissue surplus are particularly vital in the head and neck. Our aim is to reduce the rates of incomplete excision by analysing the associated risk factors.
Methodology: A review was undertaken of patients undergoing surgical excision of a cutaneous head and neck SCC between 2015-2020 at the Plastic and Reconstructive Surgery Unit of the Royal Hobart Hospital, Tasmania, Australia. This study was approved by the Human Research Ethics Committee of Tasmania (H0018554)
Results: 435 cutaneous SCC were excised during the study period. 221 (51%) were moderately differentiated, 118 (27%) well differentiated and 96 (22%) poorly differentiated. When compared with well differentiated SCC, moderately differentiated (OR: 3.26 p 0.01) and poorly differentiated (OR: 5.47, p 0.001) were more likely to be excised incompletely.
Conclusion: Our study has demonstrated that cutaneous SCC, arising on the head and neck, with moderate or poor histological differentiation are more likely to be incompletely excised than well differentiated.