Acta Oncol Tur.. 2023; 56(1): 74-80 | DOI: 10.5505/aot.2023.61582

Cutaneous Squamous Cell Carcinoma: A Type Of Cancer That Discriminates Against Young Adults

Zeynep Gülsüm Güç¹, Hasan Güç^2
1Department of Medical Oncology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
²Department Of Plastic, Reconstructive And Aesthetic Surgery, Tepecik Training And Research Hospital, Izmir, Turkey

INTRODUCTION: Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers. Young adult cSCC is rare and its clinical features, outcomes, and iatrogenic risk factors are not well defined. This study aimed to specify the clinical characteristics, potential risk factors, and the factors affecting recurrence associated with cSCC in young adults.
METHODS: Forty-three patients aged <35 years at diagnosis, who allowed their data to be retrospectively analyzed, and whose full medical history and records were available were included in the study. Their demographic characteristics, date of diagnosis, localization of lesion, pathological and family histories were recorded.
RESULTS: Patients’ mean age at diagnosis was 29 (17-34) years. Twenty patients (46.5%) had familial history of malignancy; 19 (44.2%) had precancerous lesions before SCC diagnosis. Three (7%) had a history of organ or allogeneic bone marrow transplantation and long-term use of immunosuppressants, 3 (7%) had genetic predisposition to cutaneous cancers, and 3 (7%) had a history of RT-CT. Eighteen patients (41.9%) had relapses during the 58-month follow-up. Histopathologically, presence of moderately-poorly differentiated squamous cell carcinoma, prolonged use of immunosuppressants, and history of RT-CT were statistically significantly associated with relapse (p<0.05). Kaplan-Meier analysis done for factors affecting survival showed a relationship between survival and presence of genetic risk, poor differentiation, and recurrence (p<0.05).
DISCUSSION AND CONCLUSION: Recognizing the risk factors for cSCC in young adults (long-term immunosuppressants, chemoradiotherapy, genetic cutaneous cancer predisposition syndromes, presence of precursor lesions) bear great importance in providing appropriate guidance to ensure early diagnosis and effective treatment.

Keywords: cutaneous squamous cell carcinoma, chemotherapy, radiotherapy, immunosuppressants, genetics

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Kutanöz Skuamöz Hücreli Karsinom: Genç Yetiþkinlere Karþý Ayrýmcý Bir Kanser Türü

Zeynep Gülsüm Güç¹, Hasan Güç^2
1Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim Araþtýrma Hastanesi, Týbbi Onkoloji Kliniði, Ýzmir, Türkiye
²Tepecik Eðitim Araþtýrma Hastanesi, Plastik, Estetik Ve Rekonstruktif Cerrahi Bilim Dalý, Ýzmir, Türkiye

GÝRÝÞ ve AMAÇ: Kutanöz skuamöz hücreli karsinom(cSCC) en sýk görülen kanserlerden biriyken, genç eriþkin cSCC nadirdir ve klinik özellikleri, sonuçlarý ve iyatrojenik risk faktörleri iyi tanýmlanmamýþtýr. Bu çalýþmada genç eriþkinlerde cSCC ile iliþkili klinik özellikleri, potansiyel risk faktörlerini ve nüksü etkileyen faktörleri tanýmlamak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Taný yaþý <35 olan, tam týbbi öyküsüne ve kullandýðý ilaçlara ulaþýlabilen ve retrospektif analize izin veren 43 hasta çalýþmaya dâhil edildi. Hastalarýn demografik özellikleri, taný tarihleri, lezyon lokalizasyonlarý, patoloji sonuçlarý ve aile öyküleri kaydedildi.
BULGULAR: Çalýþmaya dâhil edilen hastalarýn ortalama taný yaþý 29 (17-34) yýl olarak bulundu. 20 hastanýn (46,5%) ailesinde malignite öyküsü bulunmaktaydý. 19 hastada (44,2%) SCC tanýsýndan önce prekanseröz lezyon saptandýðý görüldü. Hastalarýn %7’sinde organ veya allojenik kemik iliði nakli ve uzun dönem immünsupresan kullanýmý, %7’sinde kutanöz kanserlere genetik yatkýnlýk ve %7’sinde RT-KT öyküsü mevcuttu. 58 aylýk takip süresinde 18 hastanýn (41,9%) nüks ettiði gözlendi. Histopatolojik olarak orta-kötü differansiye skumaöz hücreli karsinom varlýðýnýn, uzamýþ immünsupresan kullanýmýnýn, radyoterapi ve kemoterapi öyküsü bulunmasýnýn nüks geliþimi ile istatistiksel anlamlý iliþkisi olduðu gözlendi (p<0,05). Saðkalýmý etkileyen faktörler için yapýlan Kaplan-Meier analizinde genetik risk varlýðýnýn, kötü differansiyasyonun ve nüks varlýðýný saðkalým ile iliþkisi gösterilmiþtir. (p<0.05)
TARTIÞMA ve SONUÇ: Genç eriþkinlerde uzun süreli immünsupresan kullanýmý, kemoradyoterapi, genetik kutanöz kanser yatkýnlýk sendromlarý ve prekürsör lezyon varlýðý gibi cSCC geliþimi için risk faktörlerinin tanýnmasý uygun danýþmanlýk, erken taný ve etkin tedavi saðlamak için büyük önem taþýmaktadýr.

Anahtar Kelimeler: Kutanöz skuamöz hücreli karsinom, kemoterapi, radyoterapi, immünsupresan, genetik

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