World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Original Article

Volume 3, Number 5, October 2012, pages 217-226

Metastatic Cutaneous Squamous Cell Carcinoma to the Axilla: A Review of Patient Outcomes and Implications for Future Practice

**Table 1.** Patient and Tumor Demographics
	Adjuvant (n = 26)	Definitive (n = 4)	Palliative (n = 6)	Total (n = 36)
Mean age (range)	75 (36 - 92)	74 (63 - 86)	73 (58 - 86)	75 (36 - 92)
Gender (%)
Male	21 (81)	3 (75)	3 (50)	27 (75)
Female	5 (19)	1 (25)	3 (50)	9 (25)
Smoker (%)
Yes	1 (4)	0 (0)	0 (0)	1 (3)
Ex	7 (27)	2 (50)	4 (67)	13 (36)
No	15 (58)	2 (50)	2 (33)	19 (53)
Unknown	3 (11)	0 (0)	0 (0)	3 (8)
ECOG Performance status (%)
0	13 (50)	1 (25)	0 (0)	14 (39)
1	7 (27)	2 (50)	4 (67)	13 (36)
2	6 (23)	1 (25)	2 (33)	9 (25)
Previous non-melanoma skin cancer (%)
Yes	15 (58)	3 (75)	4 (67)	22 (61)
No	11 (42)	1 (25)	2 (33)	14 (39)
Location of Index Lesion (%)
Head and neck	1 (4)	0 (0)	4 (66)	5 (14)
Trunk	12 (46)	1 (25)	1 (17)	14 (39)
Upper Limb	8 (31)	2 (50)	0 (0)	10 (28)
Unknown	5 (19)	1 (25)	1 (17)	7 (19)
Size of axilla mass (%)
< 3 cm	9 (35)	1 (25)	0 (0)	10 (28)
3 - 6 cm	11 (42)	1 (25)	4 (67)	16 (44)
> 6 cm	6 (23)	2 (50)	2 (33)	10 (28)
Surgery (%)
Axillary Dissection	21 (81)	0 (0)	1 (17)	22 (61)
Lumpectomy	5 (19)	0 (0)	0 (0)	5 (14)
None	0 (0)	4 (100)	5 (83)	9 ( 25 )
Histological Differentiation (%)
Moderate	11 (42)	0 (0)	2 (33)	13 (36)
Poor	10 (39)	1 (25)	2 (33)	13 (36)
Unknown	5 (19)	3 (75)	2 (34)	10 (28)
Extracapsular extension (%)
Yes	15 (58)	1 (25)	2 (33)	18 (50)
No	6 (23)	1 (25)	0 (0)	7 (19)
Unknown	5 (19)	2 (50)	4 (67)	11 (31)
Invasion of adjacent structures (%)
Yes	3 (11)	2 (50)	3 (50)	8 (22)
No	22 (85)	2 (50)	2 (33)	26 (72)
Unknown	1 (4)	0 (0)	1 (17)	2 (6)

Table 1. Patient and Tumor Demographics

Adjuvant (n = 26)

Definitive (n = 4)

Palliative (n = 6)

Total (n = 36)

Mean age (range)

75 (36 - 92)

74 (63 - 86)

73 (58 - 86)

75 (36 - 92)

Gender (%)

Male

21 (81)

3 (75)

3 (50)

27 (75)

Female

5 (19)

1 (25)

3 (50)

9 (25)

Smoker (%)

Yes

1 (4)

0 (0)

1 (3)

7 (27)

2 (50)

4 (67)

13 (36)

15 (58)

2 (50)

2 (33)

19 (53)

Unknown

3 (11)

0 (0)

3 (8)

ECOG Performance status (%)

13 (50)

1 (25)

0 (0)

14 (39)

7 (27)

2 (50)

4 (67)

13 (36)

6 (23)

1 (25)

2 (33)

9 (25)

Previous non-melanoma skin cancer (%)

Yes

15 (58)

3 (75)

4 (67)

22 (61)

11 (42)

1 (25)

2 (33)

14 (39)

Location of Index Lesion (%)

Head and neck

1 (4)

0 (0)

4 (66)

5 (14)

Trunk

12 (46)

1 (25)

1 (17)

14 (39)

Upper Limb

8 (31)

2 (50)

0 (0)

10 (28)

Unknown

5 (19)

1 (25)

1 (17)

7 (19)

Size of axilla mass (%)

< 3 cm

9 (35)

1 (25)

0 (0)

10 (28)

3 - 6 cm

11 (42)

1 (25)

4 (67)

16 (44)

> 6 cm

6 (23)

2 (50)

2 (33)

10 (28)

Surgery (%)

Axillary Dissection

21 (81)

0 (0)

1 (17)

22 (61)

Lumpectomy

5 (19)

0 (0)

5 (14)

None

0 (0)

4 (100)

5 (83)

9 ( 25 )

Histological Differentiation (%)

Moderate

11 (42)

0 (0)

2 (33)

13 (36)

Poor

10 (39)

1 (25)

2 (33)

13 (36)

Unknown

5 (19)

3 (75)

2 (34)

10 (28)

Extracapsular extension (%)

Yes

15 (58)

1 (25)

2 (33)

18 (50)

6 (23)

1 (25)

0 (0)

7 (19)

Unknown

5 (19)

2 (50)

4 (67)

11 (31)

Invasion of adjacent structures (%)

Yes

3 (11)

2 (50)

3 (50)

8 (22)

22 (85)

2 (50)

2 (33)

26 (72)

Unknown

1 (4)

0 (0)

1 (17)

2 (6)

**Table 2.** Radiotherapy Details
	Adjuvant (n = 26)	Definitive (n = 4)	Palliative (n = 6)	Total (n = 36)
Axilla Dose (Gy) mean (range)	51 (38 - 70)	56 (50 - 70)	41 (30 - 50)	50 (30 - 70)
Fractions mean (range)	24 (15 - 33)	23 (18 - 35)	14 (5 - 20)	22 (5 - 35)
Bed Gy10 mean (range)	61 (47 - 85)	70 (63 - 84)	55 (39 - 72)	61 (39 - 85)
Treated sites n (%)
Axilla	6 (23)	2 (50)	5 (83)	13 (36)
Axilla + SCF	15 (57)	2 (50)	1 (17)	18 (50)
Axilla + SCF + Primary	5 (20)	0 (0)	0 (0)	5 (14)
Bolus n (%)	12 (46)	1 (25)	1 (17)	14 (39)
SCF BED Gy₁₀ if included mean (range)	58 (47 - 67)	55 (47 - 63)	29 (na)	57 (29 - 67)
SCF BED Gy₃ if included mean (range)	82 (69 - 95)	82 (72 - 92)	59 (na)	81 (59 - 95)

Table 2. Radiotherapy Details

Adjuvant (n = 26)

Definitive (n = 4)

Palliative (n = 6)

Total (n = 36)

Axilla Dose (Gy) mean (range)

51 (38 - 70)

56 (50 - 70)

41 (30 - 50)

50 (30 - 70)

Fractions mean (range)

24 (15 - 33)

23 (18 - 35)

14 (5 - 20)

22 (5 - 35)

Bed Gy10 mean (range)

61 (47 - 85)

70 (63 - 84)

55 (39 - 72)

61 (39 - 85)

Treated sites n (%)

Axilla

6 (23)

2 (50)

5 (83)

13 (36)

Axilla + SCF

15 (57)

2 (50)

1 (17)

18 (50)

Axilla + SCF + Primary

5 (20)

0 (0)

5 (14)

Bolus n (%)

12 (46)

1 (25)

1 (17)

14 (39)

SCF BED Gy₁₀ if included mean (range)

58 (47 - 67)

55 (47 - 63)

29 (na)

57 (29 - 67)

SCF BED Gy₃ if included mean (range)

82 (69 - 95)

82 (72 - 92)

59 (na)

81 (59 - 95)

**Table 3.** Relapse Free Survival and Overall Survival
		Adjuvant (n = 26)	Definitive (n = 4)	Palliative (n = 6)	Total (n = 36)
% Relapse Free Survival (95% CI)	1 yr	71 (49 - 85)	50 (6 - 84)	0	60 (41 - 75)
	2 yr	52 (29 - 70)	50 (6 - 84)		46 (27 - 62)
	5 yr	41 (18 - 64)	25 (0 - 67)		35 (16 - 53)
% Overall Survival (95% CI)	1 yr	75 (53 - 88)	50 (6 - 84)	0	64 (45 - 78)
	2 yr	58 (36 - 75)	50 (6 - 84)		50 (32 - 66)
	5 yr	32 (14 - 52)	25 (0 - 67)		27 (13 - 44)

Table 3. Relapse Free Survival and Overall Survival

Adjuvant (n = 26)

Definitive (n = 4)

Palliative (n = 6)

Total (n = 36)

% Relapse Free
Survival (95% CI)

1 yr

71 (49 - 85)

50 (6 - 84)

60 (41 - 75)

2 yr

52 (29 - 70)

50 (6 - 84)

46 (27 - 62)

5 yr

41 (18 - 64)

25 (0 - 67)

35 (16 - 53)

% Overall
Survival (95% CI)

1 yr

75 (53 - 88)

50 (6 - 84)

64 (45 - 78)

2 yr

58 (36 - 75)

50 (6 - 84)

50 (32 - 66)

5 yr

32 (14 - 52)

25 (0 - 67)

27 (13 - 44)