Track: Clinical Studies

Topic: Neoplasia,Carcinogensis,Tumor Biology

Abstract:

Background: It has been shown there is a relationship between ulceration and cutaneous squamous cell carcinoma. Similarly, we aimed to determine if ulceration could be a high-risk feature in basal cell carcinomas (BCC).

Methods: With IRB approval, 101 BCC cases (head and neck(HN): 69, body: 32) were randomly selected from the pathology department archive through 2019 to 2022. Two data cohorts were determined ulceration (n=31) vs no-ulceration (n=70). The definition of melanoma ulceration, extent of ulceration and tumor infiltrating lymphocytes (TILs) were used.

Results: There was significant association with depth of invasion (p-value: <0.0001), tumor size (p-value: 0.001), high-risk subtypes (p-value: <0.001), perineural inflammation (p-value: 0.00), higher density of inflammation (p-value: 0.00) and brisk TILs (p-value: 0.00). No significant correlation of ulceration with tumor site, percent of ulceration (<30%, 30-70% and >70%) and overall survival were identified.

Conclusion: Ulceration correlates with a higher T stage (depth of invasion, tumor size, perineural invasion) and aggressive subtypes (infiltrative, morphea-form or micronodular). Ulceration did not show impact in overall survival. It may be that our sample size is small and without enough follow-up time. Ulceration also did not show any correlation with site (HN vs trunk and extremities). This suggests that there is more than sun-exposure such as tumoral mechanism / vascular growth involved in ulceration of BCC, similar to melanoma.

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Arun Gopinath, MD