Abstract:

We performed a retrospective chart review of patients who were diagnosed with cutaneous squamous cell carcinoma by broad shave biopsy and were subsequently treated with excision from October 2016 to December 2019. Tumor attributes including size, histologic grade, anatomic location, excision closure length, patient immune status and wait time from biopsy to excision were evaluated. There were 276 excisions identified and 69% of tumors were completely cleared by shave biopsy with no residual tumor in the excision specimen. Tumors cleared by biopsy had average size, closure, and wait time of 9.2 mm, 49.3 mm, and 32 days, respectively. Tumors not cleared by biopsy had an average size, closure, and wait time of 11.7 mm, 54.0 mm and 33 days, respectively. There was a statistically significant difference only for tumor size and closure (p<.0001, p= .0174). Tumors on the lower extremity, trunk, upper extremity, or head and neck were cleared by biopsy 81.6%, 70.7%, 69.6%, and 50% of the time, respectively. Only the clearance rate for head and neck was statically significant (p=.043). Immunocompromised patients were cleared by biopsy 45.5% of the time while immunocompetent patients were cleared 70.9% of the time. The difference was statistically significant (p=.014). In conclusion, broad shave biopsy for cutaneous squamous cell carcinoma clears the entire tumor 69% of the time. Tumor size is the key factor for predicting clearance. Head and neck location in addition to immunocompromised status are independent risk factors for incomplete clearance. Histologic grade, wait time and other anatomical locations do not appear to play a role in predicting clearance.

Financial Disclosure: No current or relevant financial relationships exist.

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Forrest Roberson, BS