Vartan Pahalyants, Neil K Jairath, Derek E Maas, Shayan Cheraghlou, Soutrik Mandal, Steven Friedman, Maressa C Criscito, Nayoung Lee, Nicole A Doudican, Emily S Ruiz, Nina Ran, Emily E Granger, Shlomo Koyfman, Alison Vidimos, Ashley Wysong, David R Carr, Kathryn T Shahwan, Kelsey E Hirotsu, Joi B Carter, Javier Cañueto, Fabio Muradás Girardi, Aaron R Mangold, Divya Srivastava, David G Brodland, John A Zitelli, Tyler J Willenbrink, John A Carucci
{"title":"Satellitosis/in-transit metastasis in cutaneous squamous cell carcinoma: Risk factors and the prognostic significance.","authors":"Vartan Pahalyants, Neil K Jairath, Derek E Maas, Shayan Cheraghlou, Soutrik Mandal, Steven Friedman, Maressa C Criscito, Nayoung Lee, Nicole A Doudican, Emily S Ruiz, Nina Ran, Emily E Granger, Shlomo Koyfman, Alison Vidimos, Ashley Wysong, David R Carr, Kathryn T Shahwan, Kelsey E Hirotsu, Joi B Carter, Javier Cañueto, Fabio Muradás Girardi, Aaron R Mangold, Divya Srivastava, David G Brodland, John A Zitelli, Tyler J Willenbrink, John A Carucci","doi":"10.1016/j.jaad.2025.07.029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Satellitosis or in-transit metastasis (S-ITM) from cutaneous squamous cell carcinoma (cSCC) is associated with poor outcomes but is not included in current staging guidelines.</p><p><strong>Objective: </strong>To determine risk factors and prognostic significance of S-ITM.</p><p><strong>Methods: </strong>This cohort study included 8,901 patients with cSCC from 12 institutions (1998-2023). Risk factors for S-ITM were calculated using logistic regression. Outcomes were compared with 1:2 propensity score matched controls using a Fine-Gray subdistribution hazard model.</p><p><strong>Results: </strong>Seventy-seven patients developed S-ITM. Increased patient age (OR 1.03, 95% CI 1.01-1.05, p<0.01), history of immunosuppression (OR 4.31, 95% CI 2.59-7.10, p<0.001), higher BWH stage (T2a OR 4.14, 95% CI 2.05-8.41; T2b OR 15.96, 95% CI 8.58-31.19; T3 OR 30.27, 95% CI 10.70-79.04, all p<0.001) and LVI (OR 4.57, 95% CI 1.80-10.38, p=0.001) were independent risk factors for S-ITM. S-ITM was associated with LR (SHR 2.40, 95% CI 1.43-4.04, p<0.001), NM (SHR 1.89 (95% CI .02-3.49, p=0.04), DM (SHR 4.41, 95% CI 1.45-13.27, p=0.01), and DSD (SHR 4.48, 95% CI 2.34-8.58, p<0.001).</p><p><strong>Limitations: </strong>Retrospective cohort study. The rarity of S-ITM may limit statistical power.</p><p><strong>Conclusion: </strong>Patients with cSCC and S-ITM are at higher risk for poor outcomes independent of patient, tumor, and treatment characteristics.</p>","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":" ","pages":""},"PeriodicalIF":12.8000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaad.2025.07.029","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Satellitosis or in-transit metastasis (S-ITM) from cutaneous squamous cell carcinoma (cSCC) is associated with poor outcomes but is not included in current staging guidelines.
Objective: To determine risk factors and prognostic significance of S-ITM.
Methods: This cohort study included 8,901 patients with cSCC from 12 institutions (1998-2023). Risk factors for S-ITM were calculated using logistic regression. Outcomes were compared with 1:2 propensity score matched controls using a Fine-Gray subdistribution hazard model.
Results: Seventy-seven patients developed S-ITM. Increased patient age (OR 1.03, 95% CI 1.01-1.05, p<0.01), history of immunosuppression (OR 4.31, 95% CI 2.59-7.10, p<0.001), higher BWH stage (T2a OR 4.14, 95% CI 2.05-8.41; T2b OR 15.96, 95% CI 8.58-31.19; T3 OR 30.27, 95% CI 10.70-79.04, all p<0.001) and LVI (OR 4.57, 95% CI 1.80-10.38, p=0.001) were independent risk factors for S-ITM. S-ITM was associated with LR (SHR 2.40, 95% CI 1.43-4.04, p<0.001), NM (SHR 1.89 (95% CI .02-3.49, p=0.04), DM (SHR 4.41, 95% CI 1.45-13.27, p=0.01), and DSD (SHR 4.48, 95% CI 2.34-8.58, p<0.001).
Limitations: Retrospective cohort study. The rarity of S-ITM may limit statistical power.
Conclusion: Patients with cSCC and S-ITM are at higher risk for poor outcomes independent of patient, tumor, and treatment characteristics.
背景：皮肤鳞状细胞癌（cSCC）的卫星增生或转移中转移（S-ITM）与不良预后相关，但目前的分期指南并未包括这一内容。目的：探讨S-ITM的危险因素及预后意义。方法：该队列研究纳入了来自12个机构（1998-2023）的8901例cSCC患者。采用logistic回归计算S-ITM的危险因素。使用Fine-Gray亚分布风险模型将结果与1:2倾向评分匹配的对照进行比较。结果：77例患者发生S-ITM。增加患者年龄（OR 1.03, 95% CI 1.01-1.05）。S-ITM的稀有性可能会限制统计能力。结论：与患者、肿瘤和治疗特点无关，cSCC和S-ITM患者预后不良的风险更高。
期刊介绍：
The Journal of the American Academy of Dermatology (JAAD) is the official scientific publication of the American Academy of Dermatology (AAD). Its primary goal is to cater to the educational requirements of the dermatology community. Being the top journal in the field, JAAD publishes original articles that have undergone peer review. These articles primarily focus on clinical, investigative, and population-based studies related to dermatology. Another key area of emphasis is research on healthcare delivery and quality of care. JAAD also highlights high-quality, cost-effective, and innovative treatments within the field. In addition to this, the journal covers new diagnostic techniques and various other topics relevant to the prevention, diagnosis, and treatment of skin, hair, and nail disorders.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
