Surgical Delays Associated With Moderate SCCs, But Not Low-Grade SCCs or BCCs

A retrospective review recently published by Journal of the American Academy of Dermatology found that delays in Mohs surgery under 1 year were associated with growth of higher-grade squamous cell carcinomas (SCCs).

Given that the evidence is limited whether surgical delays can be a factor in tumor growth for SCCs and basal cell carcinomas (BCCs), researchers aimed to identify associations between tumor subpopulations, tumor growth, and surgical delay.

They retrospectively analyzed 299 SCCs and 802 BCCs treated with Mohs surgery. Surgical delay was defined as time from biopsy to surgery, and tumor growth was defined as change in diameter from biopsy to postoperative defect. 

Overall, surgical delays ranged from zero to 331 days. For SCCs, histologic subtype and prior treatment were independent predictors of tumor growth. Further, tumor growth and surgical delay were found to be associated with poorly differentiated and moderately differentiated SCCs, with approximately 0.28-cm and 0.24-cm growth rates per month of delay, respectively. Notably, tumor growth was not associated with prior treatment of SCCs. No BCC subgroups with surgical delay were associated with tumor growth.

“Surgical delays under a year were associated with tumor growth for higher-grade SCCs, with effect sizes bearing potential for clinical significance,” wrote the study authors. Dermatologists are encouraged to continue to seek appropriate and timely treatment for their patients with nonmelanoma skin cancers.

Reference
Lee J, Forrester VJ, Novicoff WM, Guffey DJ, Russell MA. Surgical delays less than 1 year in Mohs micrographic surgery associated with tumor growth in moderate- and poorly-differentiated squamous cell carcinomas but not lower-grade squamous cell carcinomas or basal cell carcinomas, a retrospective analysis. J Am Acad Dermatol. Published online September 6, 2021. doi:10.1016/j.jaad.2021.08.059