title: Aggressive behavior of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia.
abstract: OBJECTIVE
  Immunosuppression in organ transplant recipients increases the incidence and aggressiveness of cutaneous squamous cell carcinoma. However, there are little clinical data on cutaneous squamous cell carcinoma in patients with immunosuppression due to chronic lymphocytic leukemia. In this study we evaluated the clinical features, patterns of recurrence, and outcomes of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A review was performed of 42 consecutive patients with cutaneous squamous cell carcinoma and chronic lymphocytic leukemia presenting to our institution between July 2000 and July 2010. Baseline characteristics, treatment details, and outcomes were analyzed.
  
  
  RESULTS
  Thirty-four patients presented with primary cutaneous squamous cell carcinoma (33 node negative, 1 node positive), and eight patients presented with nodal disease without a simultaneous index primary. The 2-year cumulative incidence of local recurrence for primary cutaneous squamous cell carcinoma was 15%. Nodal recurrence occurred in 36% of node-negative patients. The 3-year overall and cause-specific survival rate for all patients was 37% and 65%, respectively. In patients managed curatively for nodal disease at presentation or relapse (n = 17), the 3-year overall and cause-specific survival rate was 21% and 53%, respectively.
  
  
  CONCLUSIONS
  Patients with cutaneous squamous cell carcinoma and chronic lymphocytic leukemia experience higher rates of skin cancer recurrence and death than expected in an immunocompetent population. Novel strategies are needed to improve outcomes.
authors.affiliation: Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Tomaszewski
authors.forename: Haim
authors.initials: H
authors.lastname: Gavriel
authors.forename: Emma
authors.initials: E
authors.lastname: Link
authors.forename: Sholeh
authors.initials: S
authors.lastname: Boodhun
authors.forename: Andrew
authors.initials: A
authors.lastname: Sizeland
authors.forename: June
authors.initials: J
authors.lastname: Corry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000276:immunology* / Q000473:pathology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology*
keywords: Cutaneous squamous cell carcinoma; chronic lymphocytic leukemia; immunosuppression; recurrence; survival