title: Squamous cell carcinoma of the pinna: which histological features could be used to predict prognosis?
abstract: Squamous cell carcinoma (SCC) that originates in the pinna is thought to have a high risk of metastases (up to 16%) compared with under 5% for cutaneous SCC at any other site, and histological features of the primary tumour may provide evidence for further surveillance or treatment. To identify any association between histological features and the risk of metastases we made an electronic search of the histopathological records at the University Hospital Southampton NHS Foundation Trust for all patients who presented with auricular SCC from 2007-2012. Inclusion criteria included origin in the pinna, complete two-year follow up, and no history of immunosuppressive treatment. We looked for histopathological features that were thought to be relevant to metastases. We studied specimens from 192 patients, four of whom developed metastases (2%), each with involved lymph nodes. Perineural invasion and local recurrence were significantly associated with increased risk of metastases (p<0.001 and p=0.006). The overall metastatic rate was much lower than those reported in other studies, and factors other than histological features alone may explain the results. We suggest that although some histological features were significantly associated, they do not predict a high enough risk of metastatic disease to provide evidence for further surveillance or elective lymphadenopathy.
authors.affiliation: Peterborough City Hospital, Edith Cavell Campus, Peterborough, Cambridgeshire PE3 9GZ. Electronic address: emzmayo@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Mayo
authors.affiliation: Department of Maxillofacial Surgery, Southampton General Hospital, Tremona Road, Southampton SO16 6YD.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Celullar Pathology, Southampton General Hospital, South Block, Tremona Road, Southampton SO16 6YD.
authors.forename: J
authors.initials: J
authors.lastname: Horne
authors.affiliation: Department of Primary Care and Population Sciences, Southampton General Hospital, South Academic Block, Tremona Road, Southampton SO16 6YD.
authors.forename: H M
authors.initials: HM
authors.lastname: Yuen
authors.affiliation: Department of Dermatology, Southampton General Hospital, Tremona Road, Southampton SO16 6YD.
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.affiliation: Department of Maxillofacial Surgery, East Kent University Hospitals NHS Trust, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent CT1 3NG.
authors.forename: A
authors.initials: A
authors.lastname: Gulati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D004428:Ear Neoplasms / Q000473:pathology*; D004431:Ear, External / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
keywords: Squamous cell carcinoma; histology; metastases; pinna