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Outcomes of Adjuvant Radiotherapy Following Negative Surgical Margins for Cutaneous Squamous Cell Carcinoma

Miller, Jonathan MD*; Chang, Timothy MD*; Schwartz, David MD; Peters, Margot MD*,‡; Baum, Christian MD*

doi: 10.1097/DSS.0000000000001827
Original Article

BACKGROUND The role of adjuvant radiotherapy (ART) for cutaneous squamous cell carcinoma (cSCC) following negative surgical margins is unclear.

OBJECTIVE To retrospectively examine the clinical outcomes in a cohort of patients with cSCC who completed ART after Mohs micrographic surgery or wide local excision with negative margins.

METHODS AND MATERIALS After the institutional review board approval, a retrospective review was conducted of all patients with cSCC treated in the Mayo Clinic Department of Radiation Oncology from March 10, 1998, through April 26, 2013. Inclusion criteria were age >18 years, resection with negative histologic surgical margins, and completion of ART.

RESULTS Thirty-two patients met the inclusion criteria: 15 patients died, 12 without evidence of disease related to cSCC. Three patients developed recurrent disease, all with poorly differentiated cSCC, > 2 cm in clinical diameter, perineural invasion, and Brigham and Women's (BWH) stage T2b/T3; 2 of 3 patients were immunosuppressed; and 2 of 3 patients died of cSCC-related causes.

CONCLUSION These data suggest that the combination of surgical resection and ART is a reasonable option for Brigham and Women's T2b/T3 tumors.

Departments of *Dermatology,

Radiation Oncology, and

Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota

Address correspondence and reprint requests to: Christian Baum, MD, Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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