METASTASES FROM SQUAMOUS-CELL CARCINOMA OF THE SKIN IN SOUTHERN AUSTRALIA

Background: The frequency with which squamous cell carcinoma (SCC) of the skin metastasizes is a matter of dispute. Studies from private pra ctices have reported much lower rates than hospital-based surveys, and one school of thought is that SCCs which arise in sun-damaged skin ha ve a low risk of metastasis. Methods: A prospective study of out-patie nts with histologically confirmed SCC was undertaken in southern Austr alia, a region with a very high incidence of skin cancer. Results: Bet ween November 1988 and November 1989, 481 patients were entered into t he study and 420 followed for at least 3 years. An SCC was the initial diagnosis for 73 patients, 3 were immunosuppressed and 2 had an SCC o f the lip, leaving 68 immunocompetent patients with SCC of the skin. M etastatic SCC developed in 2 patients (5.8% adjusted for losses) withi n 3 years. The SCCs were small and arose in sun-damaged skin. Conclusi on: Patients with SCC of the skin need a careful follow-up because of the risk of metastasis.