A structured review of quality of life in advanced and high-risk cutaneous squamous cell carcinoma shows the need for more studies and better measures

Background Cutaneous squamous cell carcinoma (cSCC) accounts for nearly a quarter of non‐melanoma skin cancers. Studies reporting Quality of Life (QoL) in this group focus on early stage disease. A small proportion of cSCC patients have high‐risk or advanced disease, with potentially significant QoL impacts, yet are largely overlooked. Aims This structured review appraises measures and published QoL outcomes in this group. Materials & Methods We conducted searches in MEDLINE, EMBASE, CINAHLplus and PsycInfo in June 2020 (updated in October) to identify publications specifically reporting QoL outcomes in this cohort. Returns were reviewed against a strict set of eligibility criteria. Results We identified seven publications for inclusion; three relating to high‐risk cSCC, three to metastatic disease and one to unresectable disease. Publications were appraised for quality using the Mixed Methods Appraisal Tool. Only one fulfilled more than two of the five quality criteria. Studies employed a range of patient reported outcome measures to assess QoL, both generic and disease specific. Discussion All studies with multiple time‐points reported stable or improving QoL, however extrapolation of these findings to the cSCC population is not warranted due to study limitations including mixed populations, incomplete data sets or single measurements. We set out to review the QoL literature for high‐risk and advanced cSCC and found a small and disparate body of evidence. Studies varied significantly in terms of study population, design and quality. While the identified studies suggested stable or improving QoL, we question the choice of measures used and highlight the need for further work in this area. Conclusion While there are some published reports about quality of life for patients with early stage cutaneous squamous cell carcinoma, these impacts for the high‐risk or advanced cohort are largely unexplored. We conducted a structured review of published measures and outcomes used in this cohort and found a demonstrable need for further, targeted, exploration of patient needs in this area

The Danish Nonmelanoma Skin Cancer Dermatology Database

Anna Lei Lamberg,1 Henrik Sølvsten,2 Ulrikke Lei,3 Gabrielle Randskov Vinding,3 Ida Marie Stender,4 Gregor Borut Ernst Jemec,5 Tine Vestergaard,6 Henrik Thormann,7 Merete Hædersdal,8 Tomas Norman Dam,9 Anne Braae Olesen10 1Dermatology Clinic, Grenaa, Central Denmark Region, 2Dermatology Clinic, Aalborg, North Denmark Region, 3Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Gentofte, 4Dermatology Clinic, Charlottenlund, Capital Region of Denmark, 5Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, Zealand Region, 6Department of Dermatology, Odense University Hospital, Odense, 7Dermatology Clinic, Vejle, Region of Southern Denmark, 8Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Capital Region of Denmark, 9Dermatology Clinic, Nykøbing Falster, Zealand Region, 10Department of Dermatology, University Hospital of Aarhus, Aarhus, Central Denmark Region, Denmark Aim of database: The Danish Nonmelanoma Skin Cancer Dermatology Database was established in 2008. The aim of this database was to collect data on nonmelanoma skin cancer (NMSC) treatment and improve its treatment in Denmark. NMSC is the most common malignancy in the western countries and represents a significant challenge in terms of public health management and health care costs. However, high-quality epidemiological and treatment data on NMSC are sparse. Study population: The NMSC database includes patients with the following skin tumors: basal cell carcinoma (BCC), squamous cell carcinoma, Bowen's disease, and keratoacanthoma diagnosed by the participating office-based dermatologists in Denmark. Main variables: Clinical and histological diagnoses, BCC subtype, localization, size, skin cancer history, skin phototype, and evidence of metastases and treatment modality are the main variables in the NMSC database. Information on recurrence, cosmetic results, and complications are registered at two follow-up visits at 3 months (between 0 and 6 months) and 12 months (between 6 and 15 months) after treatment. Descriptive data: In 2014, 11,522 patients with 17,575 tumors were registered in the database. Of tumors with a histological diagnosis, 13,571 were BCCs, 840 squamous cell carcinomas, 504 Bowen's disease, and 173 keratoakanthomas. Conclusion: The NMSC database encompasses detailed information on the type of tumor, a variety of prognostic factors, treatment modalities, and outcomes after treatment. The database has revealed that overall, the quality of care of NMSC in Danish dermatological clinics is high, and the database provides the necessary data for continuous quality assurance. Keywords: nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma, epidemiology, treatmen