New Concepts and Recent Advances in the Management of Skin Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 11301

Special Issue Editors


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Guest Editor
Department of Dermatology, University Clinic of Navarra, School of Medicine, University of Navarra, Pamplona, Spain
Interests: dermatology; skin cancer; dermatological surgery; Mohs surgery; pigmented lesions; dermoscopy; photodynamic therapy
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Co-Guest Editor
Department of Dermatology, University Clinic of Navarra, 28002 Madrid, Spain
Interests: dermatologic surgery; Mohs surgery; forehead flaps; skin cancer; vascular malformations; congenital melanocytic nevi; cutaneous reconstructive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Skin cancer is the most common human cancer and its incidence is continuosly increasing. The recent discovery of new signaling pathways related with melanoma and keratynocitic carcinomas has transformed the therapeutic landscape of this cutaneous tumors. New diagnostic tools have also been developed, leading to an earlier diagnosis and optimizing the clinical management of these tumours. However, there are still many uncertainties in the field of cutaneous oncology in need of covering for a better understanting and handling of the disease.

In this Special Issue, papers on  epidemiology, etiopathogenic mechanisms, clinical management and surgical/medical therapy in skin cancer are highly welcome.

Researchers are encouraged to submit their findings as either original articles, reviews, or brief communications.

Dr. Rafael Salido-Vallejo
Dr. Pedro Redondo
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • skin cancer
  • basal cell carcinoma
  • cutaneous squamous cell carcinoma
  • melanoma
  • Merkel cell carcinoma
  • cutaneous sarcomas
  • treatment
  • checkpoint inhibitors
  • epidemiology
  • dermatologic surgery
  • extramammary paget's disease
  • cutaneous lymphoma

Published Papers (10 papers)

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Research

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10 pages, 2506 KiB  
Article
Sex-Based Differences in Melanoma Survival Improvement from 2004 to 2018
by Vikram R. Shaw, Angela Hudock, Baoyi Zhang, Christopher Amos and Chao Cheng
Cancers 2024, 16(7), 1308; https://doi.org/10.3390/cancers16071308 - 27 Mar 2024
Viewed by 597
Abstract
Background: Melanoma is the deadliest form of skin cancer and its incidence and mortality vary by sex, age, race, and socioeconomic status. Relatively few studies, however, have characterized disparities in survival improvement across these demographic groups in melanoma. Methods: Survival data from the [...] Read more.
Background: Melanoma is the deadliest form of skin cancer and its incidence and mortality vary by sex, age, race, and socioeconomic status. Relatively few studies, however, have characterized disparities in survival improvement across these demographic groups in melanoma. Methods: Survival data from the Surveillance, Epidemiology, and End Results (SEER) database were obtained from 2004 to 2018. The compiled data were analyzed for cancer-specific survival (CSS) to produce multivariable Cox regressions that estimate sex-based survival disparities across patient demographic groups. Additionally, time-to-progression and survival analyses were conducted for a cohort of patients with carcinoma-in situ (CIS) that developed into melanoma. Results: In both female and male patients, melanoma diagnosis in more recent years (2014–2018 versus 2004–2008) was associated with an improved CSS, with females demonstrating an HR of 0.55 (95% CI: 0.49–0.60) and males demonstrating an HR of 0.49 (0.46–0.53). The trend remained consistent upon analyzing the effects of both sex and race on survival improvement for White and Hispanic males and females, but the results were not significant for Black and Asian patients. Joint sex and age analysis demonstrated significant reductions in HR across all age groups for female and male patients with a diagnosis in more recent years. Analysis of lesions progressing from CIS to melanoma (high-risk CIS) demonstrated an increased OR for males over females (OR: 1.70; 95% CI: 1.55–1.85), while survival analysis demonstrated no difference between sexes in the HR. Finally, for male patients, high-risk CIS demonstrated worse CSS compared to female patients with high-risk CIS (OR: 1.43; 95% CI: 1.15–1.79). Conclusion: Overall, melanoma survival has improved in recent years, though some patient subgroups have experienced a lower improvement in survival from 2004 to 2018. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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11 pages, 2066 KiB  
Article
Spain’s Rising Melanoma Threat: A Comprehensive 30-Year Analysis (1990–2019)
by Lucía Cayuela, José-Juan Pereyra-Rodríguez, Juan-Carlos Hernández-Rodriguez and Aurelio Cayuela
Cancers 2024, 16(6), 1167; https://doi.org/10.3390/cancers16061167 - 15 Mar 2024
Viewed by 637
Abstract
Aim: This study aims to elucidate the factors driving melanoma incidence trends in Spain by analyzing the GBD-2019 dataset (1990–2019) and investigating the age-specific, birth cohort, and period effects on incidence rates. Materials and Methods: This study analyzed melanoma incidence trends in Spain [...] Read more.
Aim: This study aims to elucidate the factors driving melanoma incidence trends in Spain by analyzing the GBD-2019 dataset (1990–2019) and investigating the age-specific, birth cohort, and period effects on incidence rates. Materials and Methods: This study analyzed melanoma incidence trends in Spain from 1990 to 2019 using an ecological design. Data were sourced from the Global Burden of Disease Study 2019 and Spain’s National Statistics Institute. Age-standardized incidence rates (ASIRs) were calculated using joinpoint regression analysis, and age–period–cohort (A-P-C) modeling was employed to assess the effects of age, time period, and birth cohort on incidence rates. Results: Between 1990 and 2019, an estimated 147,823 melanoma cases were diagnosed in Spain. The ASIRs showed a steady increase for both sexes, with slightly higher rates observed in men. Both men (average annual percentage change (AAPC): 2.8%) and women (AAPC: 2.4%) showed a steady increase in the ASIR over the period. Joinpoint analysis revealed distinct periods of incidence rate changes, with significant upward trends in earlier years followed by stabilization in recent years. Incidence rates increased steadily with age, with the highest rates in the 80–84 age group. Women tended to have slightly higher rates in younger age groups, while men had higher rates in older age groups. Both men and women experienced a steady increase in relative risk of melanoma throughout the 30-year study period, with significant upward trends across birth cohorts. Conclusions: Despite limitations, this study provides valuable insights into factors influencing melanoma incidence in Spain. By understanding age, period, and cohort effects, effective prevention strategies can be developed to reduce melanoma incidence. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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15 pages, 1776 KiB  
Article
Mucosal Melanoma Clinical Management and Prognostic Implications: A Retrospective Cohort Study
by Laia Clavero-Rovira, Álvaro Gómez-Tomás, Patricia Bassas-Freixas, Domingo Bodet, Berta Ferrer, Javier Hernández-Losa, Eva Muñoz-Couselo, Assumpció Pérez-Benavente, Vicente García-Patos and Carla Ferrándiz-Pulido
Cancers 2024, 16(1), 227; https://doi.org/10.3390/cancers16010227 - 3 Jan 2024
Viewed by 987
Abstract
Mucosal melanoma (MM) is an uncommon melanoma subtype affecting mucosal surfaces of the head and neck, anorectal region, and vulvovaginal area. We aimed to present our experience at a tertiary-level hospital regarding MM diagnosis, management, monitoring of progression, mutations, and outcome predictors. We [...] Read more.
Mucosal melanoma (MM) is an uncommon melanoma subtype affecting mucosal surfaces of the head and neck, anorectal region, and vulvovaginal area. We aimed to present our experience at a tertiary-level hospital regarding MM diagnosis, management, monitoring of progression, mutations, and outcome predictors. We performed a registry-based cohort study including MM cases diagnosed from 2012 to 2022 and retrospectively characterized somatic mutations on BRAF, NRAS and c-KIT. We employed Kaplan–Meier curves, log-rank tests, and Cox regression analysis to explore prognostic factors and survival outcomes in a cohort of 35 patients, mainly women (63%) with a median age of 70 years. Predominantly, MM occurred in the vulvovaginal region (48.6%). At diagnosis, 28.6% had lymph node involvement, and 31.4% also had distant metastasis. Mutations in BRAF and c-KIT were identified in 3/35 (9%) and 2/6 patients (33%), respectively. Surgery was performed in 71.4% of patients, and most received systemic treatment (65.7%). Lower disease stage, thinner Breslow depth, and surgical resection were associated with improved overall survival. Notably, age, sex, radiotherapy, and BRAF mutant status did not affect survival. Standard management typically involves immunotherapy. Cases with BRAF or c-KIT mutations may be considered for targeted therapies. Unfortunately, MM prognosis remains unfavorable, with a less than 50% survival rate at 2 years. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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16 pages, 1235 KiB  
Article
The Influence of the Exposome in the Cutaneous Squamous Cell Carcinoma, a Multicenter Case–Control Study
by Alba Navarro-Bielsa, Tamara Gracia-Cazaña, Manuel Almagro, Sonia De la Fuente-Meira, Ángeles Flórez, Oriol Yélamos, Trinidad Montero-Vilchez, Carlos González-Cruz, Adrián Diago, Isabel Abadías-Granado, Victoria Fuentelsaz, María Colmenero, José Bañuls, Salvador Arias-Santiago, Agustín Buendía-Eisman, Manuel Almenara-Blasco, Pedro Gil-Pallares and Yolanda Gilaberte
Cancers 2023, 15(22), 5376; https://doi.org/10.3390/cancers15225376 - 12 Nov 2023
Viewed by 1132
Abstract
Introduction: The concept of exposome refers to the total of harmful and beneficial environmental exposures that can help predict the organism’s biological responses over time. Ultraviolet radiation (UVR) from sun exposure has been recognized as the main etiological agent of skin cancer, and [...] Read more.
Introduction: The concept of exposome refers to the total of harmful and beneficial environmental exposures that can help predict the organism’s biological responses over time. Ultraviolet radiation (UVR) from sun exposure has been recognized as the main etiological agent of skin cancer, and squamous cell carcinoma (SCC) is one most commonly associated with chronic exposure. However, in recent years, evidence suggests that lifestyle, environmental pollution, and contaminants in water and food can have an influence. Objectives: To study the relationship between SCC and sun exposure, pollution, stress, and lifestyle in a Spanish cohort. Materials and Method: A multicenter case–control study was carried out in which 13 dermatologists from different regions of Spain recruited cases and controls between April 2020 and August 2022. The group of cases were patients diagnosed with SCC and, as a control group, people who attended Dermatology consultations as companions with no history of skin cancer. Results: A total of 62 patients with SCC and 126 controls were included (62.9% males, median age 76.46 (10.1) and 33.3%, median age 55.7 (15), respectively). The SCC group had experienced more outside work than the controls (75% vs. 22.4%, p < 0.001), less recreational exposure (sunbathing, p = 0.05, and outdoor sports, p = 0.01), and a lower annual income (p = 0.01), with an increase in tobacco exposure (p < 0.001), without differences in other carcinogens, such as ionizing radiation or chemical exposure. The control group had a higher daily screentime use (p < 0.001) and practiced more relaxation activities (p = 0.03). A higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with SCC (p < 0.05). Some chronic medications (anxiolytics, antidepressants, beta-blockers, statins, hydrochlorothiazide, ACE inhibitors, metformin, and omeprazole) were also statistically associated with SCC. Statistical significance for all aforementioned variables was maintained in the multivariate analysis (p < 0.05). Conclusions: The study found a significant association between SCC and multiple exposome-related factors in addition to chronic sun exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers promoting sun-safe behaviors and stress-reducing activities, in addition to adequate skin photoprotection in patients under certain medications associated with SCC. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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12 pages, 694 KiB  
Article
Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study
by Ana Morelló-Vicente, Marta Espejo-Marín, Inés Oteiza-Rius, Javier Antoñanzas, Antonio Vélez and Rafael Salido-Vallejo
Cancers 2023, 15(20), 5037; https://doi.org/10.3390/cancers15205037 - 18 Oct 2023
Viewed by 785
Abstract
Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing over the years. Risk factors for local recurrence and metastasis have been widely studied in highly sun-exposed areas of the body but less data exist about less sun-exposed ones. The main objective [...] Read more.
Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing over the years. Risk factors for local recurrence and metastasis have been widely studied in highly sun-exposed areas of the body but less data exist about less sun-exposed ones. The main objective of this study is to compare the risk of local recurrence and metastases in patients with cSCC in highly sun-exposed areas compared to cSCC in less sun-exposed areas. Material and methods: A retrospective observational study was carried out, including 558 patients with histopathologically confirmed cSCC at the Reina Sofía University Hospital (HURS), Córdoba, during the period from 1 January 2017 to 31 December 2020. Demographic, clinical and anatomopathological data were collected. Results: Local recurrence occurs more often in highly sun-exposed areas (15.8%) compared to less sun-exposed ones (7.4%) (p < 0.05). However, no differences in the rate of metastases in both groups were found. The presence of affected surgical margins and tumor thickness were identified as independent risk factors for cSCC in low sun-exposure areas. Conclusions: cSCC located in anatomical areas of high sun exposure presented a greater risk of developing local recurrence in our population, which could suggest that these tumors have worse prognosis than those that lie in areas that do not receive chronic sun exposure. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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12 pages, 1233 KiB  
Article
Risk of Second Primary Malignancies in Melanoma Survivors: A Population-Based Study
by Javier Antoñanzas, Ana Morello-Vicente, Gloria Maria Garnacho-Saucedo, Pedro Redondo, Leyre Aguado-Gil and Rafael Salido-Vallejo
Cancers 2023, 15(11), 3056; https://doi.org/10.3390/cancers15113056 - 5 Jun 2023
Viewed by 1059
Abstract
(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of [...] Read more.
(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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10 pages, 970 KiB  
Article
Resection of Skin Cancer Resulting in Free Vascularized Tissue Reconstruction: Always a Therapeutic Failure?
by Tina Rauchenwald, Angela Augustin, Theresa B. Steinbichler, Bernhard W. Zelger, Gerhard Pierer, Matthias Schmuth, Dolores Wolfram and Evi M. Morandi
Cancers 2023, 15(9), 2464; https://doi.org/10.3390/cancers15092464 - 25 Apr 2023
Viewed by 1079
Abstract
The globally increasing incidence of cutaneous malignancies leads, in parallel, to increasing numbers of locally advanced skin cancer resulting in reconstructive surgery. Reasons for locally advanced skin cancer may be a patient’s neglect or aggressive tumor growth, such as desmoplastic growth or perineural [...] Read more.
The globally increasing incidence of cutaneous malignancies leads, in parallel, to increasing numbers of locally advanced skin cancer resulting in reconstructive surgery. Reasons for locally advanced skin cancer may be a patient’s neglect or aggressive tumor growth, such as desmoplastic growth or perineural invasion. This study investigates characteristics of cutaneous malignancies requiring microsurgical reconstruction with the aim of identifying possible pitfalls and improving diagnostic and therapeutic processes. A retrospective data analysis from 2015 to 2020 was conducted. Seventeen patients (n = 17) were included. The mean age at reconstructive surgery was 68.5 (±13) years. The majority of patients (14/17, 82%) presented with recurrent skin cancer. The most common histological entity was squamous cell carcinoma (10/17, 59%). All neoplasms showed at least one of the following histopathological characteristics: desmoplastic growth (12/17, 71%), perineural invasion (6/17, 35%), or tumor thickness of at least 6 mm (9/17, 53%). The mean number of surgical resections until cancer-free resection margins (R0) were achieved was 2.4 (±0.7). The local recurrence rate and the rate of distant metastases were 36%. Identified high-risk neoplastic characteristics, such as desmoplastic growth, perineural invasion, and a tumor depth of at least 6 mm, require a more extensive surgical treatment without concerns about defect size. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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Review

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24 pages, 16730 KiB  
Review
Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches
by Júlia Verdaguer-Faja, Agustí Toll, Aram Boada, Álvaro Guerra-Amor, Carla Ferrándiz-Pulido and Ane Jaka
Cancers 2024, 16(3), 664; https://doi.org/10.3390/cancers16030664 - 4 Feb 2024
Viewed by 1575
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic [...] Read more.
Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic thickness and anatomical structure that may influence both growth pattern and treatment of primary cSCC; while clinical peripheral margins may be easily achieved during the surgery, vertical excision of the tumor is limited by the skull. Despite having a unique anatomy, current guidelines do not contemplate specific recommendations for scalp cSCC, which leads to inconsistent decision-making in multidisciplinary committees when discussing tumors with high risk factors or with close margins. This article provides specific recommendations for the management of patients with scalp cSCC, based on current evidence, as well as those aspects in which evidence is lacking, pointing out possible future lines of research. Topics addressed include epidemiology, clinical presentation and diagnosis, imaging techniques, surgical and radiation treatments, systemic therapy for advanced cases, and follow-up. The primary focus of this review is on management of primary cSCC of the scalp with localized disease, although where relevant, some points about recurrent cSCCs or advanced disease cases are also discussed. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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21 pages, 22033 KiB  
Review
A Review of Recent Advances in Computer-Aided Detection Methods Using Hyperspectral Imaging Engineering to Detect Skin Cancer
by Hung-Yi Huang, Yu-Ping Hsiao, Riya Karmakar, Arvind Mukundan, Pramod Chaudhary, Shang-Chin Hsieh and Hsiang-Chen Wang
Cancers 2023, 15(23), 5634; https://doi.org/10.3390/cancers15235634 - 29 Nov 2023
Cited by 1 | Viewed by 1796
Abstract
Skin cancer, a malignant neoplasm originating from skin cell types including keratinocytes, melanocytes, and sweat glands, comprises three primary forms: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). BCC and SCC, while constituting the most prevalent categories of skin [...] Read more.
Skin cancer, a malignant neoplasm originating from skin cell types including keratinocytes, melanocytes, and sweat glands, comprises three primary forms: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). BCC and SCC, while constituting the most prevalent categories of skin cancer, are generally considered less aggressive compared to MM. Notably, MM possesses a greater capacity for invasiveness, enabling infiltration into adjacent tissues and dissemination via both the circulatory and lymphatic systems. Risk factors associated with skin cancer encompass ultraviolet (UV) radiation exposure, fair skin complexion, a history of sunburn incidents, genetic predisposition, immunosuppressive conditions, and exposure to environmental carcinogens. Early detection of skin cancer is of paramount importance to optimize treatment outcomes and preclude the progression of disease, either locally or to distant sites. In pursuit of this objective, numerous computer-aided diagnosis (CAD) systems have been developed. Hyperspectral imaging (HSI), distinguished by its capacity to capture information spanning the electromagnetic spectrum, surpasses conventional RGB imaging, which relies solely on three color channels. Consequently, this study offers a comprehensive exploration of recent CAD investigations pertaining to skin cancer detection and diagnosis utilizing HSI, emphasizing diagnostic performance parameters such as sensitivity and specificity. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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Other

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12 pages, 5368 KiB  
Systematic Review
Combined Merkel Cell Carcinoma and Squamous Cell Carcinoma: A Systematic Review
by Elisa Ríos-Viñuela, Fatima Mayo-Martínez, Eduardo Nagore, David Millan-Esteban, Celia Requena, Onofre Sanmartín and Beatriz Llombart
Cancers 2024, 16(2), 411; https://doi.org/10.3390/cancers16020411 - 18 Jan 2024
Viewed by 937
Abstract
Combined Merkel cell carcinoma (MCC) and squamous cell carcinoma (SCC) have classically been regarded as more aggressive than conventional, pure, Merkel cell polyomavirus (MCPyV)-positive MCC. It is still unknown whether combined MCC and SCC are more aggressive than pure, MCPyV-negative MCC, and the [...] Read more.
Combined Merkel cell carcinoma (MCC) and squamous cell carcinoma (SCC) have classically been regarded as more aggressive than conventional, pure, Merkel cell polyomavirus (MCPyV)-positive MCC. It is still unknown whether combined MCC and SCC are more aggressive than pure, MCPyV-negative MCC, and the origin of both the SCC and MCC elements of these combined tumors has not been elucidated. The main objective of this systematic review was to assess whether combined MCC and SCC tumors are associated with a worse prognosis than pure MCC; the secondary goals were the characterization of the clinical and histopathological features of these combined neoplasms. A total of 38 studies, including 152 patients, were selected for review. In total, 76% of the cases were MCPyV-negative, whereas 4% were MCPyV-positive. The most frequent histopathological pattern was that of an SCC in situ combined with a dermal MCC (36%), followed by both an in situ and invasive SCC combined with a dermal MCC (20%). Forty-seven percent of all cases fitted in the morphology of the so-called “collision tumors”. Three combined MCC cases that would fit in the morphological category of collision tumors presented both squamous and neuroendocrine elements in their respective nodal metastases. The mean overall survival was 36 months, comparable to that of pure, MCPyV-negative MCC. This review found similarly aggressive behavior for combined MCC and SCC and pure, MCPyV-negative MCC. Preliminary data strongly suggest that all MCPyV-negative MCC tumors, whether combined or pure, are part of a common spectrum. Full article
(This article belongs to the Special Issue New Concepts and Recent Advances in the Management of Skin Cancer)
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