Desmoplastic cutaneous squamous cell carcinoma is an aggressive and potentially fatal skin cancer: a systematic review

Background: Incidence and mortality of cutaneous squamous cell carcinoma (cSCC) are increasing. Des-moplastic cSCC (dcSCC) is an uncommon yet highly aggressive variant. No systematic reviews of dcSCCare are currently available. Aims: Perform a systematic review of published seriesof dcSCC with focus on outcomes.Methods: Comprehensive search of Pubmed and Web of Science was performed for original series in English. Case reports, conference abstracts and studies with no follow-up were excluded. Statistical analysis was performed using R and the random effects model.Results & Discussion: Six studies reporting a total of 286 dcSCC were included in the final analysis. Most series were single site and retrospective. Pooled estimates demonstrated local recurrence rate 30% (95%CI 24%–36%, P = 0.765), nodal metastasis 17%(95% CI 12%–22%, P = 0.158), distant metastasis 5% (95% CI 2%–9%, P = 0.574) and disease-specific death 12% (95% CI 3%–36%, P = 0.047), all of which are worse than non-dcSCC. The findings con-firm the aggressive nature of dcSCC and suggest early aggressive treatment is warranted. However, given the limitations of existing studies, there is a need for large, prospective, multicentre studies to better define prognostic factors and optimize management strategies