{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T11:11:44Z","timestamp":1756897904048,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metastatic cutaneous squamous cell carcinoma to the axilla is uncommon, with limited data to guide management. We sought to assess the outcomes of patients with this condition after surgery and radiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of patients treated at two Australian hospitals from 1994 through 2016 was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 74 patients were identified, including 48 treated curatively with surgery\u2010plus\u2010radiotherapy and 15 with surgery alone. Compared with patients treated with surgery alone, a higher proportion of patients treated with surgery\u2010plus\u2010radiotherapy had lymph nodes larger than 6\u2009cm (53% versus 8%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.012) and multiple adverse histopathological features (75% versus 47%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04). The groups had similar 5\u2010year disease\u2010free survival (45% versus 46%) and overall survival (51% versus 48%). Presence of multiple positive lymph nodes was associated with reduced disease\u2010free survival (hazard ratio 4.57, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and overall survival (hazard ratio 3.53, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Regional recurrence was higher in patients treated with surgery alone (38% versus 22%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.22) and patients with lymph nodes larger than 6\u00a0cm (34% versus 10%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). All recurrences occurred within 2\u2009years following treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined\u2010modality therapy for metastatic cutaneous squamous cell carcinoma to the axilla is recommended for high\u2010risk patients, although outcomes remain modest. The key period for recurrence is within 2\u2009years following treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16584","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T22:04:38Z","timestamp":1611871478000},"page":"878-884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Outcomes of patients with metastatic cutaneous squamous cell carcinoma to the axilla: a multicentre cohort study"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-1758","authenticated-orcid":false,"given":"Phillip F.","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"Prince of Wales Clinical School, Faculty of Medicine The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Veness","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Westmead Clinical School, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8184-2012","authenticated-orcid":false,"given":"Edward A.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert I.","family":"Smee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Lehane","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0927-3721","authenticated-orcid":false,"given":"Philip J.","family":"Crowe","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"Prince of Wales Clinical School, Faculty of Medicine The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3634-246X","authenticated-orcid":false,"given":"Julie R.","family":"Howle","sequence":"additional","affiliation":[{"name":"Westmead Clinical School, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Surgery Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-3449","authenticated-orcid":false,"given":"Stephen R.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Prince of Wales Clinical School, Faculty of Medicine The University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Radiation Oncology Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00086.x"},{"key":"e_1_2_8_3_1","unstructured":"Cancer Council Australia Keratinocyte Cancers Guideline Working Party.Clinical practice guidelines for keratinocyte cancer. 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