Assessing Recurrence Patterns of Cutaneous Squamous Cell Carcinoma (cSCC) in Post-surgical Patients in Iran: A Cross-sectional Study

Background: Cutaneous squamous cell carcinoma (cSCC) is a common invasive skin malignancy. This study assesses recurrence patterns and risk factors in post-surgical Iranian patients, aiming to enhance understanding and inform prevention, diagnosis, and treatment strategies for cSCC. Materials and Methods: A cross-sectional design was used in this study to evaluate the epidemiology of cSCC among patients operated at Shahid Faghihi Hospital in Shiraz, Iran, from ۲۰۱۶ to ۲۰۲۳. It included patients with confirmed cSCC who underwent surgical treatments, ensuring comprehensive data collection through medical records and patient contact. A total of ۱۶۷ records were reviewed, with ۷۸ patients meeting the inclusion criteria. Data analysis was performed in SPSS version ۲۷.۰, applying Chi-square and Fisher’s exact tests with statistical significance set at P<۰.۰۵. Results: A total of ۷۸ patients with cSCC were included in this study, with a mean age of ۶۱.۳±۱۷.۰۳ years and ۲۸.۲% being female. Tumors were predominantly located on the face (۲۵.۶%), head (۲۳.۱%), neck (۲۰.۶%), and extremities (۲۰.۶%). Margin involvement was observed in ۳۴.۶% of cases. The average tumor depth was ۴.۷۲ mm, with a mean lesion length of ۲۴ mm and a width of ۲۲ mm. Recurrent disease occurred in ۲۵.۶% of patients, with a mean relapse time of ۱۱.۰۵ months. Metastasis was observed in ۱۹.۲% of cases, and ۷۶.۹% of patients were alive at the time of analysis. Tumor recurrence was significantly associated with margin involvement, adjuvant radiation therapy, chemotherapy, and metastasis (P<۰.۰۰۱ for all). Patients with recurrent cSCC had significantly higher mean tumor depth (۵.۷۵ mm vs. ۴.۳۶ mm, P<۰.۰۰۱) and wider surgical margins (۵.۹۰ mm vs. ۴.۶۲ mm, P=۰.۰۱) compared to those without recurrence. Conclusion: This study identified surgical margins, tumor depth, and metastasis as key recurrence predictors of cSCC, emphasizing the need for personalized treatment and further research on biological and molecular factors.