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Treatment of squamous cell carcinoma in situ of the lower extremity: a study of patient-reported outcomes.

BACKGROUND
Squamous cell carcinoma in situ (SCCis) commonly presents on lower extremities (LE). Treatment may include local destruction, excision, or topical therapy, with efficacy supported by evidence. To date, evaluations of patient reported outcomes (PRO) following treatment of SCCis of the LE are lacking. Additionally, treatment of SCCis on the LE may be complicated by delayed wound healing and an increased risk of surgical site complications.


METHODS
This retrospective study evaluated PRO following treatment of SCCis of the LE. Healing time, satisfaction with aesthetic appearance of scar, interference with activities of daily living (ADLs), perceived tumor recurrence, and future preference for the same treatment were evaluated via patient survey. The recurrence rates associated with these therapies and anatomic site were also examined.


RESULTS
From February 2014 to February 2017, 152 patients met inclusion criteria; 62 of these patients completed the 5-question survey on PRO. Local destruction was the most commonly selected therapy. When comparing local destruction, excision, and topical therapy, there was no statistically significant difference in PRO regarding healing time, aesthetic appearance of scar, interference in ADLs, or likelihood of choosing the same treatment. There was also no significant difference in recurrence rates between therapies. Biopsy-proven and clinical recurrence rates in a sample of 152 patients were only 4.0% and 1.3%, respectively, and the overall rate of complications was 5.9%.


CONCLUSIONS
Taken together with the low recurrence rates of the three treatment categories, these PRO suggest that excisional, destructive, and topical therapies are all effective and appropriate for management of SCCis of the LE. Thus, therapeutic selection can be based on the relevant clinical context and patient preference.