David Wilkinson, Julia Sottovia, Sonje Hoogstad
Abstract
Introduction
Well-differentiated squamous cell skin cancer (WDSCC) is common in sun-exposed populations. Guidelines promote active treatment, with excision preferred. Isolated cases of spontaneous regression (SR) have been reported. Having observed multiple patients with apparent SR following partial, diagnostic biopsy, we did a retrospective cohort study to explore this further.
Objectives
We sought to report frequency of SR of WDSCC following partial biopsy by a general practitioner (GP) in a primary care setting and referral to a public hospital general surgery service for excision, to report patient characteristics, and to estimate the time interval between biopsy and SR.
Methods
Retrospective cohort study (22 months) of patients in Queensland, Australia, with a diagnosis of WD-SCC following a partial biopsy by a GP. SR was defined as no clinical or dermoscopy evidence of squamous cell carcinoma (SCC).
Results
Among 153 consecutive patients with WDSCC referred for excision, 51 showed SR at consultation (33.3%, 95% CI: 25.6–41). There was no significant difference in age or sex of the SR and non-SR groups. In almost all patients with SR (N=49, 96.1%), lesions were located below the knee, compared with 90 (88.2%, P=0.042) without SR. Average interval between biopsy and surgical consultation was 13.6 weeks (range 2.7–24.7 weeks).
Conclusions
WDSCC may spontaneously resolve following partial, diagnostic biopsy more often than previously reported. These preliminary observations may have implications for treatment options, especially among frail patients with comorbidities.
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