MONDAY, Dec. 30, 2024 -- Watchful waiting is a reasonable management option for cutaneous squamous cell carcinoma determined clinically resolved at follow-up, according to a study published online Dec. 18 in the Journal of the American Academy of Dermatology.

In a retrospective cohort study, Blake Boudreaux, M.D., from the University of Vermont Medical Center in Burlington, and colleagues describe oncologic outcomes for patients diagnosed with cutaneous squamous cell carcinoma that was determined clinically resolved at follow-up and managed by watchful waiting. Cases occurred from Jan. 1, 2013, to April 30, 2023, and required clinical resolution more than four weeks after biopsy, watchful waiting management, and follow-up of at least 12 months.

The researchers observed two cases of local recurrence among 148 tumors managed by watchful waiting and no cases of nodal metastasis, distant metastasis, or disease-specific death. Immunocompromised participants and those with rheumatologic disease had a significantly increased risk for recurrence (hazard ratios, 12.87 and 16.18, respectively).

"The distinguishing feature of this study is preselection for a well-healed biopsy site," the authors write. "A skilled physical examination capable of distinguishing healthy scar tissue from residual cutaneous squamous cell carcinoma is crucial to select appropriate patients for which watchful waiting may yield a very low risk of local recurrence."