The role of adjuvant radiotherapy in primary cutaneous squamous cell carcinoma with perineural invasion

1468 leads will liaise with local surgeons to complete an on-line questionnaire which will provide a comprehensive description of current national practice, service provision and adherence with National Guidelines. Eligible centres identified using the questionnaire will progress to the audit phase of the project. All patients receiving IBBR over a six-month period will be included and clinical and patient-reported outcomes will be audited against NMBRA quality standards. Appropriate statistical methods will be used to compare the outcomes of implant-based breast reconstruction with and without lower-pole support. Conclusions: The iBRA study will provide comprehensive data relating to the practice and outcomes of IBBR in the UK. It will allow variations in the quality of care to be identified and addressed and the experiences of women undergoing the procedure in the future improved.

THE ROLE OF ADJUVANT RADIOTHERAPY IN PRIMARY CUTANEOUS SQUAMOUS CELL CARCINOMA WITH PERINEURAL INVASION Roman I. Mykula 1, Christina Bordea 2, Gavin Mccoubrey 3, Emily West 3, John Cubitt 5, Oliver Cassell 4, Peter G. Budny 5 1

Salisbury Hospital, United Kingdom St Thomas Hospital, United Kingdom 3 Salisbury District Hospital, United Kingdom 4 John Radcliffe Hospital, Oxford University Hospitals NHS Trust, United Kingdom 5 Stoke Mandevile Hospital, United Kingdom 2

Abstracts Introduction and aims: The presence of Perineural invasion in cutaneous squamous cell carcinoma carries an increased risk of recurrence and metastasis. Worse prognosis is specifically associated with larger calibre nerve involvement and in patients presenting with clinical symptoms. The current management guidelines recommend surgical excision, with margin or with histological control (Mohs). The role of adjuvant radiotherapy remains unclear. Due to preliminary evidence cited, our MDT altered practice, increasing consideration of adjuvant radiotherapy in high risk cases.Our aim is to review the role of adjuvant radiotherapy effect on outcomes of cutaneous squamous cell carcinoma with perineural invasion. Material and methods: Retrospective consecutive case series review within three centres from 1-1-2007 to 31-12-2010 of patients with cutaneous squamous cell carcinoma with perineural invasion. Results: Of 2153 consecutive patients with cutaneous Scc, 162 cases (7.5%) with perineural invasion were identified. 25 patients treated with adjuvant radiotherapy after complete excision, had a reduced overall recurrence rate of 20%, as opposed to 33%, despite having thicker tumours (6.1mm to 5.4mm) and closer deep margin of excision (0.94mm to 2.07mm). Regional recurrence was more likely in patients without adjuvant radiotherapy (19% vs 4%(p< 0.05)). There was no difference in mean age (78years), distribution, or follow-up (25months). Conclusion(s): Those patients not definitively managed at initial presentation are higher risk of recurrence. Due to potentially biased nature of selection, a randomized control trial is needed to confirm the apparent advantage of adjuvant radiotherapy in the treatment of high risk cutaneous squamous cell carcinoma with perineural invasion.