40-Gene expression profile test predicting metastatic risk in localized, high-risk cutaneous squamous cell carcinoma for peer review

Abstract

This case study investigates the use of a 40-gene expression profile to independently predict the risk of metastasis in an immunocompromised 75-year-old male patient with cutaneous squamous cell carcinoma of his left cheek. The patient’s previous medical history included non-melanoma skin cancer. Traditional staging methods, such as those from the American Joint Committee on Cancer 8th edition and Brigham and Women’s Hospital, suggested a high risk of metastasis for this patient. However, the 40-gene expression profile test identified the patient as having a low risk (Class 1 result) of metastasis within 3 years. The patient successfully underwent Mohs surgery, and pathology was notable for positive perineural invasion of large caliber nerves. This case highlights the potential of the 40-gene expression profile as an independent predictor in assessing metastatic risk compared to traditional staging methods.