Review of the Management of Periocular Cutaneous Squamous Cell Carcinoma With Perineural Spread Over the Last Decade
Bibliographic record
Abstract
PURPOSE: This study aimed to evaluate the efficacy of various treatment modalities for periocular cutaneous squamous cell carcinoma (pcSCC) with perineural spread (PNS), including immunotherapy, targeted therapy, radiation therapy (RT), and observation. METHODS: A retrospective review of 21 patients with pcSCC and PNS treated with immunotherapy, targeted therapy, RT, or observation over the past decade at a single center. RESULTS: Twelve cases were treated with immunotherapy: 6 patients received cemiplimab, 1 pembrolizumab, and 5 combined with chemotherapy/epidermal growth factor receptor (EGFR) blocker/RT (mean follow-up 32 months). MRI showed improvement in 92% of patients (complete response 42% and partial response 50%). Trigeminal neuralgia improved in 92%. Motor and sensory nerve recovery were noted in 50%. Survival rates were 100% in 1 year, 88% in 2 years, and 75% in 3 years. Three patients received EGFR blocker (cetuximab) with RT: 2 patients experienced clinical regression, and 1 had stable disease (mean follow-up 31 months). Neuropathic pain improved in all cases, but no motor or sensory nerve recovery was observed. Survival rates were 100% at 1 year, and 33% at 2 years. Four patients received RT-only (3 had progressive disease, 1 stable disease) and 2 patients opted for observation. No clinical improvement or nerve function recovery was observed in both groups. Both mean survivals were less than 2 years. The 2-year survival rates were 88% in the immunotherapy group, 33% in the EGFR + RT group, and 0% in the RT-only and observation groups. CONCLUSIONS: Immunotherapy demonstrated superior clinical outcomes in pcSCC with PNS, improving symptoms, nerve function, MRI findings, and survival rates compared to other treatment modalities.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".