Lymphovascular Invasion in Cutaneous Squamous Cell Carcinoma

Although there is a large body of literature regarding risk stratification and outcomes for perineural invasion (PNI) in cutaneous squamous cell carcinoma (cSCC), there is a relative paucity of studies exploring the role of lymphovascular invasion (LVI) in cSCC and a lack of clear evidence-based guidelines for how to manage patients with these tumors. This article is intended to review the available literature regarding LVI in cSCC and formulate evidence-based recommendations for clinical management. A literature review was conducted using PubMed to find relevant articles relating to outcomes and management of primary cSCC with LVI. The available literature suggests that LVI is a major risk factor for poor outcomes and increased morbidity and mortality in cSCC. Lymphovascular invasion is a very high-risk feature that should place these tumors in the highest-risk category, and management of these tumors should be similar to that of squamous cell carcinoma with PNI.