Management of cutaneous squamous cell carcinoma at high risk of recurrence
Management of cutaneous squamous cell carcinoma at high risk of recurrence
cSCC: cutaneous squamous cell carcinoma; CCPDMA: complete circumferential peripheral and deep margin assessment; PD-1: programmed cell death protein 1; BCC: basal cell carcinoma. * Definition of high-risk primary cSCC.[1]
High-risk cSCCs:
Lesions of any size located on head, neck, hands, feet, pretibia, and anogenital area
Lesions ≥2 cm located on trunk or extremities (excluding pretibia, hands, and feet)
Recurrent tumor
Histopathologically acantholytic (adenoid), adenosquamous (showing mucin production), or metaplastic (carcinosarcomatous) subtypes, with perineural invasion
Very high-risk cSCC:
Lesions ≥4 cm on any location
Histopathologically poorly differentiated tumor, desmoplastic cSCC, >6 mm in thickness or invasion beyond the subcutaneous fat
Perineural invasion – Tumor cells within the nerve sheath of a nerve lying deeper than the dermis or ≥0.1 mm
Lymphatic or vascular involvement
¶ Refer to additional UpToDate topics on the systemic treatment of advanced BCCs and cSCCs not amenable to local therapies for detailed discussion of immunotherapy and systemic therapies.
Reference:
National Comprehensive Cancer Network (NCCN) Guidelines in Oncology: Squamous Cell Skin Cancer. Version 1.2021. Available at: https://www.nccn.org (Accessed on July 2, 2021).
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