Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8715296 | Journal of the American Academy of Dermatology | 2018 | 13 Pages |
Abstract
While the majority of cutaneous squamous cell carcinomas (cSCCs) can be treated surgically, the additional work-up and treatments indicated for high-risk cSCC remain undefined. In recent years, improvements in tumor staging systems have allowed for the more accurate stratification of tumors into high- and low-risk categories. This insight, along with the publication of cSCC guidelines, brings us closer to the development of a consensus approach. The second article in this continuing medical education series addresses in question and answer format the most common questions related to advanced and high-stage cSCCs, with a simplified flowchart. The questions include the following: 1) Does my patient have high-risk cSCC?; 2) What is the next step for patients with cSCC and palpable lymphadenopathy?; 3) In patients with no clinically evident lymphadenopathy, who are candidates for lymph node staging?; 4) What forms of radiologic imaging can help detect subclinical lymph node metastases?; 5) What is the role of sentinel lymph node biopsy in cSCC?; 6) Which patients with cSCC need adjuvant radiation therapy?; 7) Is adjuvant chemotherapy an option for patients with high-stage cSCC after surgery?; 8) Are targeted and immunologic therapies an option for advanced cSCC?; 9) How often should I follow up with my patient after he/she has been diagnosed with a high-risk cSCC?; 10) What are the options for chemoprophylaxis in a patient with an increased risk of cSCC?; and 11) What chemopreventive measures can be started in coordination with medical oncology or transplant physicians?
Keywords
EGFRNotch15-ALANivolumabCDKN2ASLNBCSCCBWHRASingenol mebutatePDTPD-1p535-FU5-Aminolevulinic acidAcitretinMRIImiquimodBrigham and Women's HospitalMagnetic resonance imagingcomputed tomographyPhotodynamic therapyRetinoidsHigh-riskCetuximabSirolimusChemotherapyClassificationRisk factors5-fluorouracilManagementStagingSentinel lymph node biopsyNicotinamideARTAdjuvant radiation therapyRadiation therapyPembrolizumabcutaneous squamous cell carcinomaActinic keratosisAmerican Joint Commission on CancerCapecitabineEpidermal growth factor receptor
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Authors
Syril Keena T. MD, Fiona O. MD, Chrysalyne D. MD, MSCE,