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Consensus for Nonmelanoma Skin Cancer Treatment, Part II: Squamous Cell Carcinoma, Including a Cost Analysis of
Arielle N B Kauvar1, Christopher J Arpey, George Hruza
1*New York University School of Medicine, New York, New York; †New York Laser & Skin Care, New York, New York; ‡Mayo Clinic, Rochester, Minnesota; §St. Louis University, St Louis, Missouri; ‖Laser & Dermatologic Surgery Center, Chesterfield, Missouri; ¶Lahey Clinic; Associate Professor, Harvard Medical School, Boston, Massachusetts; #David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; **Keck School of Medicine, University of Southern California, Los Angeles, California.
For cutaneous squamous cell carcinoma (cSCC), Mohs surgery offers the best cure rates and cosmetic outcomes. While other treatments exist, surgery is preferred for high-risk cSCC, balancing cure with patient factors.
Area of Science:
- Oncology
- Dermatology
- Surgical Oncology
Background:
- Cutaneous squamous cell carcinoma (cSCC) is a prevalent cancer in the US, with over 700,000 cases annually.
- cSCC carries a significant risk of metastasis, estimated at 5%.
Purpose of the Study:
- To establish clinical guidelines for managing cSCC.
- Guidelines are based on a comprehensive literature review and expert consensus.
Main Methods:
- Extensive review of medical literature on cSCC treatments.
- Evaluation of cure rates, recurrence, metastasis, aesthetics, function, and cost-effectiveness.
Main Results:
- Surgical treatments yield optimal outcomes for cSCC.
- Mohs micrographic surgery provides the highest cure rates, tissue preservation, and cosmetic results.
- Nonsurgical options are suitable for low-risk cSCC but have lower cure rates.
Conclusions:
- Cure rate is paramount in treatment selection for cSCC.
- Patient condition, psychosocial factors, tumor location, and cost-effectiveness are also critical considerations.
- Mohs surgery is the preferred method for high-risk and cosmetically sensitive cSCC cases.
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