[Cutaneous squamous cell carcinoma]

Area of Science:

• Oncology
• Dermatology
• Cancer Research

Background:

• Cutaneous squamous cell carcinoma (cSCC) is a prevalent cancer among Caucasians, representing 20% of all skin tumors.
• A German S3 guideline for cSCC management has been established since 2019.
• Accurate diagnosis relies on clinical examination, with excision and histological confirmation crucial for prognosis and treatment planning.

Purpose of the Study:

• To summarize current diagnostic and therapeutic strategies for cutaneous squamous cell carcinoma (cSCC) based on the German S3 guideline.
• To outline treatment options for various stages of cSCC, including primary, recurrent, and metastatic disease.
• To provide guidance on risk-adapted follow-up care for cSCC patients.

Main Methods:

• Diagnosis is primarily clinical, confirmed by histological examination post-excision.
• First-line treatment involves complete surgical excision with margin control.
• Risk stratification guides decisions on sentinel lymph node biopsy, adjuvant radiation, and electrochemotherapy for recurrence.

Main Results:

• Complete excision with histological margin control is the primary therapy.
• Sentinel lymph node biopsy's role in cSCC requires further evidence.
• Adjuvant radiation and electrochemotherapy are options for high-risk or recurrent cases.
• Cemiplimab is approved for inoperable or metastatic cSCC; alternative systemic therapies (chemotherapy, EGFR inhibitors) or palliative radiotherapy are options when indicated, preferably within clinical trials.
• Risk-adapted follow-up includes dermatological checks and ultrasound for high-risk patients.

Conclusions:

• Complete surgical excision is the cornerstone of cSCC treatment.
• Systemic therapies, including immune checkpoint inhibitors, offer options for advanced or metastatic cSCC.
• Risk-adapted follow-up is essential for monitoring and managing cSCC patients.