Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

Area of Science:

• Oncology
• Radiology
• Immunotherapy

Background:

• Nonmelanoma skin cancer (NMSC) incidence and mortality are increasing, posing challenges for radiologists in managing advanced cases.
• Systemic treatments and phototherapy can elevate NMSC risk, highlighting the need for precise risk stratification.
• Immunotherapy has transformed cancer treatment but introduces complexities like atypical responses and immune-related adverse events.

Purpose of the Study:

• To underscore the need for advanced imaging-based risk stratification and staging methods for nonmelanoma skin cancer (NMSC).
• To emphasize the critical role of radiologists in assessing immunotherapy treatment response and managing immune-related adverse events.
• To highlight the importance of understanding radiologic features for optimizing patient prognosis and management in the era of immunotherapy.

Main Methods:

• Review of current challenges in diagnosing and staging advanced nonmelanoma skin cancer (NMSC).
• Evaluation of imaging modalities like PET/CT for metastasis detection and post-surgical surveillance.
• Discussion of the impact of immunotherapy on radiological interpretation, including atypical responses and adverse events.

Main Results:

• PET/CT demonstrates superior sensitivity for detecting nodal and distant metastasis compared to CT and MRI.
• Immunotherapy has improved patient treatment response, necessitating standardized evaluation criteria.
• Radiologists face new challenges in identifying atypical response patterns, pseudo-progression, and immune-related adverse events.

Conclusions:

• Improved diagnostic imaging and risk stratification are crucial for managing rising nonmelanoma skin cancer (NMSC) rates.
• Radiologists require specialized knowledge of tumor characteristics and immunotherapy effects to accurately assess treatment response and adverse events.
• Early identification of imaging findings is essential for optimizing patient prognosis and management in advanced NMSC treated with immunotherapy.