European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2....

Area of Science:

• Dermato-oncology
• Clinical oncology
• Evidence-based medicine

Background:

• Invasive cutaneous squamous cell carcinoma (cSCC) requires updated treatment guidelines.
• A multidisciplinary expert panel was convened to address this need.
• Existing recommendations needed consolidation and evidence-based updates.

Purpose of the Study:

• To update recommendations for treatment, supportive care, education, and follow-up of patients with invasive cSCC.
• To provide a comprehensive, evidence-based framework for managing cSCC.
• To standardize care across different stages and risk profiles of cSCC.

Main Methods:

• An evidence-based literature review was conducted.
• Existing guidelines were analyzed.
• Expert consensus was achieved through a multidisciplinary panel.

Main Results:

• First-line treatment for primary cSCC involves surgical excision or micrographically controlled surgery.
• Adjuvant radiotherapy shows limited benefit for high-risk localized cSCC with clear margins.
• Anti-PD-1 agents are recommended as first-line systemic treatment for unresectable or metastatic cSCC.
• Lymph node dissection is advised for confirmed regional nodal metastasis.
• Multidisciplinary board decisions are crucial for advanced cSCC management.

Conclusions:

• Updated recommendations cover a spectrum of cSCC, from primary to metastatic disease.
• Surgical management is key for resectable cSCC, while radiotherapy serves non-surgical candidates.
• Systemic therapies, including anti-PD-1 agents, are vital for advanced cSCC.
• Shared decision-making, supportive care, and tailored follow-up are integral to patient management.