Management of cutaneous squamous cell carcinoma: A literature review and update

Cutaneous squamous cell carcinoma (cSCC) is the second most common keratinocyte carcinoma after basal cell carcinoma and accounts for 20% to 50% of all keratinocyte carcinomas. While most cSCCs are low risk, a subset is associated with a higher likelihood of poor outcomes, including recurrence, metastasis, and death. The majority of low-risk tumors may be cured with surgical treatment alone. However, high-risk tumors require more aggressive therapy. Here, we provide an evidence-based update surrounding the evaluation and management of cSCC. We discuss the approach to a suspicious lesion risk stratification, role of imaging and sentinel lymph node biopsy, and treatment recommendations stratified by risk. Additionally, we discuss evidence surrounding newer prognostic tools such as the gene expression profiles. Proper risk stratification of cSCCs can guide treatment decisions and management, and identify those tumors that may benefit from more aggressive therapy.