Advances in the management of cutaneous squamous cell carcinoma

Abstract

Cutaneous squamous cell carcinoma is one of the most common non-melanoma skin cancers worldwide. While most cutaneous squamous cell carcinomas are easily managed, there is a high-risk subset of tumors that can cause severe morbidity and mortality. Tumor characteristics as well as patient characteristics contribute to the classification of cutaneous squamous cell carcinomas as low-risk vs. high-risk. Advances in the treatment of cutaneous squamous cell carcinomas largely relate to the management of this high-risk subset. Surgical and non-surgical management options, including newer targeted molecular therapies, will be discussed here. Larger, multicenter studies are needed to determine the exact significance of individual risk factors with respect to aggressive clinical behavior and the risks of metastasis and death, as well as the role of surgical and adjuvant therapies in patients with high-risk cutaneous squamous cell carcinomas.

Malignant proliferating trichilemmal tumour

“…In contrast, the treatment algorithm for SCCs is more established, with either surgery or radiotherapy used as first-line treatment, followed by adjuvant chemotherapy, molecular therapy or additional radiotherapy depending on staging 26. Misdiagnosing MPTT as SCC could alter management and prognosis.…”

Downregulation of kynureninase restrains cutaneous squamous cell carcinoma proliferation and represses the PI3K/AKT pathway

“…2 Most patients with cSCC will have a good prognosis if the lesion is completely excised by surgery; however, there is a subsection (about 4%) of lesions that metastasize, and 1.5% of patients will die from the disease. 2,3 Brunner et al reported that of 603 patients with metastatic cSCC, 89% of patients with distant metastasis died within 5 years. 4 Hence, other effective treatments are also necessary for cSCC.…”

“…5 However, it carries a number of adverse effects such as soft-tissue necrosis, epidermal atrophy and radiation-induced malignancy, which some patients with cSCC may not be able to tolerate. 3 Chemotherapy is another frequently used method for the treatment of metastatic cSCC, and includes drugs such as cisplatin, bleomycin, doxorubicin and methotrexate, alone or combined with 5-fluorouracil. 6,7 However, the results are inconsistent and an effective chemotherapeutic method is still lacking.…”

Atypisches Ansprechen mit Pseudoprogression im Knochen unter Nivolumab bei einem Patienten mit fortgeschrittenem kutanem Plattenepithelkarzinom

“…Wegen der hohen Strahlensensitivität des cSCC kann diese Therapiemodalität für Patienten in Betracht gezogen werden, die für eine operative Behandlung nicht infrage kommen, sowie für Patienten mit lokal fortgeschrittener Erkrankung oder in Situationen, in denen eine Exzision mit anschließender Rekonstruktion kosmetisch/funktionell inakzeptabel ist. Darüber hinaus ist eine Strahlentherapie mit adjuvanter Zielsetzung häufig in Fällen indiziert, in denen die Tumorränder positiv sind, sowie bei Vorliegen einer perineuralen Invasion oder Beteiligung benachbarter Strukturen oder bei Rezidiven [4]. …”