High Risk Head and Neck Cutaneous Squamous Cell Carcinoma Treated With Mohs Surgery or Mohs Surgery and Adjuvant Radiation Therapy

Anker, Christopher J.; Sajisevi, Mirabelle; Cintolo-Gonzalez, Jessica; Bax, Daniel; Chen, D L; Goldman, Glenn D.; Holmes, Todd E.; Leonard, K W; Rehman, Hibba tul; Self, Quinn; Weinberger, Christine H.; Bui, Melanie R.

doi:10.1016/j.ijrobp.2021.07.970

Cited by 2 publications

(6 citation statements)

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“…Extensive documentation shows that ART improves locoregional control of metastatic SCC, including for ITM following the surgical removal of visible lesions. 1,16,18,30,64,70,76,[94][95][96][97][98][99][100] High-risk SCC should be surgically excised if possible and ART considered for perineural invasion or if other at high-risk features are present. 1,18,95 ART for recurrent SCC of the head and neck is reported to improve 5-year-recurrence-free interval (78% vs. 30%) and overall survival (79% vs. 46%), compared to surgery alone.…”

Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

“…1,14,64,76,94,[96][97][98][99]101 These include reports of benefit following Mohs surgery, with or without identified perineural disease. 25,[96][97][98]102,103 The process of lymphatic micrometastasis appears similar for high-risk SCC as for melanoma and MCC and extended treatment approaches are gaining increasing support. 64,94…”

Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

“…72,95 ART has been occasionally recommended for nodes without identifiable metastasis following surgical removal of the primary site lesion for certain high-risk SCC. 1,14,64,76,94,[96][97][98][99]101 These include reports of benefit following Mohs surgery, with or without identified perineural disease. 25,[96][97][98]102,103 The process of lymphatic micrometastasis appears similar for high-risk SCC as for melanoma and MCC and extended treatment approaches are gaining increasing support.…”

Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

“…Extensive documentation shows that ART improves locoregional control of metastatic SCC, including for ITM following the surgical removal of visible lesions 1,16,18,30,64,70,76,94–100 . High‐risk SCC should be surgically excised if possible and ART considered for perineural invasion or if other at high‐risk features are present 1,18,95 .…”

Section: Radiotherapymentioning

confidence: 99%

“…More extensive lists of potential indications have been published supporting the routine use of adjunctive RT for advanced or recurrent SCC 72,95 . ART has been occasionally recommended for nodes without identifiable metastasis following surgical removal of the primary site lesion for certain high‐risk SCC 1,14,64,76,94,96–99,101 . These include reports of benefit following Mohs surgery, with or without identified perineural disease 25,96–98,102,103 .…”

Section: Radiotherapymentioning

confidence: 99%

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The role of micrometastasis in high‐risk skin cancers

Sinclair,

Wong,

Shumack

et al. 2023

Aust J Dermatology

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The propensity to metastasize is the most important prognostic indicator for solid cancers. New insights into the mechanisms of early carcinogenesis have revealed micrometastases are generated far earlier than previously thought. Evidence supports a synergistic relationship between vascular and lymphatic seeding which can occur before there is clinical evidence of a primary tumour. Early vascular seeding prepares distal sites for colonisation while regional lymphatics are co‐opted to promote facilitative cancer cell mutations. In response, the host mounts a global inflammatory and immunomodulatory response towards these cells supporting the concept that cancer is a systemic disease. Cancer staging systems should be refined to better reflect cancer cell loads in various tissue compartments while clinical perspectives should be broadened to encompass this view when approaching high‐risk cancers. Measured adjunctive therapies implemented earlier for low‐volume, in‐transit cancer offers the prospect of preventing advanced disease and the need for heroic therapeutic interventions. This review seeks to re‐appraise how we view the metastatic process for solid cancers. It will explore in‐transit metastasis in the context of high‐risk skin cancer and how it dictates disease progression. It will also discuss how these implications will influence our current staging systems and its consequences on management.

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Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

Section: Use In Squamous Cell Carcinomamentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

See 3 more Smart Citations

The role of micrometastasis in high‐risk skin cancers

Sinclair,

Wong,

Shumack

et al. 2023

Aust J Dermatology

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Rapidly Growing and Aggressive Squamous Cell Carcinoma of the Forearm: A Report of Successful Treatment With Mohs Surgery and Complex Reconstruction With Rhombic Triple Z-Plasty

Ezaldein

2024

Cureus

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Reconstruction of complex post-surgical wounds requires functional and aesthetic considerations. We present a case of a complex radial-dorsal forearm defect in a patient who underwent Mohs surgery for an aggressive and rapidly growing squamous cell carcinoma. Following complete tumor excision, we utilized a modified rhombic flap for complete wound coverage with long-term conservation of extensor function. The rhombic flap modification included three Z-plasties at the flap base to add rotational components to the flap transposition. Long-term follow-up showed acceptable cosmesis, preserved extensor tendon function, and no evidence of tumor recurrence.

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High Risk Head and Neck Cutaneous Squamous Cell Carcinoma Treated With Mohs Surgery or Mohs Surgery and Adjuvant Radiation Therapy

Abstract: volumes and large number of patients receiving prior treatments, the acute and late toxicities were relatively low in this cohort.

Cited by 2 publications

References 0 publications

The role of micrometastasis in high‐risk skin cancers

The role of micrometastasis in high‐risk skin cancers

Rapidly Growing and Aggressive Squamous Cell Carcinoma of the Forearm: A Report of Successful Treatment With Mohs Surgery and Complex Reconstruction With Rhombic Triple Z-Plasty

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