Detection of subclinical disease with baseline and surveillance imaging in high-risk cutaneous squamous cell carcinomas

Maher, Jacqueline; Schmults, Chrysalyne D.; Murad, Fadi; Karia, Pritesh S.; Benson, Carol B.; Ruiz, Emily S.

doi:10.1016/j.jaad.2019.10.067

Cited by 21 publications

(20 citation statements)

References 14 publications

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“…More concerning is that a large number of respondents are not using either system to drive their decision to perform radiologic imaging, SLNB, adjuvant radiation therapy, adjuvant systemic therapy, or increased follow‐up. There is no clear consensus about how to utilize T staging to drive management despite evidence of the benefit of additional interventions in HRCSCC 23,24 . Uncertainty is expected given the inconsistent risk estimates by T stage 19,20 .…”

Section: Discussionmentioning

confidence: 99%

“…There is no clear consensus about how to utilize T staging to drive management despite evidence of the benefit of additional interventions in HRCSCC. 23 , 24 Uncertainty is expected given the inconsistent risk estimates by T stage. 19 , 20 Furthermore, the scarcity of staging system implementation in clinical practice may be compounded by the high incidence of CSCC, together with the T stage heterogeneity, as well as the potential lack of concern or knowledge about this tumor compared with melanoma.…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous squamous cell carcinoma staging may influence management in users: A survey study

et al. 2021

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Purpose This study aims to determine whether there is consensus regarding staging and management of cutaneous squamous cell carcinoma (CSCC) across the various specialties that manage this disease. Materials and Methods A survey regarding CSCC high‐risk features, staging, and management was created and emailed to cutaneous oncology experts including dermatology, head and neck surgery/surgical oncology, radiation oncology, and medical oncology. Results One hundred fifty‐six (46%) of 357 invited physicians completed the survey. Depth of invasion (92%), perineural invasion (99%), histologic differentiation (85%), and patient immunosuppression (90%) achieved consensus (>80%) as high‐risk features of CSCC. Dermatologists were more likely to also choose clinical tumor diameter (79% vs. 54%) and histology (99% vs. 66%) as a high‐risk feature. Dermatologists were also more likely to utilize the Brigham and Women's Hospital (BWH) staging system alone or in conjunction with American Joint Committee on Cancer (AJCC) (71%), whereas other cancer specialists (OCS) tend to use only AJCC (71%). Respondents considered AJCC T3 and higher (90%) and BWH T2b and higher (100%) to be high risk and when they consider radiologic imaging, sentinel lymph node biopsy, post‐operative radiation therapy, and increased follow‐up. Notably, a large number of respondents do not use staging systems or tumor stage to determine treatment options beyond surgery in high‐risk CSCC. Conclusion This survey study highlights areas of consensus and differences regarding the definition of high‐risk features of CSCC, staging approaches, and management patterns between dermatologists and OCS. High‐risk CSCC is defined as, but not limited to, BWH T2b and higher and AJCC T3 and higher, and these thresholds can be used to identify cases for which treatment beyond surgery may be considered. Dermatologists are more likely to utilize BWH staging, likely because BWH validation studies showing advantages over AJCC were published in dermatology journals and discussed at dermatology meetings. Additional data are necessary to develop a comprehensive risk‐based management approach for CSCC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cutaneous squamous cell carcinoma staging may influence management in users: A survey study

et al. 2021

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“…This study recommends selective lymphadenectomy and postoperative radiotherapy for enlarged lymph nodes. Many reports agreed that negative node biopsy examination should be closely followed up, otherwise to proceed for prophylactic radiation therapy 44,50,52‐54 …”

Section: Discussionmentioning

confidence: 99%

“…Many reports agreed that negative node biopsy examination should be closely followed up, otherwise to proceed for prophylactic radiation therapy. 44 , 50 , 52 , 53 , 54 …”

Section: Discussionmentioning

confidence: 99%

Post‐burn scar malignancy: 5‐year management review and experience

Mousa

Elshenawy

Maklad

et al. 2021

International Wound Journal

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The study spotlights a severe uncommon post-burn complication, Marjolin's ulcer, in upper Egypt plastic and wound care centres. This problem is mainly related to inadequate medical care and awareness. No community or race is immune. The underlying malignant transformation mechanism remains unclear. The study aims, according to our experience, to review the prognostic factors through the management protocol of Marjolin's ulcers. This prospective study was conducted in the Aswan University Plastic & Burn surgery department in South Egypt between 2013 and 2020 and investigated 226 patients with chronic post-burn ulceration. Nineteen cases were proved to have Marjolin's

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“…Imaging is not recommended in the absence of concerning signs or symptoms but can be used similarly to high-risk squamous cell carcinomas. 33 Undifferentiated pleomorphic sarcoma (UPS) Undifferentiated pleomorphic sarcoma (UPS) is a superficial sarcoma primary to the skin which, although similar to AFX, is a 3).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous mesenchymal tumors treated with Mohs micrographic surgery: a comprehensive review

Rosenfeld

Cappel

Tolkachjov³

2021

Int J Dermatology

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Cutaneous mesenchymal tumors (CMT) are rare tumors with wide clinicopathologic heterogeneity. Treatment of malignant cutaneous mesenchymal tumors traditionally includes wide local excision (WLE), though Mohs micrographic surgery (MMS) has been increasingly used. A PubMed literature review of articles from inception until September 2019 related to malignant CMT and surgical treatment with MMS or WLE was completed.Dermatofibrosarcoma protuberans treated with MMS recurred in 1.2% of patients with no reported metastasis. Atypical fibroxanthoma treated with MMS recurred and metastasized in 2.7 and 2.5%, respectively. Undifferentiated pleomorphic sarcoma treated with MMS recurred in 32% with an unknown metastatic rate. Superficial leiomyosarcoma treated with MMS recurred in 3.8% with no reported metastasis. Cutaneous angiosarcoma and myofibrosarcoma treated with MMS have shown no recurrence or metastatic disease, but literature is sparse. The rarity of malignant CMT and the lack of comparative data on treatment make conclusive treatment recommendations difficult. However, recent literature suggests MMS is a useful option and potentially a superior treatment for primary cutaneous mesenchymal tumors. tumor of mesenchymal origin with an incidence of 0.8-4.2 cases per million persons per year. It accounts for 2-6% of all soft tissue sarcomas and is the most common skin sarcoma. [1][2][3][4] It often presents as a skin-colored, brown-yellow, nodule or plaque. Its

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Detection of subclinical disease with baseline and surveillance imaging in high-risk cutaneous squamous cell carcinomas

Cited by 21 publications

References 14 publications

Cutaneous squamous cell carcinoma staging may influence management in users: A survey study

Cutaneous squamous cell carcinoma staging may influence management in users: A survey study

Post‐burn scar malignancy: 5‐year management review and experience

Cutaneous mesenchymal tumors treated with Mohs micrographic surgery: a comprehensive review

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