European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment–Update 2023

Stratigos, Alexander J.; Garbe, Claus; Dessinioti, Clio; Lebbe, Célèste; Akkooi, Alexander C. J. van; Bataille, Véronique; Bastholt, Lars; Dréno, Brigitte; Dummer, Reinhard; Fargnoli, Maria Concetta; Forsea, Ana Maria; Harwood, Catherine A.; Hauschild, Axel; Höeller, Christoph; Kandolf-Sekulovic, Lidija; Kaufmann, Roland; Kelleners‐Smeets, Nicole W.J.; Lallas, Aimilios; Leiter, Ulrike; Malvehy, Josep; Marmol, Véronique Del; Moreno‐Ramírez, D.; Pellacani, Giovanni; Peris, Ketty; Saïag, Philippe; Tagliaferri, Luca; Trakatelli, M.; Ioannides, Dimitrios; Vieira, Ricardo; Zalaudek, Iris; Arenberger, Petr; Eggermont, Alexander; Röcken, Martin; Grob, Jean‐Jacques; Lorigan, Paul

doi:10.1016/j.ejca.2023.113252

Cited by 13 publications

(34 citation statements)

References 213 publications

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“…Moreover, it can be performed as a palliative treatment in patients with locoregional recurrences or metastases. The aims of treatment in this case are control of symptoms, improve the quality of life, reduce new cancer related symptoms, and prolong overall survival 7 , 8 .…”

Section: Indicationsmentioning

confidence: 99%

Electrochemotherapy as palliative care in patients with local or metastatic recurrence of head and neck cancer: review of state of the art

Cariti,

Caivano,

de Robertis

et al. 2024

Acta Otorhinolaryngol Ital

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SUMMARY Head and neck cancers are mostly represented by squamous cell carcinoma. Despite effective treatment of primary tumours, local recurrences and metastases are frequent, with up to a 60% risk of local and 30% of distant failure. Moreover, second primary tumours sometimes occur in these patients (2-3% per year). Treatment of recurrences, metastases, and second primary tumours can be extremely challenging for Otorhinolaryngologists, especially in patients who have already been treated with radiotherapy, previous surgery, or both. Electrochemotherapy represents an effective and valid option in these cases.

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Section: Indicationsmentioning

confidence: 99%

Electrochemotherapy as palliative care in patients with local or metastatic recurrence of head and neck cancer: review of state of the art

Cariti,

Caivano,

de Robertis

et al. 2024

Acta Otorhinolaryngol Ital

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“…The standard treatment for invasive SCC is surgical removal, ensuring appropriately safe margins of macroscopically normal skin, followed by postoperative histologic examination with scrupulous margins assessment [ 5 , 17 ▪▪ ]. Intraoperative frozen sections are useful to ensure clear resection margins, especially in high-risk cases.…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

“…For high-risk SCCs, wider margins are recommended, varying between 6 and 13 mm according to different guidelines [ 5 , 21 – 24 ]. The European consensus group suggests safe margins range from 6 to 10 mm, while the latest 2024 National Comprehensive Cancer Network (NCCN) guidelines recommend determining margin adequacy on a case-by-case basis, factoring in tumor and patient-specific features [ 12 , 17 ▪▪ , 23 ]. This approach is particularly relevant in the head and neck area, where achieving wide resection margins without compromising important structures and functions can be challenging.…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

“…For cutaneous SCCs not suitable for surgery due to invasion of vital structures or patient-related factors, definitive radiotherapy should be considered based on multidisciplinary evaluation [ 17 ▪▪ ]. The level of evidence supporting the efficacy of radiotherapy in the adjuvant setting is limited, with mostly retrospective data available.…”

Section: Radiotherapymentioning

confidence: 99%

“…The level of evidence supporting the efficacy of radiotherapy in the adjuvant setting is limited, with mostly retrospective data available. However, in advanced cases, it often becomes the sole alternative, whether used in combination with systemic therapies including immunotherapy, CHT, or targeted therapies, or not [ 17 ▪▪ ]. Adjuvant radiotherapy can represent an alternative in cases with positive tumor margins at definitive histologic examination.…”

Section: Radiotherapymentioning

confidence: 99%

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Head and neck nonmelanoma skin cancers: surgical management and debated issues

Rampinelli,

Pinacoli,

Piazza

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and neck nonmelanoma skin cancers (NMSCs), focusing on squamous, basal, and Merkel cell carcinomas. Recent findings Recent developments underscore the complexity of treatment for NMSC, particularly in the head and neck region. There is a lack of high-level evidence for the management of these tumors, especially in advanced stages. The need to tailor the extent of surgical margins and parotid/neck management to different histotypes, considering the varying risk factors for recurrence, is beginning to emerge in the literature. Moreover, the role of immunotherapy and targeted therapies for locally advanced disease, alongsi de traditional treatment options, is progressively growing. Summary NMSCs represent a heterogeneous group of malignancies with varying treatment complexities and prognoses. Management of NMSC is evolving towards an increasingly personalized strategy within a multidisciplinary therapeutic framework.

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Long-term survival after anti-PD-1 discontinuation in advanced cutaneous squamous cell carcinoma (cSCC): a proof of concept of benefit of concomitant cemiplimab and radiotherapy

Bailly-Caillé,

Levard,

Kottler

et al. 2024

Cancer Immunol Immunother

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Background In a princeps study we conducted in patients with advanced cutaneous squamous cell carcinoma treated with concomitant anti-Programmed cell death protein 1 (PD-1) and radiotherapy, we demonstrated a clinico radiological response to cemiplimab that appeared to persist over time, 1 year after treatment discontinuation. Method We conducted a single-center descriptive study at Caen Hospital from September 1, 2021 to September 2023, in 14 patients with advanced carcinoma treated with cemiplimab until September 1, 2021. The aim of this update is to examine clinical and radiological follow-up 2 years after discontinuation of cemiplimab. Results Of the 12 patients with a partial or complete response, we report 8 (66.7%) persistent responses 2 years after stopping cemiplimab, with only 2 patients progressing to distant disease, one lost to follow-up, and one death a priori unrelated to the disease. Conclusion Our study confirms a long-term and persistent effect despite discontinuation of cemiplimab at least up to 2 years later.

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European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment–Update 2023

Cited by 13 publications

References 213 publications

Electrochemotherapy as palliative care in patients with local or metastatic recurrence of head and neck cancer: review of state of the art

Electrochemotherapy as palliative care in patients with local or metastatic recurrence of head and neck cancer: review of state of the art

Head and neck nonmelanoma skin cancers: surgical management and debated issues

Long-term survival after anti-PD-1 discontinuation in advanced cutaneous squamous cell carcinoma (cSCC): a proof of concept of benefit of concomitant cemiplimab and radiotherapy

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