Guidelines for the excision of cutaneous squamous cell cancers in the United Kingdom: The best cut is the deepest

Khan, Aadil; Potter, Matthew; Cubitt, Jonathan; Khoda, Ben; Smith, Joel; Wright, Edmund; Scerri, G.V.; Crick, A.; Cassell, Oliver; Budny, P.G.

doi:10.1016/j.bjps.2012.12.016

Cited by 40 publications

(55 citation statements)

References 11 publications

(4 reference statements)

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“…This percentage is in the range of the data reported in the literature, in which the involvement of margins was between 11 and 27.9% [8,10,16,17]. Khan et al [14] reported rates of incomplete excision of 7.6% in the series overall and of 7.9% in those >2 cm. Further, 94% of incomplete excision margins were at the deep margin, while only 0.47% involved the lateral margins.…”

Section: Discussion and Review Of The Literaturesupporting

confidence: 71%

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Squamocellular Carcinoma of the Skin: Clinicopathological Features Predicting the Involvement of the Surgical Margins and Review of the Literature

et al. 2016

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Background: The new AJCC classification has highlighted some particular risk factors for squamous cell carcinoma (SCC) relevant for prognosis. Incomplete excision is not infrequent in SCC. The aim of this study is to examine features that can predict an incomplete excision on the basis of the new AJCC classification and to review the literature on this topic. Materials and Methods: 81 SCC patients were included. All patients were submitted to excisional biopsy with a margin of at least 4 mm from the clinical edges as recommended. Histological characteristics of the lesions analysed were maximum diameter, grading, site, Breslow thickness, Clark level, deep tissue invasion (neural, bone, muscle), presence of ulceration and positivity of the margins. Results: The average Breslow thickness was 3.93 mm. Out of the 81 patients included, 14 showed involved margins. The 2 parameters that were implicated in predicting involvement of the margins in the multivariable model were Breslow thickness and location of the lesion on the ear or lip. Grading was not associated with involvement of margins. Conclusion: According to the new AJCC classification, this study could be useful to plan the most suitable surgical technique in order to avoid the risk of incomplete surgery.

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Section: Discussion and Review Of The Literaturesupporting

confidence: 71%

“…Khan et al [14] reported a greater thickness in their series, with an average of 5.1 mm in the whole population and 5.9 mm in those >2 cm. The same authors' decision led them to recommend high rates of suspicious lesions excised in high-risk areas such as the ear, nose and cheek.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Squamocellular Carcinoma of the Skin: Clinicopathological Features Predicting the Involvement of the Surgical Margins and Review of the Literature

et al. 2016

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“…10,12 Rates of incomplete excision range from 5 to 17.6%, with a particular association with high-risk areas of the head and neck. [45][46][47][48][49] Positive findings on reexcision of incompletely excised cSCC have been associated with a 10-fold increased risk of recurrence when compared with negative reexcision margins in a 5-year prospective study from Bovill et al…”

Section: High-risk Pathological Featuresmentioning

confidence: 99%

“…55 Caution should be applied to ensure that the deep excision margin extends to the hypodermis, macroscopically deep to tumor, as the majority of positive margins occur at the deep margin. 48,55 Where possible neural structures, for example, perichondrium or periostium, should not be disturbed. 48 Neck dissection should be performed in cases of cervical nodal involvement, with priority given to dissection of levels I and II, where the majority of metastases occur.…”

Section: Conventional Surgical Excisionmentioning

confidence: 99%

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High-risk Cutaneous Squamous Cell Carcinoma

Fitzgerald¹,

O’Neill²

2017

International Journal of Head and Neck Surgery

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Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer worldwide. Cutaneous squamous cell carcinoma can potentially be treated fully with minimal morbidity when detected early; however, certain subtypes of cSCC have been shown to confer a poorer prognosis for patients. In these high-risk tumors, increased incidence of recurrence, as well as metastasis to local lymph nodes and distant sites, is seen as a result of certain patient characteristics and pathological features. While guidelines regarding the management of high-risk cSCC have been produced, no clear consensus management or prognostic algorithms exist. In this review, we discuss current definitions of high-risk cSCC, recommendations regarding the management of cSCC, and current guidelines.

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