Abstract | April 4, 2022
Squamous Cell Carcinoma: 2021 Updated Review of Treatment
- Review diagnosis of squamous cell carcinoma, including previous and new methods of grading and staging;
- Define current and future guidelines for the treatment of squamous cell carcinoma, including devices and immune checkpoint inhibitors, and prevention of recurrence;
- List the current clinical trials in progress, including proposed targets and indications, and discuss ongoing research on specific factors, such as genetic and genomic variants, that may be targeted.
Background/Knowledge Gap: Squamous cell carcinoma (SCC) is the second most common cutaneous malignancy after basal cell carcinoma and has an increasing prevalence worldwide. SCC requires early diagnosis to prevent metastasis. Cumulative sun exposure has been shown to increase the odds of SCC over time. Furthermore, immunosuppression from organ transplantation has been shown to add to tumorigenesis and constant inflammation.
Methods/Design: Updated guidelines in the definition of clinical features, diagnostic modalities, grading, staging, surgical, and nonsurgical treatment methods are necessary. Diagnostic methods from biopsy, dermoscopy, and reflectance confocal microscopy (RCM) have improved to include high-frequency ultrasonography, optical coherence tomography (OCT), and computed tomography. Non-surgical treatment methods include topical therapy, cryosurgery, photodynamic therapy, and radiation. Surgical treatment methods include surgical excision with margins and Mohs surgery.
Results/Findings: The National Comprehensive Cancer Network (NCCN) differentiates low and high-risk SCC using tumor information including location, size, borders, primary vs. recurrent, immunosuppression, site of prior radiation therapy or chronic inflammatory process, rapid growth, and neurologic symptoms. The AJCC staging for head and neck cutaneous SCC includes T0-T4 staging.
Conclusions/Implications: Clinical trials encourage further research to address the knowledge base of genetic variations and lymph node metastasis. The increased use of immune checkpoint inhibitors and anti-epidermal growth factor receptors for advanced and high-risk SCC decrease metastatic risk.
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