Cutaneous squamous cell carcinoma : Management of advanced and high-stage tumors - 13/01/18
Abstract |
While the majority of cutaneous squamous cell carcinomas (cSCCs) can be treated surgically, the additional work-up and treatments indicated for high-risk cSCC remain undefined. In recent years, improvements in tumor staging systems have allowed for the more accurate stratification of tumors into high- and low-risk categories. This insight, along with the publication of cSCC guidelines, brings us closer to the development of a consensus approach. The second article in this continuing medical education series addresses in question and answer format the most common questions related to advanced and high-stage cSCCs, with a simplified flowchart. The questions include the following: 1) Does my patient have high-risk cSCC?; 2) What is the next step for patients with cSCC and palpable lymphadenopathy?; 3) In patients with no clinically evident lymphadenopathy, who are candidates for lymph node staging?; 4) What forms of radiologic imaging can help detect subclinical lymph node metastases?; 5) What is the role of sentinel lymph node biopsy in cSCC?; 6) Which patients with cSCC need adjuvant radiation therapy?; 7) Is adjuvant chemotherapy an option for patients with high-stage cSCC after surgery?; 8) Are targeted and immunologic therapies an option for advanced cSCC?; 9) How often should I follow up with my patient after he/she has been diagnosed with a high-risk cSCC?; 10) What are the options for chemoprophylaxis in a patient with an increased risk of cSCC?; and 11) What chemopreventive measures can be started in coordination with medical oncology or transplant physicians?
Le texte complet de cet article est disponible en PDF.Key words : 5-fluorouracil, imiquimod, ingenol mebutate, acitretin, American Joint Commission on Cancer, Brigham and Women's Hospital staging system, capecitabine, CDKN2A, cetuximab, chemotherapy, classification, cSCC, CT, cutaneous squamous cell carcinoma, familial cancer syndromes, high-risk, management, MRI, N1S3 staging, nicotinamide, nivolumab, NOTCH1, p53, PD-1, pembrolizumab, photodynamic therapy, radiation therapy, Ras, retinoids, risk factors, sentinel lymph node biopsy, sirolimus, staging
Abbreviations used : 5-ALA, 5-FU, AJCC-8, AK, ART, BWH, cSCC, CT, EGFR, MRI, PDT, SLNB
Plan
Funding sources: None. |
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Dr Schmults was involved in the development of the Brigham and Women's tumor staging system for cutaneous squamous cell carcinoma. Drs Que and Zwald have no conflicts of interest to declare. |
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Reprints not available from the authors. |
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Date of release: February 2018 |
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Expiration date: February 2021 |
Vol 78 - N° 2
P. 249-261 - février 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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