KEY TAKEAWAYS
- The study aimed to compare recently published US guidelines for managing cSCC and cBCC.
- US guidelines offer current guidance on cBCC and cSCC, highlighting research needs in staging, adjuvant treatment, nerve invasion, and systemic therapy.
Management guidelines for cutaneous squamous cell carcinoma (cSCC) and cutaneous basal cell carcinoma (cBCC) vary, necessitating a comparative analysis of current US recommendations.
Amit Mittal and his team spearheaded the study that aimed to compare recently published US guidelines for managing cSCC and cBCC.
The study conducted a PubMed database search spanning from June 1, 2016, to December 1, 2022. A thorough comparison was undertaken across key clinical domains, including staging and risk assessment, curative management of primary tumors and regional nodes, and palliative care strategies.
The guidelines from the American Academy of Dermatology (AAD), National Comprehensive Cancer Network (NCCN), and American Society for Radiation Oncology (ASTRO) were reviewed. Methodologies for grading evidence differed, posing challenges for comparison. Consensus favored surgery as the preferred treatment for curative management of cBCC and cSCC.
The definitive radiation was recommended for surgery-ineligible patients. AAD and NCCN suggested exploring topical modalities for select low-risk cBCC cases. Postoperative radiation therapy (PORT) was universally endorsed for patients with positive margins or nerve invasion, although the definition and extent of nerve invasion varied. Surgery was unanimously advocated as the primary treatment for lymph node metastases in curative settings. Criteria for recommending PORT varied; NCCN and ASTRO considered factors like lymph node size, number, and extracapsular extension. Both NCCN and ASTRO recommended systemic treatment in conjunction with PORT for patients with extracapsular extension.
The study found that the contemporary US guidelines offer comprehensive insights into managing cBCC and cSCC, highlighting research gaps in staging, adjuvant treatment indications, nerve invasion, prognosis, and systemic therapies.
Source: https://www.hindawi.com/journals/jsc/2024/3859066/
Mittal A, Mittal BB. (2024) “Comparative Analysis of US Guidelines for the Management of Cutaneous Squamous Cell and Basal Cell Carcinoma”, Journal of Skin Cancer, vol. 2024, Article ID 3859066, 12 pages, 2024. https://doi.org/10.1155/2024/3859066.
