Peri-Operative Management of High-Risk CSCC

The presentation focuses on the preoperative management of high-risk cutaneous squamous cell carcinoma (CSCC), discussing current practices and considerations for patient treatment. The speaker engages the audience through a series of interactive questions to assess their experiences with CSCC diagnosis and treatment. A patient case is introduced, highlighting the diagnostic approach, including imaging and sentinel lymph node biopsy recommendations based on the tumor's characteristics and staging systems. Current guidelines, specifically from the NCCN, suggest using imaging to evaluate potential metastasis and considering sentinel lymph node biopsies in cases of high-risk tumors. The discussion extends to neoadjuvant therapy's efficacy, detailing a study where 79 high-risk patients were treated with anti-PD-1 therapy, resulting in significant pathological response rates. While the approach shows promise, the safety profile raised concerns about potential adverse events, especially in older populations with pre-existing conditions. The presentation also addresses postoperative management strategies, including the potential use of radiation and systemic therapy, though the latter's role requires further exploration. In summary, the evolving landscape of perioperative management for high-risk CSCC emphasizes the integration of neoadjuvant therapies and individualized treatment plans while addressing the need for additional research to optimize patient outcomes.