Staging, Work-up and Management of High Risk Cutaneous Squamous Cell Carcinoma

In this presentation on high-risk cutaneous squamous cell carcinoma (SCC), Dr. Ashley Weisong emphasizes the significance of understanding prognostic risk factors beyond traditional staging systems. SCC is prevalent in the United States, with approximately one million cases treated annually. Dr. Weisong highlights the need for improved predictive measures for aggressive forms of the disease, noting that existing guidelines like the NCCN are beginning to incorporate factors such as patients' underlying genetic makeup and immune status. The talk includes discussions on cutting-edge gene expression profiling to predict metastasis risk and identifies the importance of imaging techniques (like CT and MRI) in evaluating tumors and guiding treatment. Notably, new NCCN recommendations suggest wider surgical margins for high-risk patients and the consideration of sentinel lymph node biopsies to improve outcomes. The complexity of SCC management is highlighted, including intraoperative practices and postoperative follow-up protocols, aimed at early detection of recurrence through regular imaging and clinical assessments. Overall, this comprehensive approach underscores the evolving landscape of SCC management and the integration of advanced diagnostic tools and personalized medicine in clinical practice.