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ASDS consensus recommendations include Mohs micrographic surgery for SCC

Mohs micrographic surgery is the preferred treatment for high-risk cutaneous squamous cell carcinoma tumors, according to a consensus report recently published in Dermatologic Surgery.

Arielle N. B. Kauvar, MD, and colleagues reviewed medical literature on treatment methods for cutaneous squamous cell carcinoma (SCC), focusing on cure rates, recurrence and metastasis rates, aesthetic and functional outcomes and cost-effectiveness of procedures.

Arielle N. B. Kauvar

Kauvar and colleagues had previously conducted a comprehensive review of medical literature to evaluate optimal treatment methods for cutaneous basal cell carcinoma. The group of dermatologic surgeons was appointed by the American Society for Dermatologic Surgery (ASDS) board of directors, according to a prior press release from the ASDS. 

Therapy options for cutaneous SCC reviewed included Mohs micrographic surgery (MMS), standard surgical excision, radiation therapy, electrodesiccation and curettage, cryotherapy, topical therapy and photodynamic therapy. The best outcomes for cutaneous SCC were surgical treatments, according to the review.

“[MMS] is a cost-effective procedure that affords the highest cure rate, maximal tissue preservation and superior cosmetic outcomes,” the researchers wrote.

Primary treatment for low-risk SCC could include nonsurgical options, but these produced a lower cure rate.

“Because the risk of metastasis and death from [cutaneous] SCC dramatically increases for tumors recurring after treatment, the best chance of a cure is with the most effective primary therapy,” the researchers concluded. “There are multiple modalities to treat [cutaneous] SCC, but cure rates, adverse effects, cosmesis, and cost varies. Nonsurgical modalities are used to treat [actinic keratoses], field cancerization and low-risk [cutaneous SCC in situ-Bowen disease].

“Surgical modalities typically provide the optimal results for [cutaneous] SCCs, and MMS affords the highest cure rate, maximal tissue preservation, and best cosmetic outcome. MMS is an effective modality for all [cutaneous] SCCs and remains the preferred treatment of high-risk tumors.”  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.