Squamous cell carcinoma of the skin surgery
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Squamous cell carcinoma of the skin Microchapters |
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Differentiating Squamous cell carcinoma of the skin from other Diseases |
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Squamous cell carcinoma of the skin surgery On the Web |
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American Roentgen Ray Society Images of Squamous cell carcinoma of the skin surgery |
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Directions to Hospitals Treating Squamous cell carcinoma of the skin |
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Risk calculators and risk factors for Squamous cell carcinoma of the skin surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Raviteja Guddeti, M.B.B.S. [3]
Overview
Surgery is the most widely used management of choice for high risk Squamous cell carcinomas (SCC). Two types of Surgical methods exist which are Surgical excision and Moh's micrographic surgery.
Surgical Treatment
- Surgical excision is the most widely used treatment of choice in high risk SCCs. It is well tolerated, extremely effective and completeness of the procedure can be confirmed by assessing the margins of the lesion histologically. Deeply invasive and metastatic lesion require more wide excision and exploration of the adjacent nodes. Cure rates with method approach 92% and 77% for primary and recurrent SCCs at the end of 5 years. Well defined, small (< 2 cm) lesions without any high risks the margin of the normal tissue around the tumor mass that is required during excision is 4mm. For larger, high risk lesions the margin has to be wide to make sure no residual lesion is left over after excision.
- Moh's micrographic surgery is particularly effective for high-risk localized cutaneous SCCs and SCCs located in cosmetically sensitive or critical areas because of its high cure rate and ability to spare normal tissue. 5 year cure rates for primary and recurrent tumors are 97% and 90% - 94% respectively. It is performed in the out patient setting and is well tolerated.[1] The procedure is performed in stages and the lesion is excised at an oblique angel along with a small rim of normal tissue. Histological assessment is then done and if the margins of the specimen test positive for tumor cells the locations are noted on Mohs map and a repeat procedure is done in the involved area itself and this process is repeated until the margins are clear of any tumor cells. This procedure is some what prolonged and take 2-4 hrs to complete.
References
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