Cutaneous squamous cell carcinoma (CSCC) is the second most common malignant neoplasm in the United States, with an estimated 1 million cases diagnosed annually.1 Most patients have an excellent prognosis with surgery alone, but a small subset have poor outcomes. Margin status following surgery greatly affects outcomes.2 Complete circumferential peripheral and deep margin assessment, which involves en face sectioning to allow for nearly 100% histologic margin assessment, is associated with lower recurrence rates compared with standard assessment, in which approximately 1% of the margin is evaluated (A. Waldman, MD, written communication, January 2019). National Comprehensive Cancer Network guidelines for CSCC include salvage radiation therapy as an option for positive histologic margins after surgical excision.3 However, there are limited data evaluating outcomes after salvage radiation therapy. Herein we review outcomes of patients with primary CSCCs treated with salvage limited-field irradiation for microscopic residual disease after surgery.
Ruiz ES, Koyfman SA, Kass J, Schmults CD. Surgery and Salvage Limited-Field Irradiation for Control of Cutaneous Squamous Cell Carcinoma With Microscopic Residual Disease. JAMA Dermatol. Published online August 21, 2019155(10):1193–1195. doi:10.1001/jamadermatol.2019.2190
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