Topics:
Radiation Oncology • Melanoma/Skin Cancer
How would you approach a cutaneous squamous cell carcinoma with primary tumor completely excised, but multiple foci of LVI at the peripheral specimen margin and no other high-risk features?
Would you consider re-excision and/or adjuvant RT? If RT, what margins on the scar and treatment volume would you use?
Answer from: Radiation Oncologist at Academic Institution
In a prospective study that assessed clinical and pathological risk factors for primary tumor site recurrence after margin negative excision of cutaneous squamous cell carcinoma, the presence of desmoplasia was reported to be the primary variable associated with this event. The authors specified tha...
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Answer from: Radiation Oncologist at Academic Institution
We handle H&N skin cancers differently from limbs and trunk. For H&N, if there is extensive LVSI that’s already an indication to consider PORT with a generous margin in my mind, especially in an immunocompromised patient. A re-resection is not going to change that. Limbs and trunk are ...