What is included in long-term monitoring of cutaneous squamous cell carcinoma (cSCC)?

Updated: Jul 08, 2020
  • Author: Talib Najjar, DMD, MDS, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

With exposure to risk factors, patients require vigilant follow-up care even after successful treatment, because they continue to be at risk for development of additional cutaneous skin malignancies (eg, basal cell carcinoma and SCC of the eyelid). The incidence of multiple primaries is 40% in long-term survivors. Therefore, minimization of modifiable risk factors and early detection of new skin cancers are essential to improve prognosis.

Low-risk tumors are usually cured with appropriate surgical therapy; however, patients who develop 1 SCC have a 40% risk of developing additional SCCs within the next 2 years. This risk likely becomes even greater as more time elapses. Thus, patients with a history of SCC should be evaluated with a complete skin examination every 6-12 months.

Patients with high-risk tumors require skin and lymph node examinations at 3- to 6-month intervals for at least 2 years after diagnosis. In very ̶ high-risk cases, surveillance with CT scanning or MRI may be considered. Recurrent lesions should be treated aggressively. Success in treating recurrences with topical mitomycin C has been reported. In areas of bare sclera, however, pyogenic granulomas occasionally occur soon after tumor excision. These lesions typically respond quickly to topical steroid treatment and must be differentiated from recurrent tumor.


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