Halim Ahmad Sukari, Ramasenderan Nandinii
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Asian J Surg. 2023 Jan;46(1):47-51. doi: 10.1016/j.asjsur.2022.04.079. Epub 2022 May 8.
Cutaneous squamous cell carcinoma (CSCC) is a common type of skin malignancy that affects people who have been exposed to sunlight for a long time. It has been associated to a high mutational load, making treatment problematic, especially for individuals with high-risk CSCC characteristics. Patients with high-risk CSCC are difficult to define since definitions are still imprecise. Firstly, we review the evidence to see how relevant locoregional involvement is in terms of patient survival and recurrence risk. Second, we go through the difficulties and obstacles that come with sentinel lymph node biopsy (SLNB) and their importance in the management of locally progressed CSCC. Methods and findings from a variety of lymph node investigations are described. There is yet no empirical evidence for the involvement of SLNB in CSCC. Finally, we discussed the most recent developments in the treatment of CSCC. The mainstays of treatment are surgery and radiation. To slow the disease progression, cancer medicines have switched to disrupting particular signaling pathways. Advanced nations have more easily accessible drugs like Cetuximab (epidermal growth factor receptor inhibitor) and Cemiplimab (anti-programme receptor-1 antibodies), which are utilized in advanced CSCC. The response rate varies based on the patient, although there is still a lack of proof. This article discusses the misconception that CSCC is a tumor with a favorable prognosis, as well as the difficulties in treating high-risk CSCC.
皮肤鳞状细胞癌(CSCC)是一种常见的皮肤恶性肿瘤,影响长期暴露于阳光下的人群。它与高突变负荷相关,这使得治疗存在问题,尤其是对于具有高危CSCC特征的个体。高危CSCC患者难以界定,因为相关定义仍不精确。首先,我们回顾证据,以了解局部区域受累在患者生存和复发风险方面的相关性。其次,我们探讨前哨淋巴结活检(SLNB)所面临的困难和障碍及其在局部进展期CSCC管理中的重要性。描述了各种淋巴结检查的方法和结果。目前尚无SLNB参与CSCC的经验证据。最后,我们讨论了CSCC治疗的最新进展。治疗的主要手段是手术和放疗。为了减缓疾病进展,抗癌药物已转向干扰特定的信号通路。发达国家更容易获得如西妥昔单抗(表皮生长因子受体抑制剂)和西米普利单抗(抗程序性受体-1抗体)等药物,这些药物用于晚期CSCC。尽管仍缺乏证据,但有效率因患者而异。本文讨论了认为CSCC是预后良好的肿瘤这一误解,以及治疗高危CSCC的困难。