From the Research
For a well-differentiated invasive squamous cell carcinoma on the right chest with negative margins and no lymphovascular or perineural invasion, follow-up should include regular skin examinations every 3-6 months for the first 2 years, then every 6-12 months for 3-5 years, as recommended by the most recent European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma 1.
Key Considerations
- No additional surgical intervention is needed since the margins are adequate, generally considered sufficient when greater than 4 mm 2.
- The patient should perform monthly self-examinations of the skin and lymph nodes, particularly checking the axillary and cervical regions for any enlargement.
- Sun protection measures are essential, including daily use of broad-spectrum SPF 30+ sunscreen, protective clothing, and avoiding peak sun hours.
- Patient education about warning signs of recurrence or new skin cancers is important.
Prognostic Factors
- The favorable prognostic factors in this case include well-differentiated histology, absence of lymphovascular/perineural invasion, and adequate margins, which together suggest a low risk of recurrence 3, 4.
- However, patients with one skin cancer have a higher risk of developing others, necessitating vigilant surveillance and preventive measures.
Follow-Up and Management
- The frequency of follow-up visits and investigations for subsequent new cSCC depends on underlying risk characteristics, as outlined in the European consensus-based guideline 1.
- Multidisciplinary board decisions are mandatory for all patients with advanced cSCC, considering the risks of toxicity, the age and frailty of patients, and co-morbidities, including immunosuppression.