Treatment of Recurrent Nonmetastatic Squamous Cell Carcinoma of the Skin

SCCs have definite metastatic potential, and patients are monitored regularly after initial treatment. Overall, local recurrence rates after treatment of primary SCCs have ranged from about 3% to 23%, depending on anatomical site.[9] About 58% of local recurrences manifest within 1 year, 83% within 3 years, and 95% within 5 years. Tumors that are 2 cm or larger in diameter, 4 mm or greater in depth, or poorly differentiated have a relatively poor prognosis [19] and even higher local recurrence and metastasis rates than those listed.[9] Reported local recurrence rates also vary by treatment modality, with the lowest rates associated with Mohs micrographic surgery. However, at least some of the variation may be the result of patient selection factors. No randomized trials directly compare the various local treatment modalities.

Treatment options for recurrent nonmetastatic SCCs include:

Recurrent nonmetastatic SCCs are considered high risk and are generally treated with excision, often using Mohs micrographic surgery. Radiation therapy is used for lesions that cannot be completely resected.

As is the case with BCC, patients who develop a primary SCC are also at increased risk of subsequent primary skin cancers.[20,21]