Invasive SCC, characterised histologically by the spread of malignant cells into the dermis, could arise de novo or from the transformation of precursor lesions such as actinic keratosis and Bowen’s disease. Protocol registration International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42011001450.Ĭutaneous squamous cell carcinoma (SCC), the second most common type of non-melanoma skin cancer after basal cell carcinoma, arises most commonly in sun exposed areas of the body from keratinocytes in the epidermis. Further evidence is needed to develop a prognostic model and stratify individuals at high risk of developing SCC, to improve the evidence base for this common cancer and to optimise clinical management. Comparison of outcomes after different treatments should be interpreted cautiously owing to biases inherent in the types of study included, and lack of direct comparisons to enable the estimation of relative treatment effect. Evidence was limited for laser treatment (1 study) and for topical and systemic treatments (mostly single case reports or small non-comparative series with limited follow-up).Ĭonclusions Many observational studies have looked at different treatment modalities for SCC, but the evidence base for the effectiveness of these interventions is poor. After an apparently successful initial response of SCCs to photodynamic therapy, pooled average recurrence of 26.4% (12.3% to 43.7% 8 studies) was significantly higher than other treatments. After Mohs micrographic surgery, the pooled estimate of local recurrence during variable follow-up periods from 10 studies was 3.0% (2.2% to 3.9%), which was non-significantly lower than the pooled average local recurrence of 5.4% (2.5% to 9.1%) after standard surgical excision (12 studies), and 6.4% (3.0% to 11.0%) after external radiotherapy (7 studies). Pooled estimates of recurrence of SCCs were lowest after cryotherapy (0.8% (95% confidence interval 0.1% to 2%)) and curettage and electrodesiccation (1.7% (0.5% to 3.4%)), but most treated SCCs were small, low risk lesions. Results 118 publications were included, covering seven treatment modalities. Meta-analysis was performed where appropriate using a random effects model to estimate the pooled proportion of an event with 95% confidence intervals. ![]() Data were extracted independently by two reviewers. Studies were excluded if data for primary cutaneous SCC was not separable from other data. Review methods Observational studies of interventions for primary, non-metastatic, invasive, SCC of the skin that reported recurrence during follow-up, quality of life, initial response to treatment, adverse events, cosmetic appearance, or death from disease. We offer treatments to meet all of your skincare needs, including, but not limited to, Fraxel repair, PRP hair growth treatments, cosmetic injections, laser hair removal, and more.Objectives To assess the effects of treatments for non-metastatic invasive squamous cell carcinoma (SCC) of the skin using evidence from observational studies, given the paucity of evidence from randomised controlled trials.ĭesign Systematic review of observational studies.ĭata sources Medline, Embase, to December 2012. We also house laser services, aesthetic services, and cosmetic and plastic surgery services. Our office addresses medical dermatology needs, cosmetic treatments, and Mohs Surgery. Our office specializes in the surgical management of skin disease and tumors and advanced cosmetic dermatological surgery. The San Jose – Los Gatos dermatology office is conveniently located off of Samaritan Drive and the physicians and staff provide full range of dermatology services.
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