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Staging Disease and Risk Stratification in CSCC and BCC

Opinion
Video

Experts discuss optimal utilization of CSCC and BCC staging systems and risk stratification to guide treatment decisions and the appropriate timing for active surveillance vs intervention.

This is a video synopsis/summary of a Peer Exchange involving Jason Luke, MD, FACP; Christopher Barker, MD; Omid Hamid, MD; Vishal Patel, MD; and Catherine Pisano, MD.

Patel explained that while dermatologic risk stratification focuses on recurrence potential to guide surgical margins, oncologic staging assesses metastatic risk and mortality. For medical oncologists, Patel advised developing relationships with dermatology to jointly discuss moderately and highly rated cSCC disease under either system early, as these aggressive tumors will likely recur and ultimately need systemic therapy. Luke asked Barker to describe factors determining tumor resectability. Barker emphasized starting with a thorough history and physical to guide tests selection while getting specialist input. He explained resection candidacy involves both tumor considerations and acceptable patient trade-offs between surgery/radiation morbidity and disease control. Barker stated when curative-intent surgery and radiation are declined, systemic therapy is considered, often initially in the neoadjuvant setting, which requires additional study.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.

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