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01-01-2015 | Non-melanoma skin cancer | Article

3. Evaluation, Staging and Prognostication

Authors: MBBS, MIPH, MS Zubair Hasan, MBBS, FRACS Carsten Palme, BSc, MBBS, FRACS Faruque Riffat

Publisher: Springer India

Abstract

The majority of non-melanoma skin cancers (NMSCs), particularly those encountered in primary care settings, will be identified and are easily amenable to local therapy. The most common types of NMSC are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and rarer tumours, including Merkel cell cancer (MCC) and sarcoma. Metastatic SCC is a rare entity (<5 % of cases); metastatic BCC even more so [1]. However, it is important to identify high-risk patients because of the significant morbidity and mortality experienced by this subgroup of patients. Optimal management of these patients requires multidisciplinary input. Considerable research has been conducted into early identification of such high-risk patients. The initial approach involves a thorough clinical assessment, including detailed history and evaluation of any relevant systemic disease, risk factors and comorbidities, followed by histological analysis. Advanced lesions will require more detailed investigations, including cross-sectional imaging in the form of computed tomography (CT) and or magnetic resonance imaging (MRI). The investigation should not only focus on the primary lesion but also on any potential regional and distant metastatic disease. One approach to the initial assessment of NMSC is shown in Fig. 3.1.

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