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15-10-2021 | Treatment | Adis Journal Club | Article

Advances in Therapy

Non-Surgical Treatments for Keratinocyte Carcinomas

Authors: Kylee J. B. Kus & Emily S. Ruiz

Abstract

Skin cancer is the most common malignancy worldwide, comprising approximately 30% of all human tumors. In recent decades, the incidence of keratinocyte carcinomas, which include basal cell carcinoma and cutaneous squamous cell carcinoma, has been steadily increasing globally (Rogers et al. in JAMA Dermatol 151(10):1081–1086. https://doi.org/10.1001/jamadermatol.2015.1187, 2015; Nehal and Bichakjian in N Engl J Med 379(4):363–374. https://doi.org/10.1056/nejmra1708701, 2018). Most tumors are cured with surgical excision; however, some tumors are best treated with non-surgical approaches. Superficial tumors can often be cured with non-surgical methods whereas more advanced stage tumors may not be amenable to surgery. Additionally, surgical treatment may not be available for all populations depending on geographic location and accessibility to care. This article reviews commonly utilized nonsurgical options such as cryotherapy, photodynamic therapy, topical treatments, and radiation as well as systemic treatments including immunotherapies and chemotherapies.

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Key Summary Points

Most KCs are cured with surgical excision; however, in some cases particular tumor- or patient-related factors make surgery an unsuitable option

Epidermally limited skin cancers can be treated with cryotherapy, photodynamic therapy, or topical treatments

Nonsurgical treatment options for low-risk invasive skin cancers include superficial radiation, EDC, and intralesional chemotherapies

Locally advanced skin cancers can be treated with targeted therapies, immunotherapies, or systemic chemotherapy

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