As high-stage cutaneous squamous cell carcinoma cases continue to challenge dermatologists, Mohs surgery is contributing to improved outcomes by providing enhanced precision in tumor removal and reducing recurrence rates.
High-stage cutaneous squamous cell carcinoma (cSCC) often defies traditional wide local excision due to subclinical extension and variable tumor margins, leaving patients at risk for incomplete resection and local recurrence. Dermatologists face an urgent need for approaches that ensure clear margins while conserving healthy tissue and minimising morbidity. Mohs surgery offers a precise method for excising skin cancers, demonstrating real-world data from clinical studies that reveal lower recurrence and reduced mortality compared with wide local excision.
Clinicians comparing Mohs surgery with wide local excision note a significant divergence in long-term control. Margin control in Mohs translates to recurrence reduction in cSCC that surpasses wide local excision, particularly in high-stage lesions where subclinical spread is common. The staged approach preserves cosmetic and functional outcomes on critical anatomical sites, making it a cornerstone in contemporary cSCC management.
Attention is also turning to adjunctive, non-surgical modalities that may address field cancerisation and other complex dermatoses. The study of delgocitinib, as detailed in clinical trials exploring innovative therapies, offers insights into future applications for difficult-to-treat skin conditions. Though initial investigations focus on palmoplantar pustulosis, emerging topical agents may one day complement surgical strategies by targeting residual disease or preventing new lesion development.
Adapting clinical practice to incorporate Mohs surgery in high-stage cases is imperative. Structured referral pathways between dermatology and surgical oncology ensure that patients benefit from margin‐controlled excision, while ongoing surveillance of novel therapies will fill therapeutic gaps left by surgery alone. This integration of precise surgical technique with targeted pharmacologic innovation defines the next frontier in cSCC management.
Key Takeaways:- Mohs surgery provides superior outcomes in managing high-stage cSCC by significantly reducing recurrence and mortality rates.
- Emerging therapies like delgocitinib propose new avenues for treatment in skin conditions lacking effective systemic options.
- Integration of surgical precision with innovative therapies is crucial in advancing skin cancer treatment practices.