title: Consensus for Nonmelanoma Skin Cancer Treatment, Part II: Squamous Cell Carcinoma, Including a Cost Analysis of Treatment Methods.
abstract: BACKGROUND
  Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in the United States. Cutaneous squamous cell carcinoma has an estimated incidence of more than 700,000 new cases per year and a 5% risk of metastasis.
  
  
  OBJECTIVE
  To provide clinicians with guidelines for the management of cSCC based on evidence from a comprehensive literature review and consensus among the authors.
  
  
  METHODS
  The authors conducted an extensive review of the medical literature on treatment methods for cSCC, taking into consideration cure rates, recurrence and metastatic rates, aesthetic and functional outcomes, and cost effectiveness of the procedures.
  
  
  RESULTS
  Surgical treatments provide the best outcomes for cSCC. Mohs micrographic surgery is a cost-effective procedure that affords the highest cure rate, maximal tissue preservation, and superior cosmetic outcomes. Nonsurgical methods may be used as a primary treatment for low-risk squamous cell carcinomas, but the cure rates are lower.
  
  
  CONCLUSIONS
  The cure rate remains the most important consideration in choosing the treatment method, but additional factors, such as the patient's general medical condition, psychosocial circumstances, the location of the tumor and cost effectiveness of the therapy should be considered. Mohs micrographic surgery remains the preferred treatment for high-risk tumors and tumors located in cosmetically sensitive areas.
authors.affiliation: *New York University School of Medicine, New York, New York; †New York Laser & Skin Care, New York, New York; ‡Mayo Clinic, Rochester, Minnesota; §St. Louis University, St Louis, Missouri; ‖Laser & Dermatologic Surgery Center, Chesterfield, Missouri; ¶Lahey Clinic; Associate Professor, Harvard Medical School, Boston, Massachusetts; #David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; **Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Arielle N B
authors.initials: AN
authors.lastname: Kauvar
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Arpey
authors.forename: George
authors.initials: G
authors.lastname: Hruza
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Olbricht
authors.forename: Richard
authors.initials: R
authors.lastname: Bennett
authors.forename: Bassel H
authors.initials: BH
authors.lastname: Mahmoud
mesh_terms: D000279:Administration, Cutaneous; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics; D002294:Carcinoma, Squamous Cell / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D017679:Cryotherapy / Q000191:economics; D019317:Evidence-Based Medicine; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D015580:Mohs Surgery / Q000191:economics; D010778:Photochemotherapy / Q000191:economics; D011878:Radiotherapy / Q000191:economics; D012307:Risk Factors; D012878:Skin Neoplasms / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents