Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic thickness and anatomical structure that may influence both growth pattern and treatment of primary cSCC; while clinical peripheral margins may be easily achieved during the surgery, vertical excision of the tumor is limited by the skull. Despite having a unique anatomy, current guidelines do not contemplate specific recommendations for scalp cSCC, which leads to inconsistent decision-making in multidisciplinary committees when discussing tumors with high risk factors or with close margins. This article provides specific recommendations for the management of patients with scalp cSCC, based on current evidence, as well as those aspects in which evidence is lacking, pointing out possible future lines of research. Topics addressed include epidemiology, clinical presentation and diagnosis, imaging techniques, surgical and radiation treatments, systemic therapy for advanced cases, and follow-up. The primary focus of this review is on management of primary cSCC of the scalp with localized disease, although where relevant, some points about recurrent cSCCs or advanced disease cases are also discussed.
皮肤鳞状细胞癌是皮肤癌中第二常见的亚型。与其他部位相比，头皮是最常受累的部位之一，且并发症发生率更高。此外，头皮具有独特的厚度和解剖结构，可能影响原发性皮肤鳞状细胞癌的生长模式和治疗；虽然手术中容易达到临床周边切缘，但肿瘤的垂直切除受颅骨限制。尽管头皮解剖结构特殊，但现行指南并未针对头皮皮肤鳞状细胞癌制定具体建议，导致多学科委员会在讨论具有高风险因素或切缘接近的肿瘤时决策不一致。本文基于现有证据以及证据不足的领域，为头皮皮肤鳞状细胞癌患者的治疗管理提供具体建议，并指出未来可能的研究方向。涉及的主题包括流行病学、临床表现与诊断、影像学技术、手术与放射治疗、晚期病例的全身治疗以及随访。本综述主要关注局限性原发性头皮皮肤鳞状细胞癌的治疗管理，但在相关部分也讨论了复发性或晚期病例的若干要点。
肿瘤(癌症)患者之家