Staging
Staging is a standardized process that allows doctors to describe a patient’s prognosis based on tumor characteristics, lymph nodes, and tumor spread, if applicable. There are many different staging systems for skin cancer. There are many different staging systems for tumors of the skin. SCC, although not as aggressive as melanoma, is responsible for more deaths than melanoma. As a result, it is important to evaluate the American Joint Commission on Cancer (AJCC) staging system for cutaneous SCC (cSCC) of the head and neck.
Stage 0 (Carcinoma In Situ)
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Description
- Cancerous cells in the top layer of skin (epidermis) only).
Treatment
- Treatment
Topical chemotherapy, destruction (electrodesiccation, cryotherapy, laser surgery, photodynamic therapy), or excision (standard vs Mohs-assisted)
Stage I
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Description
- Tumor is no more than 2 cm in diameter and confined to the skin.
Treatment
- Simple excision, Mohs surgery, radiation therapy, electrodessication, cryosurgery, photodynamic therapy, laser therapy, topical chemotherapy.
Stage II
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Description
- Tumor is larger than 2 cm in diameter on confined to the skin.
Treatment
- Treatment
Excision (standard vs Mohs-assisted), and radiation therapy.
Stage III
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Description
- The tumor is greater than 4 cm with minor invasion of the bone, perineural invasion of named nerves or deep invasion. Additionally, the tumor has spread to a single regional node; the involved node is less than 3 cm in diameter.
Treatment
- Standard excision with adjuvant radiation therapy, chemotherapy, immunotherapy, and clinical trials.
Stage IV
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Description
- Cancer has spread to a single node greater than 3 cm, multiple regional nodes, distant nodes, or to distant sites in the body.
Treatment
- Treatment
Immunotherapy, chemotherapy, and clinical trials; surgery and radiation may be used in select cases
