Surgical Treatments of Non-Melnaoma Skin Cancers: A Review

摘要

Background Non-melanoma skin cancers (NMSC) are the most common cancers diagnosed in Australia. The most common forms of NMSC are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The continuing rise in the incidence of NMSC will translate to greater need for surgical interventions. Objective This article aims to review the current literature regarding excisional surgical treatments of NMSC. Data sources A review of all literature using databases of Pubmed and Medline searching for keywords of ‘skin’ or ‘cancer’ or ‘surgery’ was carried out. Review methods All the titles and abstracts of all articles found were searched and relevant articles were selected. A further review of all the references mentioned in the selected studies was carried out and all relevant articles were added to the database. Results Although early or superficial NMSC can be effectively treated with topical agents[ii] [iii], there are numerous factors that call for surgical management[iv]. Broadly ‘surgical’ approaches include surgical excision, curettage, electro-desiccation, cryosurgery, and Mohs micrographic surgery (MMS). Surgical excision, curettage, and MMS are treatments that have the advantage of including histological evaluation. Conclusions Surgical management of NMSC remains the most reliable and the most convenient method of treatment of simple NMSC. The operator needs to remain mindful of the limitations of this modality. The surgeons who maintain an interest in this field should remain abreast of the developments in diagnostic technologies as well topical and non-excisional treatment modalities which are in use by our colleagues in dermatology. AIHW & AACR 2004. Cancer in Australia 2001. AIHW cat. no. CAN 23. Canberra: AIHW (Cancer Series no. 28)[ii] Goette, DK. Topical chemotherapy with 5-fluorouracil. A review. J. Am. Acad. Dermatol. 1981; 4:633[iii] Love WE; Bernhard JD; Bordeaux JS; Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: a systematic review; Arch. Dermatol. 2009; 145: 1431-8[iv] Silverman MK; Kopf AW; Grin CM; Bart RS; Levenstein MJ; Recurrence rates of treated basal cell carcinomas. Part 1: Overview; J. Dermatol. Surg. Oncol. 1991; 17: 713-8