Challenging Cases in the Management of Squamous Cell Carcinoma of the Skin

There is a general understanding and comfort in management of small, relatively well-defined SCC of the skin, even those that carry some high risk features (PNI, high DOI, high grade, etc). There is less comfort and consensus, in general, with management of advanced skin SCC's that are large, less well-defined, those with satellitosis, those requiring large reconstructions, those in whom upfront resection would compromise function (vision, facial motor), recurrent lesions, multiple LNs positive, etc. This activity highlights some of these complex cases that require thoughtful integration of multidisciplinary care to achieve optimal tumor control, function and QoL.

We present four to five challenging cases of squamous cell carcinoma of the skin. A moderator presents the preselected challenging cases and guides the panel discussion. This is a joint activity between the Cutaneous/Sarcoma disease site and the Head and Neck disease site. We present 2-3 body skin SCC cases and 2-3 H&N SCC cases. Panelists include a H&N surgeon, Surg/Onc, Med/Onc and Rad/Onc all specializing in the management of skin cancers. Through the various cases we explore: Surgical management of cutaneous SCC, including when nodal evaluation is indicated. Use of systemic therapy (standard chemotherapy, immunotherapy, targeted therapy). Sequencing of therapy (neoadjuvant vs. adjuvant strategies). Role of radiation therapy (definitive, neoadjuvant, post-operative and palliative).

Topic:

  1. Introduction and Case Presentation
    Yen-Lin Evelyn E. Chen, MD
  2. Surgical Management of Advanced Cutaneous SCC - A Multidisciplinary Team Approach
    Callisia N. Clarke, MD, MS, FACS, FSSO
  3. Challenging Cases in the Management of Cutaneous Squamous Cell Carcinoma
    April K.S. Salama, MD
  4. Surgical Considerations for cSCC of the Head and Neck
    Karen Y. Choi, MD, FACS
  5. Radiation Therapy in Managing Challenging cSCC
    Yen-Lin Evelyn E. Chen, MD
  6. Q and A
    Full Panel 

This activity is available from January 3, 2025, through 11:59 p.m. Eastern time on January 2, 2027. 

This activity was originally recorded at the 2024 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, dermatologists, dermatopathologists and residents.   

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Determine the best course of action when faced with a challenging cutaneous SCC as it relates to sequencing of therapy (surgery first vs. a neoadjuvant strategy - and what advantages the latter can provide).
  • Identify clinical scenarios and risk factors that should motivate recommendation of RT in the definitive and post-operative settings.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
Course opens: 
01/03/2025
Course expires: 
01/02/2027
Cost:
$149.00
Rating: 
0
  • Yen-Lin Evelyn E. Chen, MD, is employed by Massachusetts General Hospital, Harvard Medical School. 
  • Callisia N. Clarke, MD, MS, FACS, FSSO is employed by Medical College of Wisconsin. Dr. Clarke serves as President-Elect of the Academy of Academic Surgeons.   
  • April K.S. Salama, MD, is employed by Duke University. Dr. Salama receives grant/research funding from BMS, Regeneron, Seagen, Ideaya, Immunocore, Merck, Oleatec Therapeutics and Replimune. Dr. Salama receives honoraria for consulting work from Iovance, Pfizer, and Novartis. 
  • Karen Y. Choi, MD, is employed by MD Anderson Cancer Center. Dr. Choi receives honoraria for consulting work with Cardinal Health and travel expenses from Intuitive Surgical. Dr. Choi serves as Vice Chair of Women in HNS Service and Education Chair for the Cutaneous Section of HNS for the AHNS. Dr. Choi is a Board member of the Texas Association of Otolaryngology.  

The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.

ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification. 

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

Nonmember: $149
Member: $99
Member-in-training: $49
Student/Grad Student/PGY Member: $49
Postdoctoral Fellow Member: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.

Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.

The course and its materials will only be available on the ASTRO website until January 2, 2027, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.

Required Hardware/software

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