IntroductionNonmelanoma skin cancer (NMSC) is the most common cancer worldwide. Approximately 3 million individuals are diagnosed with NMSC in the United States each year. Of these, 75–80% are basal cell carcinoma (BCC), and 20–25% are squamous cell carcinoma (SCC). The head and neck region is the most commonly affected site (80%), largely due to significant sun exposure to this area. The incidence of skin cancers continues to rise and is highest in Australia, with an age‐standardized incidence rate of 387 cases per 100,000 individuals for SCC and 884 cases per 100,000 individuals for BCC.The vast majority of patients with NMSC are at low risk for invasion and recurrence and are typically treated with simple excision or Mohs surgery. External beam radiotherapy (EBRT) can be offered when surgery is not preferred. Approximately 5% of patients with NMSC have high‐risk clinicopathologic features for loco‐regional recurrences, distant metastasis, and death, and these patients need more aggressive treatment. High‐risk features for NMSC are regional nodal involvement, perineural invasion (PNI), recurrent disease, poor histologic differentiation, and immunosuppression. The published literature addressing high‐risk features and indications for adjuvant radiotherapy are largely comprised of SCC datasets, which are more likely to develop severe disease with a
International Journal of Dermatology – Wiley
Published: Jan 1, 2018
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