Perioperative Management of High Risk Primary Cutaneous Squamous Cell Carcinoma: Role of Radiologic Imaging, Elective Lymph Node Dissection, Sentinel Lymph Node Biopsy, and Adjuvant Radiotherapy

Nonmelanoma skin cancers occur at an epidemic rate in many parts of the world. With an aging population, more patients will develop these cancers and at an ever increasing rate. While in the majority of cases local treatment is curative, a subset of the population will be diagnosed with a high-risk primary cutaneous squamous cell carcinoma. The morbidity and mortality associated with high-risk primary squamous cell carcinoma is usually a consequence of local recurrence and/or the development of metastatic nodal disease. The management of these patients requires knowledge of the role of radiation therapy, elective lymph node dissection, and sentinel lymph node biopsy, which in many cases may be lifesaving, as well as the appropriate imaging modalities to consider in these patients.