Optimization of surgical treatment of squamous cell skin cancer with subsequent radiation therapy

Abstract

Background. Squamous cell carcinoma (SCCC) is the second most common epithelial malignancy. Despite a high cure rate in the early stages, the 10-year survival rate does not exceed 20% for regional metastases, and less than 10% for distant metastases. The search for methods that ensure radical intervention, good functional and aesthetic results, and a reduced recurrence rate remains an important challenge. Study Objective. To evaluate the results of two approaches to surgical treatment of SCCC followed by radiation therapy. Materials and Methods. The study included 64 patients with morphologically verified SCCC (T1-T3, N0M0) treated between 2013 and 2019. Patients were divided into two groups: Group 1 (n=32) – organ-preserving tumor resection with minimal excision, while maintaining radicality, followed by radiation therapy; Group 2 (n=32) – standard radical surgical removal of the tumor followed by radiation therapy. Surgical duration, blood loss, pain intensity, complication rate, relapse-free and overall survival were assessed. Results and discussion. In Group 1, the average surgical duration was 39 ± 1.7 minutes, blood loss was 7.5 ± 2.1 ml, pain resolved in 0.89 ± 1.23 days, and no complications were detected. Three-year relapse-free survival was 78%, and overall survival was 67%. In Group 2, the average surgical duration was 89 ± 12.8 minutes, blood loss was 36.5 ± 12.7 ml, pain persisted for 3.68 ± 1.84 days, and complications occurred in 9.3% of patients (flap necrosis, seroma). The three-year relapse-free survival rate is 68%, and the overall survival rate is 76%. Conclusion. Surgical treatment of CCRC followed by radiation therapy provides high oncological efficacy. The organ-preserving approach shortens the duration of the procedure, reduces blood loss and postoperative morbidity, while maintaining survival rates comparable to standard surgeries, making it a viable option for patients with complicated medical conditions.

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