Austr Melanoma Guidelines - SCC Flashcards
Risk factors, low risk, tumor factors
Diameter < 20 mm (pT1) Thickness <= 4 mm Invasion into dermis No peri-neural invasion Well or moderately diff No lymphvasc invasion.
Risk factors, low risk, Margin Status
Clear pathology margins in all directions > = 1 mm
Risk factors, low risk, Patient factors
Immune competent
Risk factors, low risk, Follow up
6m, 12m, annual full skin check.
Risk factors, very high risk, Tumour factors
Diam > 40 mm
Thickness > 6 mm
Invasion beyond subcutis, any bone
Peri-neural invasion in named nerve; nerve > 0.1mm, nerve beyond dermis
High grade subtype - (adenosquamous, demoplastic, spindle, sarcomatoid, metaplastic.
In transit Mets
Any single factor denotes very high risk.
Risk factors, very high risk, margin status
1 or more involved or close (< 1 mm ) margin in high risk tumour.
Risk factors, very high risk, Patient factors
As for high risk, especially solid organ transplant, hematol. Malignancy, other significant immunosup.
Risk factors, very high risk, Follow up
Every 4 m for 24 m, then every 6 month thereafter.
Risk factors, high risk, Tumour factors
Diameter > 20 - 40 mm = pT2 Thickness > 4 mm - 6 mm Invasion into subcutaneous fat Perineural invasion, dermal only, nerve diam < 0.1 mm. Poorly differentiated. Lymphovascular invasion Ear or lip. Any single factor denotes high risk.
Risk factors, high risk, Margin status
1 or more involved margin in a pT1 tumour, close margin in a PT2 tumour.
Risk factors, high risk, Patient factors
Iatrogenic immunosupression or biological therapies, frailty, comorbitiies; HIV or HAART
Risk factors, high risk, Follow up
Every 4 m for 12 m, and every 6 m thereafter.
