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Skin cancer surgery; Excisional surgery; Mohs micrographic surgery; Sentinel lymph node biopsy; Adjuvant therapy

Introduction

Skin cancer, encompassing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma, is the most common malignancy worldwide. The primary treatment modality for these cancers is surgical intervention, aimed at complete removal of the tumor while preserving as much healthy tissue as possible. Advances in surgical techniques over recent years have significantly improved the prognosis and quality of life for patients with skin cancer [1]. Excisional surgery, the traditional approach, involves the complete removal of the tumor with a margin of healthy tissue and is widely used for various types of skin cancer. Mohs micrographic surgery (MMS) is a specialized technique that offers the highest cure rates for BCC and SCC by allowing immediate microscopic examination of the excised tissue margins. Sentinel lymph node biopsy (SLNB) is a critical procedure for staging melanoma and assessing the spread of cancer to regional lymph nodes. Despite these advancements, challenges remain, such as achieving clear margins while minimizing cosmetic and functional deficits, managing recurrent or metastatic disease, and integrating adjuvant therapies effectively [2]. The introduction of novel technologies, such as imaging techniques and robotic-assisted surgery, along with a growing emphasis on personalized medicine, promises to further refine skin cancer surgery and enhance patient outcomes.

Methodology

This study employs a comprehensive literature review and meta-analysis to evaluate the current advancements in skin cancer surgery. It systematically collects and synthesizes data from various sources, including peer-reviewed journals, clinical trials, and meta-analyses, to provide a detailed understanding of the efficacy and outcomes of different surgical techniques [3]. The literature review was conducted using databases such as PubMed, MEDLINE, and Cochrane Library. Search terms included "skin cancer surgery," "excisional surgery," "Mohs micrographic surgery," "sentinel lymph node biopsy," "adjuvant therapy," "basal cell carcinoma," "squamous cell carcinoma," and "melanoma." The search was limited to articles published in the last 20 years to ensure the inclusion of the most recent advancements. Studies included in the review met the following criteria focused on surgical treatment of basal cell carcinoma, squamous cell carcinoma, or melanoma. Reported on surgical techniques such as excisional surgery, Mohs micrographic surgery, or sentinel lymph node biopsy [4]. Provided data on success rates, recurrence rates, patient outcomes, and complications. Were case reports, letters to the editor, or opinion pieces without primary data? The quality of the included studies was assessed using standardized criteria, including the Newcastle-Ottawa Scale for cohort studies and the Cochrane Risk of Bias Tool for randomized controlled trials [5]. Factors considered included study design, sample size, follow-up duration, and outcome measurement consistency. Data were synthesized qualitatively and quantitatively. Cure rates, recurrence rates, and complication rates were compared across different surgical techniques [6]. Meta-analyses were performed where possible to pool data and provide summary estimates of the effectiveness of each surgical method. Subgroup analyses were conducted to explore variations in outcomes based on factors such as tumor type, location, and patient demographics. The study acknowledges potential limitations, including heterogeneity in study designs, variations in surgical technique execution, and differences in follow-up durations across the included studies. These factors may influence the generalizability of the findings.

Results and Discussion

The analysis revealed that Mohs micrographic surgery (MMS) offers the highest cure rates for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), with cure rates exceeding 99% for primary BCC and 97% for primary SCC. Excisional surgery remains the standard approach for a wide range of skin cancers, particularly effective when clear margins are achieved [7]. Sentinel lymph node biopsy (SLNB) has proven crucial in staging melanoma, significantly impacting treatment decisions and patient prognosis. Adjuvant therapies, such as immunotherapy and targeted therapy, have shown promise in reducing recurrence rates and improving survival in advanced cases [8]. The integration of novel imaging techniques and minimally invasive procedures has further enhanced the precision and outcomes of skin cancer surgeries.

Discussion

The findings underscore the importance of selecting appropriate surgical techniques based on tumor type, location, and patient-specific factors [9]. MMS is particularly advantageous for tumors in cosmetically and functionally sensitive areas due to its tissue-sparing benefits. SLNB has emerged as a vital tool in managing melanoma, providing critical staging information that guides further treatment. The role of adjuvant therapies, including immunotherapy and targeted therapy, continues to expand, offering new hope for patients with advanced or recurrent skin cancer [10]. Future directions in skin cancer surgery point towards the increasing use of personalized medicine, leveraging genetic and molecular profiling to tailor treatments more effectively.

Conclusion

Skin cancer surgery has made significant strides, resulting in improved patient outcomes and survival rates. Techniques such as Mohs micrographic surgery and sentinel lymph node biopsy have revolutionized the management of BCC, SCC, and melanoma. The integration of adjuvant therapies and novel technologies continues to enhance the precision and effectiveness of surgical interventions. Ongoing research and innovation are expected to further refine these techniques, emphasizing the need for personalized approaches in the treatment of skin cancer. Clinicians must stay informed about these advancements to provide optimal care and improve the quality of life for patients with skin cancer. This article aims to provide a comprehensive overview of the current practices in skin cancer surgery, highlighting the latest techniques, outcomes, and future directions in this dynamic field. By understanding these advancements, healthcare professionals can better navigate the complexities of skin cancer treatment and improve patient care.

Acknowledgement

None

Conflict of Interest

None

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