Das Kutane Plattenepithelkarzinom

Squamous cell carcinoma (SCC) of the skin is one of the most common types of cancer in the white population, accounting for 20% of epithelial skin tumors. The incidence is rising steadily, especially among patients over the age of 60. This poses a major challenge for the treating physician, particularly in the case of advanced tumors. For this reason, the German Cancer Society’s Oncology Guidelines Program has developed an S3 guideline for SCC, which was published in 2020 and updated in 2023. Advanced PEK develops in 5–20% of patients. Risk factors for this include vertical tumor thickness > 6 mm, horizontal diameter ≥ 2 cm, histological differentiation > grade 3, desmoplasia, perineural growth, location in the lower lip or ear, and immunosuppression. Excision and histological confirmation are necessary for all clinically suspicious lesions to enable prognostic assessment and correct treatment. The treatment of choice is complete excision of the primary tumor with histological margin control or, in the case of advanced tumors, anti-PD-1 treatment.