Clinical practice guidelines for keratinocyte cancer

The guideline recommendations were approved by the Chief Executive Officer of the National Health and Medical Research Council (NHMRC) on
7 November 2019 under section 14A of the National Health and Medical Research Council Act 1992.

In approving the guideline recommendations, NHMRC considers that they meet the NHMRC standard for clinical practice guidelines. This approval is valid for a period of five years.

NHMRC is satisfied that the guideline recommendations are systematically derived, based on the identification and synthesis of the best available scientific evidence, and developed for health professionals practising in an Australian health care setting.

This publication reflects the views of the authors and not necessarily the views of the Australian Government.

Cite this guideline

Cancer Council Australia Keratinocyte Cancers Guideline Working Party. Clinical practice guidelines for keratinocyte cancer. Sydney: Cancer Council Australia. [Version URL: https://wiki.cancer.org.au/australiawiki/index.php?oldid=213931, cited 2023 May 28]. Available from: https://wiki.cancer.org.au/australia/Guidelines:Keratinocyte_carcinoma.

Endorsed by Endorsement validity: 31 July 2020 – 30 June 2023

Download: Short-form keratinocyte cancer guidelines (recommendations only)
Please also see the following files:

• Administrative report
• Dissemination plan

This is a wiki-based guideline. A PDF version of the recommendations in the guideline (short-form guideline), has been made available for download using the link above.

Quick reference guide: General practice management of keratinocyte cancer

1. Epidemiology

• Epidemiology of basal cell carcinoma
• Epidemiology of cutaneous squamous cell carcinoma

2. Prevention of keratinocyte cancer

• Strategies for UV radiation protection
• Chemoprevention
• Vitamin D

4. Clinical features

• Clinical features of basal cell carcinoma
• Clinical features of cutaneous squamous cell carcinoma and related keratinocyte tumours

5. Pathology

• Pathology of basal cell carcinoma
• Pathology of cutaneous squamous cell carcinoma and related tumours
• Pathology of keratoacanthoma
• Pathology of rare tumours
• Biopsy considerations and the biopsy report

6. Prognosis

• Prognosis of basal cell carcinoma
• Prognosis of cutaneous squamous cell carcinoma

7. Surgical treatment

• Considerations before selecting a surgical treatment modality
• Optimal primary excision techniques:
  • Optimal surgical technique for the treatment of basal cell carcinoma
  • Considerations when planning surgical treatment for cutaneous squamous cell carcinoma
• Post-surgical care and interpretation of the pathology report
• Protocol to manage incompletely resected basal cell carcinoma
• Protocol to manage rapidly growing tumours
• Criteria for choosing Mohs micrographic surgery in preference to other surgical techniques
• Surgical management of advanced cutaneous squamous cell carcinoma
• Surgical treatment – Health system implications and discussion

8. Radiotherapy

• Radiotherapy with or without surgical treatment for keratinocyte cancer
• Radiotherapy for basal cell carcinoma
• Radiotherapy for primary cutaneous squamous cell carcinoma
• Radiotherapy for regional (nodal) metastatic disease (non-distant)
• Radiotherapy for actinic keratosis and cutaneous squamous cell carcinoma in situ
• Radiotherapy for keratoacanthoma
• Recent advances in the radiotherapy of skin cancer
• Management of radiotherapy side effects
• Radiotherapy – Health system implications and discussion

9. Cryotherapy and electrodessication and curettage (EDC)

• Cryotherapy and EDC for basal cell carcinoma
• Cryotherapy and EDC for cutaneous squamous cell carcinoma
• Cryotherapy and EDC – Health system implications and discussion

10. Topical treatments and photodynamic therapy

• Topical treatments (imiquimod, diclofenac, 5-flourouracil, ingenol mebutate)
• Photodynamic therapy
• Topical treatments and photodynamic therapy – Health system implications and discussion

11. Organ transplantation and other conditions associated with immunosuppression

• Epidemiology of keratinocyte cancers in immunosuppressed patients
• Management of keratinocyte cancer risk in organ transplant recipients
• Strategies to manage keratinocyte cancer in organ transplant recipients
• Organ transplantation and other conditions associated with immunosuppression – Health system implications and discussion

12. Metastatic disease and systemic therapies

• Systemic therapies for advanced and metastatic basal cell carcinoma
• Systemic therapies for metastatic cutaneous squamous cell carcinoma
• Metastatic disease and systemic therapies – Health system implications and discussion

Appendices

• TNM classification of primary cutaneous carcinomas
• Guideline development process
• List of clinical questions
• Technical report
• Working party members and contributors
• Declarations of interest register
• Glossary of technical terms and abbreviations

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