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Life sciences · Journal article
Ieccmexico · October 4, 2026
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High-risk cutaneous cancer represents a complex clinical scenario in which adequate oncological control must be balanced with preservation of anatomy, function, and quality of life. This study aimed to analyze and integrate current evidence regarding surgical margin assessment, contemporary oncological treatment, and function-oriented reconstruction in patients with aggressive cutaneous malignancies, particularly cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma. A clinically oriented integrative review guided by the Scientific Method was conducted using evidence from clinical practice guidelines, systematic reviews, clinical trials, observational studies, and reconstructive series. The analysis was organized into three domains: risk stratification and margin control, oncological treatment, and functional reconstruction. Available evidence demonstrated a pooled incomplete excision rate of approximately 13% in cutaneous squamous cell carcinoma, highlighting the relevance of accurate histological margin assessment and the role of micrographically controlled surgery in selected high-risk lesions. In resectable high-risk cutaneous squamous cell carcinoma, neoadjuvant cemiplimab produced a pathological complete response in 51% of patients and a major pathological response in an additional 13%. In the adjuvant setting, cemiplimab was associated with higher 24-month disease-free survival compared with placebo in patients at high risk of recurrence after definitive local treatment. Reconstructive evidence showed considerable heterogeneity and limited incorporation of standardized functional and patient-reported outcomes. The findings support a multidisciplinary and risk-adapted therapeutic model integrating staging, margin control, oncological therapy, confirmation of tumor clearance, function-preserving reconstruction, and long-term follow-up. Future studies should evaluate oncological, reconstructive, functional, and patient-centered outcomes simultaneously to optimize both disease control and post-treatment quality of life.