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Surgery remains central for curative skin cancer care, yet more patients now present with high-risk, locally advanced, recurrent, or aggressive disease that challenges a surgery-only approach. This narrative review synthesizes innovations and explains how dermatologic surgery shifts into integrated precision oncology. It emphasizes risk-adapted margin-controlled and function-preserving techniques, multidisciplinary treatment sequencing, and outcome data across major malignancies, including roles for Mohs surgery, radiotherapy, systemic therapy, and combined strategies in neoadjuvant, adjuvant, and salvage settings, with attention to toxicity and patient selection.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/innovations-in-cutaneous-oncology-and-dermatologic-surgery-from-margin-control-to-integrated-precision-oncology/353775/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/innovations-in-cutaneous-oncology-and-dermatologic-surgery-from-margin-control-to-integrated-precision-oncology/353775.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-25","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why has cutaneous oncology treatment evolved beyond surgery alone?","Question",{"text":112,"@type":113},"Treatment pathways now face high proportions of patients with high-risk, locally advanced, recurrent, or biologically aggressive disease. Advances in systemic and locoregional therapies have reshaped care, requiring more than surgery-only strategies.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does dermatologic surgery fit into integrated precision oncology?",{"text":117,"@type":113},"Dermatologic surgery is described as transitioning from a standalone intervention to a central component within multidisciplinary precision oncology. Sequencing combines surgery with systemic and radiotherapeutic approaches to optimize outcomes and preserve function.",{"name":119,"@type":110,"acceptedAnswer":120},"Which surgical techniques are emphasized for margin control and function preservation?",{"text":121,"@type":113},"The review highlights margin-controlled and function-preserving techniques, with particular attention to Mohs micrographic surgery. It also compares when standard excision, Mohs surgery, radiotherapy, systemic therapy, or combinations are preferred.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},353775,1790330895,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Review  \nInnovations in Cutaneous Oncology and Dermatologic Surgery: From Margin Control to Integrated Precision Oncology  \nMaria Goreti Baião Catorze 1, * and Paulo Filipe 2  \nAcademic Editor: Philip R. Cohen  \nReceived: 21 January 2026  \nRevised: 12 February 2026  \nAccepted: 15 February 2026  \nPublished: 18 February 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Dermatology, Hospital Egas Moniz—ULS Lisboa Ocidental, 1349-019 Lisbon, Portugal  \n2 Department of Dermatology, Centro Hospitalar Universitário de Lisboa Norte, Faculty of Medicine, University of Lisbon, 1649-019 Lisbon, Portugal; [paulolealfilipe@gmail.com](paulolealfilipe@gmail.com)  \n* Correspondence: [goreticatorze@hotmail.com](goreticatorze@hotmail.com)  \nSimple Summary  \nSkin cancer treatment has evolved beyond surgery alone. While surgical excision remains the cornerstone of cure for most tumours, advances in targeted therapy, immunotherapy, and locoregional treatments have transformed care for complex and advanced cases. Dermatologic surgery is now integrated within multidisciplinary precision oncology, where treatment sequencing combines surgery with systemic and radiotherapeutic approaches to optimize outcomes and preserve function. This review summarizes recent innovations in cutaneous oncology and explains how modern dermatologic surgeons play a central role in coordinating personalized, multimodal cancer care.  \nAbstract  \nCutaneous oncology is undergoing a major transformation driven by advances in tumour biology, immunotherapy, targeted agents, and locoregional technologies. Although surgery remains the cornerstone of curative treatment for most skin cancers, an increasing proportion of patients present with high-risk, locally advanced, recurrent, or biologically aggressive disease that challenges a surgery-only paradigm. In this evolving landscape, dermatologic surgery has transitioned from a standalone intervention to a central component of integrated precision oncology. This narrative review provides a clinically oriented synthesis of recent innovations in cutaneous oncology and dermatologic surgery, with a focus on risk-adapted surgical decision-making and multidisciplinary treatment sequencing. We examine the evolving role of margin-controlled and function-preserving techniques, particularly Mohs micrographic surgery, and define clinical scenarios in which standard excision, Mohs surgery, radiotherapy, systemic therapy, or combined approaches are preferred. Quantitative outcome data from pivotal trials are incorporated where available, including local control, recurrence risk, response rates, and survival outcomes. Across major cutaneous malignancies—basal cell carcinoma, cutaneous squamous cell carcinoma, melanoma, and selected rare tumours—we discuss how targeted therapies, immune checkpoint inhibitors, radiotherapy, and locoregional treatments are increasingly integrated with surgery in neoadjuvant, adjuvant, consolidative, and salvage settings. Particular attention is given to treatment-related toxicities, patient selection, and the implications of systemic therapy on surgical timing, reconstruction, and morbidity. High-risk populations, including immunosuppressed patients, are specifically addressed. By outlining adaptive therapeutic algorithms and emphasizing multidisciplinary collaboration, this review highlights the expanding role of the dermatologic surgeon in modern oncology. Surgery remains indispensable for local control and cure; however, its greatest impact now lies in strategic integration with systemic and locoregional therapies to optimise oncologic outcomes, preserve function, and deliver personalised, patient-centred care.  \nKeywords: cutaneous oncology; dermatologic surgery; Mohs micrographic surgery; precision oncology; immunotherapy; targeted ther","cbCaiv60tkXGchcD","https://ap.wps.com/l/cbCaiv60tkXGchcD","pdf",576180,14,"English","# Introduction\n## Evolution of cutaneous oncology and dermatologic surgery\n## Need for integrative, clinically focused analyses\n# Objective of the review","[{\"question\":\"Why has cutaneous oncology treatment evolved beyond surgery alone?\",\"answer\":\"Treatment pathways now face high proportions of patients with high-risk, locally advanced, recurrent, or biologically aggressive disease. Advances in systemic and locoregional therapies have reshaped care, requiring more than surgery-only strategies.\"},{\"question\":\"How does dermatologic surgery fit into integrated precision oncology?\",\"answer\":\"Dermatologic surgery is described as transitioning from a standalone intervention to a central component within multidisciplinary precision oncology. Sequencing combines surgery with systemic and radiotherapeutic approaches to optimize outcomes and preserve function.\"},{\"question\":\"Which surgical techniques are emphasized for margin control and function preservation?\",\"answer\":\"The review highlights margin-controlled and function-preserving techniques, with particular attention to Mohs micrographic surgery. It also compares when standard excision, Mohs surgery, radiotherapy, systemic therapy, or combinations are preferred.\"}]","Innovations in Cutaneous Oncology and Dermatologic Surgery - From Margin Control to Integrated Precision Oncology | PDF",1790107162,35]