There aren't really any other must-have abilities within practical reach. Punishing Barbs is great situationally, such as when you're soloing leves with humanoids/undead/etc. in them.
Feint and Trammel are the best dmg/TP WSs that Lancer can use. Moonrise and Leg Sweep are both useful and great because the debuff can proc another skill gain. Skull Sunder from Marauder is another great dmg/TP WS. You should only use Skewer or Doomspike if you can line up several mobs that you need to kill in a hurry.
When you need to bind something in order to run away.
You definitely need more VIT. I currently have a fairly even physical build (90/90/95 STR/VIT/DEX) and AoEs from mobs that I grind on in parties can take a good 80-90% of my health off, even with Shell.
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