BACKGROUND: The purpose of the study was to develop a system of risk stratification, based on clinical and histological factors that would aid prediction of metastasis from cutaneous squamous cell carcinoma (SCC) of the head and neck. METHOD: The method used was a retrospective case control study comparing clinical and histological parameters of 78 patients who developed metastasis with 92 patients who did not develop metastasis over a 5-year period. RESULTS: The two 'absolute' (highest) risk factors for development of metastatic disease are poor histological differentiation and perineural/lymphovascular infiltration. The three 'relative' risk factors are moderate histological differentiation, diameter ≥20 mm and Clark level 5. RISK STRATIFICATION: High-risk lesions have either one of the absolute risk factors or all three of the relative risk factors with a predicted incidence of metastasis of 37%. Intermediate risk lesions have two of three relative risk factors and a predicted incidence of metastasis of 5%. Low-risk lesions have one or none of the relative risk factors and a predicted incidence of metastasis of 0.3%. CONCLUSION: Ongoing management of patients with histo-pathologically proven invasive SCC of the head and neck should be based upon risk stratification for metastasis.
BACKGROUND: The purpose of the study was to develop a system of risk stratification, based on clinical and histological factors that would aid prediction of metastasis from cutaneous squamous cell carcinoma (SCC) of the head and neck. METHOD: The method used was a retrospective case control study comparing clinical and histological parameters of 78 patients who developed metastasis with 92 patients who did not develop metastasis over a 5-year period. RESULTS: The two 'absolute' (highest) risk factors for development of metastatic disease are poor histological differentiation and perineural/lymphovascular infiltration. The three 'relative' risk factors are moderate histological differentiation, diameter ≥20 mm and Clark level 5. RISK STRATIFICATION: High-risk lesions have either one of the absolute risk factors or all three of the relative risk factors with a predicted incidence of metastasis of 37%. Intermediate risk lesions have two of three relative risk factors and a predicted incidence of metastasis of 5%. Low-risk lesions have one or none of the relative risk factors and a predicted incidence of metastasis of 0.3%. CONCLUSION: Ongoing management of patients with histo-pathologically proven invasive SCC of the head and neck should be based upon risk stratification for metastasis.
Authors: Agnieszka K Thompson; Benjamin F Kelley; Larry J Prokop; M Hassan Murad; Christian L Baum Journal: JAMA Dermatol Date: 2016-04 Impact factor: 10.282
Authors: Melinda B Chu; Jordan B Slutsky; Maulik M Dhandha; Brandon T Beal; Eric S Armbrecht; Ronald J Walker; Mark A Varvares; Scott W Fosko Journal: J Skin Cancer Date: 2014-09-17
Authors: Joshua Lubov; Mathilde Labbé; Krystelle Sioufi; Grégoire B Morand; Michael P Hier; Manish Khanna; Khalil Sultanem; Alex M Mlynarek Journal: J Otolaryngol Head Neck Surg Date: 2021-09-07
Authors: Aaron S Farberg; Alison L Fitzgerald; Sherrif F Ibrahim; Stan N Tolkachjov; Teo Soleymani; Leah M Douglas; Sarah J Kurley; Sarah T Arron Journal: Dermatol Ther (Heidelb) Date: 2022-01-07