Sinclair M Gore1,2, Douglas Shaw1, Richard C W Martin1,3, Wendy Kelder1,4, Kathryn Roth1,5, Roger Uren6,7, Kan Gao1, Sarah Davies1, Bruce G Ashford8, Quan Ngo9, Kerwin Shannon1, Jonathan R Clark1,7,9. 1. Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. 2. Blenheim Head and Neck Cancer Centre, Oxford University Hospitals, Oxford, United Kingdom. 3. Melanoma Unit, Waitemata Health and Auckland Regional Head and Neck Service, University of Auckland, Auckland, New Zealand. 4. Department of Surgery, Martini Hospital, Groningen, The Netherlands. 5. Department of Otolaryngology - Head and Neck Surgery, St. Joseph's Health Care, London, Ontario, Canada. 6. Nuclear Medicine and Diagnostic Ultrasound, Royal Prince Alfred Hospital Medical Centre, Newtown, New South Wales, Australia. 7. Sydney Medical School, University of Sydney, New South Wales, Australia. 8. Wollongong Hospital, Wollongong, New South Wales, Australia. 9. Liverpool Hospital, Liverpool, New South Wales, Australia.
Abstract
BACKGROUND: Nodal metastasis from cutaneous squamous cell carcinoma (SCC) is poorly predicted clinically and is associated with a high mortality rate. METHODS: From 2010 to 2013, patients with high-risk cutaneous SCC were assessed with sentinel node biopsy (SNB) either at the time of primary cutaneous tumor resection or at secondary wide local excision. RESULTS: Of 57 patients, 8 (14%) had nodal metastasis. Significant predictors of metastasis are the number of high-risk factors (p = .008), perineural invasion (PNI; p = .05), and lymphovascular invasion (LVI; p = .05). During a mean of 19.4 months, 9 patients developed recurrence and 6 died of cutaneous SCC, indicating that over 1300 patients would be required for a randomized controlled trial with 80% power to detect a significant difference in disease-free survival. CONCLUSION: Lymph node metastasis occurs in 14% of patients with high-risk cutaneous SCC. Larger studies will be required to identify which "high-risk" factors should be considered as an indication for surgical assessment of the nodal basin.
BACKGROUND: Nodal metastasis from cutaneous squamous cell carcinoma (SCC) is poorly predicted clinically and is associated with a high mortality rate. METHODS: From 2010 to 2013, patients with high-risk cutaneous SCC were assessed with sentinel node biopsy (SNB) either at the time of primary cutaneous tumor resection or at secondary wide local excision. RESULTS: Of 57 patients, 8 (14%) had nodal metastasis. Significant predictors of metastasis are the number of high-risk factors (p = .008), perineural invasion (PNI; p = .05), and lymphovascular invasion (LVI; p = .05). During a mean of 19.4 months, 9 patients developed recurrence and 6 died of cutaneous SCC, indicating that over 1300 patients would be required for a randomized controlled trial with 80% power to detect a significant difference in disease-free survival. CONCLUSION: Lymph node metastasis occurs in 14% of patients with high-risk cutaneous SCC. Larger studies will be required to identify which "high-risk" factors should be considered as an indication for surgical assessment of the nodal basin.
Authors: Patrick L Quinn; Jin K Kim; Vishnu Prasath; Neal Panse; Thomas J Knackstedt; Ravi J Chokshi Journal: Arch Dermatol Res Date: 2022-03-18 Impact factor: 3.017
Authors: Matthew Fox; Marc Brown; Nicholas Golda; Dori Goldberg; Christopher Miller; Melissa Pugliano-Mauro; Chrysalyne Schmults; Thuzar Shin; Thomas Stasko; Yaohui G Xu; Kishwer Nehal Journal: J Am Acad Dermatol Date: 2018-09-15 Impact factor: 11.527
Authors: Guilherme Rabinowits; Michael R Migden; Todd E Schlesinger; Robert L Ferris; Morganna Freeman; Valerie Guild; Shlomo Koyfman; Anna C Pavlick; Neil Swanson; Gregory T Wolf; Scott M Dinehart Journal: JID Innov Date: 2021-08-25
Authors: Elahe Minaei; Simon A Mueller; Bruce Ashford; Amarinder Singh Thind; Jenny Mitchell; Jay R Perry; Benjamin Genenger; Jonathan R Clark; Ruta Gupta; Marie Ranson Journal: Front Oncol Date: 2022-04-11 Impact factor: 5.738