Predicting the pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck based on location of the primary

Authors

  • Ardalan Ebrahimi FRACS,

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Marc D. Moncrieff MD, FRCS (Plast),

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Jonathan R. Clark FRACS,

    Corresponding author
    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
    • Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Kerwin F. Shannon FRACS,

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Kan Gao BEng,

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Christopher G. Milross MD, FRANZCR,

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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  • Christopher J. O'Brien MS, MD, FRCS, FRACS, AO

    1. Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia
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    • Deceased.


Abstract

Background

We aimed to analyze the distribution of regional nodal metastases according to primary tumor location in patients with cutaneous squamous cell carcinoma of the head and neck (SCCHN).

Methods

Analysis of 295 neck dissections performed for patients with clinically evident regional metastases from cutaneous SCCHN between 1987 and 2009.

Results

Level I involvement in the absence of level II or III only occurred in patients with facial primaries. In patients with clear nodes in level II–III, the risk of level IV–V involvement was 0.0% for external ear primaries, 2.7% for face and anterior scalp, and 15.8% for posterior scalp and neck.

Conclusion

In patients undergoing parotidectomy for metastatic cutaneous SCCHN with a clinically negative neck, the results of this study support selective neck dissection including level I–III for facial primaries, level II–III for anterior scalp and external ear primaries, and levels II–V for posterior scalp and neck primaries. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

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