Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck

Sinclair M. Gore*, Douglas Shaw, Richard C W Martin, Wendy Kelder, Kathryn Roth, Roger Uren, Kan Gao, Sarah Davies, Bruce G. Ashford, Quan Ngo, Kerwin Shannon, Jonathan R. Clark

*Corresponding author for this work

Research output: Contribution to journalArticle

37 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)E884-E889
Number of pages6
JournalHead and Neck
Volume38
Issue numberS1
DOIs
Publication statusPublished - Apr 2016
Externally publishedYes

Keywords

  • squamous cell carcinoma
  • metastasis
  • skin cancer
  • head and neck
  • sentinel node biopsy

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