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

doi:10.1002/hed.24120

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 journal › Article › peer-review

77 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 language	English
Pages (from-to)	E884-E889
Number of pages	6
Journal	Head and Neck
Volume	38
Issue number	S1
DOIs	https://doi.org/10.1002/hed.24120
Publication status	Published - Apr 2016
Externally published	Yes

Keywords

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

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10.1002/hed.24120

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

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.",

keywords = "squamous cell carcinoma, metastasis, skin cancer, head and neck, sentinel node biopsy",

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

year = "2016",

month = apr,

doi = "10.1002/hed.24120",

language = "English",

volume = "38",

pages = "E884--E889",

journal = "Head and Neck",

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TY - JOUR

T1 - Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck

AU - Gore, Sinclair M.

AU - Shaw, Douglas

AU - Martin, Richard C. W.

AU - Kelder, Wendy

AU - Roth, Kathryn

AU - Uren, Roger

AU - Gao, Kan

AU - Davies, Sarah

AU - Ashford, Bruce G.

AU - Ngo, Quan

AU - Shannon, Kerwin

AU - Clark, Jonathan R.

PY - 2016/4

Y1 - 2016/4

N2 - 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.

AB - 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.

KW - squamous cell carcinoma

KW - metastasis

KW - skin cancer

KW - head and neck

KW - sentinel node biopsy

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U2 - 10.1002/hed.24120

DO - 10.1002/hed.24120

M3 - Article

C2 - 25965008

AN - SCOPUS:84937047097

SN - 1043-3074

VL - 38

SP - E884-E889

JO - Head and Neck

JF - Head and Neck

IS - S1

ER -

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

Abstract

Keywords

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