Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes

• Published in: Head & neck 2007-07, Vol.29 (7), p.621-631
• Main Authors: Veness, Michael J., Porceddu, Sandro, Palme, Carsten E., Morgan, Gary J.
• Format: Article
• Language: English
• Subjects: Adjuvants; Biological and medical sciences; Biomarkers, Tumor - metabolism; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cervix; Chemotherapy; Clinical trials; cutaneous squamous cell carcinoma; Dermatology; Ear; Epidemics; Epidermal growth factor receptors; Head; Head and neck; Head and neck cancer; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Humans; Immunocompromised Host; Lymph nodes; Lymph Nodes - pathology; Lymphatic Metastasis; Medical sciences; Metastases; Morbidity; Mortality; Neck; Neoplasm Invasiveness; Neoplasm Staging; nodal metastases; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Parotid Gland - pathology; Parotid Gland - surgery; Prognosis; Radiotherapy; Radiotherapy, Adjuvant; Risk factors; Risk groups; Scalp; Sentinel Lymph Node Biopsy; Skin cancer; Skin Neoplasms - pathology; Skin Neoplasms - therapy; squamous cell carcinoma; Surgery; Survival; Tumors; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.20576

Nonmelanoma skin cancers occur at an epidemic rate in Australia and are increasing in incidence worldwide. In most patients, local treatment is curative. However, a subset of patients will be diagnosed with a high‐risk cutaneous squamous cell carcinoma (SCC) and are defined as patients at increased risk of developing metastases to regional lymph nodes. Patients with high‐risk SCC may be identified based on primary lesion and patient factors. Most cutaneous SCC arises on the sun‐exposed head and neck. The parotid and upper cervical nodes are common sites for the development of metastases arising from ear, anterior scalp, temple/forehead, or scalp SCC. The mortality and morbidity associated with high‐risk cutaneous SCC is usually a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Patients with operable nodal disease have traditionally been recommended for surgery. The efficacy of adjuvant radiotherapy has previously been questioned based on weak evidence in the early literature. Recent evidence from larger studies has, however, strengthened the case for adjuvant radiotherapy as a means to improve locoregional control and survival. Despite this, many patients still experience relapse and die. Research aimed at improving outcome such as a randomized trial incorporating the addition of chemotherapy to adjuvant radiotherapy is currently in progress in Australia and New Zealand. Ongoing research also includes the development of a proposed new staging system and investigating the role of molecular factors such as the epidermal growth factor receptor. © 2007 Wiley Periodicals, Inc. Head Neck, 2007