ReviewNodal staging of high-risk cutaneous squamous cell carcinoma
Section snippets
Clinical examination
Patients with HRcSCC should receive a comprehensive history and physical examination including a full-body skin examination, evaluation of peritumoral nerve function, and regional lymph node examination via manual palpation, generally every 6 to 12 months or more often depending on the risk profile of the tumor(s).17 The predictive value and limitations of clinical lymph node examination are outlined in Table III.18, 19, 20, 21, 22, 23 While clinical lymph node examination is clearly a
Discussion
The importance of risk stratification among patients with cSCC is clear, and the process of defining meaningful prognostic markers among the subset of patients with HRcSCC continues to evolve.
Among patients with cSCC who were diagnosed in the BWH cohort study from 2000 to 2009, the risk of nodal metastasis using the BWH T staging system is 0.1% (95% CI 0-0.4%) for BWH T1 tumors and 3% (1-5%) for BWH T2a tumors.11 The risk increases to 21% (13-27%) for BWH T2b tumors and 67% (30-90%) for BWH T3
References (52)
- et al.
Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study
Lancet Oncol
(2008) - et al.
Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection
J Am Acad Dermatol
(1992) - et al.
Accuracy of clinical examination versus computed tomography in detecting occult lymph node involvement in patients with oral epidermoid carcinoma
J Oral Maxillofac Surg
(1994) - et al.
The positive impact of radiologic imaging on high-stage cutaneous squamous cell carcinoma management
J Am Acad Dermatol
(2017) - et al.
Use of positron emission tomography scanning in metastatic head and neck cutaneous squamous cell cancer: does it add to patient management?
Am J Otolaryngol
(2014) - et al.
Ultrasound-guided fine needle aspiration cytology as an addendum to sentinel lymph node biopsy can perfect the staging strategy in melanoma patients
Eur J Cancer
(2014) - et al.
Detection of lymph node metastases in head and neck cancer: a meta-analysis comparing US, USgFNAC, CT and MR imaging
Eur J Radiol
(2007) - et al.
Lymphatic mapping and sentinel lymph node biopsy in squamous cell carcinoma of the lower lip
Eur J Surg Oncol
(2002) - et al.
Sentinel lymph node biopsy for high risk cutaneous squamous cell carcinoma: case series and review of the literature
Eur J Surg Oncol
(2007) - et al.
Sentinel node biopsy for high-risk cutaneous squamous cell carcinoma
Eur J Surg Oncol
(2014)
High-risk cutaneous squamous cell carcinoma and the emerging role of sentinel lymph node biopsy: a literature review
J Am Acad Dermatol
Complications of sentinel lymph node biopsy for melanoma - A systematic review of the literature
Eur J Surg Oncol
Utility of positron emission tomography/computed tomography for nodal staging of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia
Am J Otolaryngol
Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: a 10-year, single-institution cohort study
JAMA Dermatol
Metastases from squamous cell carcinoma of the skin in southern Australia
Dermatology
Squamous cell carcinoma of the skin of the trunk and limbs: the incidence of metastases and their outcome
Aust N Z J Surg
Evaluation of AJCC tumor staging for cutaneous squamous cell carcinoma and a proposed alternative tumor staging system
JAMA Dermatol
Mortality risk from squamous cell skin cancer
J Clin Oncol
Invasive squamous cell carcinoma of the skin: defining a high-risk group
Ann Surg Oncol
Evaluation of American Joint Committee on Cancer, International Union Against Cancer, and Brigham and Women’s Hospital tumor staging for cutaneous squamous cell carcinoma
J Clin Oncol
Staging for cutaneous squamous cell carcinoma as a predictor of sentinel lymph node biopsy results: meta-analysis of American Joint Committee on Cancer criteria and a proposed alternative system
JAMA Dermatol
Distant metastases from cutaneous squamous cell carcinoma--analysis of AJCC stage IV
Head Neck
Analysis and comparison of the 7th edition American Joint Committee on Cancer (AJCC) nodal staging system for metastatic cutaneous squamous cell carcinoma of the head and neck
Ann Surg Oncol
Metastatic head and neck cutaneous squamous cell carcinoma: defining a low-risk patient
Head Neck
Cited by (31)
Molecular imaging techniques for the knee
2023, Cartilage Tissue and Knee Joint Biomechanics: Fundamentals, Characterization and ModellingManagement of the parotid for high-risk cutaneous squamous cell carcinoma: A review from the salivary section of the American Head and Neck Society
2022, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryCitation Excerpt :In a meta-analysis examining the detection of lymph node metastasis, US with FNA had the highest sensitivity and specificity [35]. US has been put forth as more sensitive due to the superficial location of LN, however it should be noted that these conclusions were drawn mainly from other types of head and neck squamous cell carcinomas [36]. The utility of PET imaging is not well established for HRcSCC.
Sex-based differences in the anatomic distribution of cutaneous squamous cell carcinoma
2020, International Journal of Women's DermatologyCitation Excerpt :The majority of cSCCs are curable, particularly when treated at an early stage. However, invasive cSCCs with clinically aggressive features can reoccur and metastasize (Fox et al., 2019). In certain geographic regions of the United States, the number of deaths from invasive cSCC rivals that of melanoma (Karia et al., 2013), highlighting the need to focus screening and prevention efforts on identifying invasive cSCC.
Funding sources: None.
Conflicts of interest: Dr Schmults developed the Brigham and Women's Hospital staging system for high-risk squamous cell carcinoma referenced herein. Drs Nehal and Schmults are members of the American Joint Committee on Cancer cutaneous squamous cell carcinoma subcommittee for the American Joint Committee on Cancer 8th edition. The other authors have no conflicts of interest to disclose.