Issue N# 2 - 2001
Cervical lymph node metastases of cutaneous squamous cell carcinoma of the head and neck. Personal series and pronostic factors studies, management of cervical nodes.
Authors : J.-P. Bessède, D. Vinh, N. Khalifa, B. Rhein, P. Clavère, S. Orsel, J.-P. Sauvage (Limoges)
Ref. : Rev Laryngol Otol Rhinol. 2001;122,2:111-117.
Article published in french
Downloadable PDF document french
Squamous cell skin carcinoma has a relatively low rate of metastasis (0.5 to 16%), but the prognosis of these metastases is poor (22% of survival at 5 years). Patients and methods: from a series of 243 patients, we studied 13 patients who were found initially to have metastases or who developed metastases later. Fifty-four percent (54%) of the patients presented initially with regional lymph node and parotid involvement in 54%. Results: all patients underwent surgery with removal of the skin cancer and a neck dissection. Radiotherapy was performed later in 92% of the cases.The 2 years survival rate was 62% and mean survival by Kaplan Meier curve was 47 months. Discussion: poor criteria of these cutaneous tumors are defined: tumor size, histologic differentation, perineural spread. Patients with severe criteria must have a neck dissection to control the first lymph node. Along the anatomic area of the cutaneous tumor, a parotidectomy, a submaxillary control or a neck dissection will be performed. Its involvement will be followed by a neck dissection. A comparative study of the literature is made. Poor prognostic criteria of these cutaneous tumors are defined, in addition to the initial management of the cervical and parotid lymph nodes.
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