Delayed regional metastasis from small face/scalp cutaneous squamous carcinoma: outcomes and predictors

IF 1.8 4区医学 Q3 DERMATOLOGY

Archives of Dermatological Research Pub Date : 2025-04-12 DOI:10.1007/s00403-025-04224-9

Courtney B. Shires, John D. Boughter, Christopher P. Golembeski, Nicholas M. Sharp, Arabella T. Hall, Merry E. Sebelik

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引用次数: 0

Abstract

Objective: CSCC (cutaneous squamous cell carcinoma) of the face/scalp generally has a favorable outcome. However, patients with delayed regional metastasis from scalp/facial CSCC do very poorly. Historically, prophylactic treatment of the N0 neck for the T1-T2 (as staged in the AJCC 7th edition) face/scalp cancers has not been recommended. This study aims to determine predictors of delayed regional metastases in < 4 cm CSCC of the face and scalp. Methods: We retrospectively analyzed medical records of patients diagnosed regional metastasis of CSCC of the scalp/face at least 6 months after the diagnosis of the primary CSCC at a tertiary academic head and neck clinic during a period between 2012 and 2018. Results: A total of 50 patients with CSCC of the face/scalp were diagnosed and treated for delayed cervical lymph node metastasis during a 6-year period. All patients were male. Areas affected were the scalp, cheeks, and forehead. No patient had neck lymph node metastases at initial presentation for their scalp/face cancer. The presence of perineural invasion in the primary tumor was the only observed predictor of delayed neck lymph node recurrence. We did not observe an association between diameter/depth of the primary skin tumor or lymphovascular invasion and the presence of regional lymph node recurrence. Conclusion: In our review, perineural invasion (PNI) was the one factor predictive of delayed regional lymph node metastasis. This observation confirms the use of PNI to upstage even small CSCC to T3. Prophylactic treatment of the neck in patients with small scalp/face cancers with PNI should be strongly considered, especially in the age of immunotherapy.

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小面部/头皮皮肤鳞状癌的延迟区域转移：结果和预测因素

目的：面部/头皮的皮肤鳞状细胞癌（CSCC）通常具有良好的预后。然而，头皮/面部CSCC延迟区域转移的患者表现非常差。历史上，对于T1-T2（在AJCC第7版中分期）面部/头皮癌，0号颈的预防性治疗尚未被推荐。本研究旨在确定面部和头皮4cm CSCC延迟区域转移的预测因素。方法：回顾性分析2012年至2018年在三级学术头颈门诊诊断为原发性CSCC后至少6个月诊断为头皮/面部CSCC区域转移的患者的医疗记录。结果：在6年的时间里，共有50例面部/头皮CSCC患者因迟发性颈部淋巴结转移被诊断和治疗。所有患者均为男性。受影响的部位包括头皮、脸颊和前额。没有患者在最初出现头皮/面部癌时出现颈部淋巴结转移。原发肿瘤中神经周围浸润的存在是唯一观察到的延迟性颈部淋巴结复发的预测因子。我们没有观察到原发皮肤肿瘤的直径/深度或淋巴血管浸润与区域淋巴结复发之间的关联。结论：在我们的综述中，神经周围浸润（PNI）是延迟性区域淋巴结转移的一个预测因素。这一观察结果证实了PNI的使用，甚至可以将小的CSCC抢到T3。应强烈考虑对伴有PNI的小头皮/面部癌患者的颈部进行预防性治疗，特别是在免疫治疗的时代。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Dermatological Research 医学-皮肤病学

CiteScore

4.10

自引率

3.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Archives of Dermatological Research is a highly rated international journal that publishes original contributions in the field of experimental dermatology, including papers on biochemistry, morphology and immunology of the skin. The journal is among the few not related to dermatological associations or belonging to respective societies which guarantees complete independence. This English-language journal also offers a platform for review articles in areas of interest for dermatologists and for publication of innovative clinical trials.