title: [Lymph node metastasis of cutaneous epidermoid carcinomas of the head and neck: prognostic factors and therapeutic strategies. Apropos of a series of 13 cases].
abstract: 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).
  
  
  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.
  
  
  CONCLUSIONS
  Poor criteria of these cutaneous tumors are defined: tumor size, histologic differentiation, 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.
authors.affiliation: CHU Dupuytren, Service d'ORL et de Chirurgie Cervico-Faciale, 2 avenue Martin Luther King, F-87042 Limoges, France. bessede@unilim.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Bessède
authors.forename: D
authors.initials: D
authors.lastname: Vinh
authors.forename: N
authors.initials: N
authors.lastname: Khalifa
authors.forename: B
authors.initials: B
authors.lastname: Rhein
authors.forename: P
authors.initials: P
authors.lastname: Clavère
authors.forename: S
authors.initials: S
authors.lastname: Orsel
authors.forename: J P
authors.initials: JP
authors.lastname: Sauvage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery; D013997:Time Factors