title: Pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck.
abstract: OBJECTIVE
  To assess the pattern of regional metastases from SCC of the skin of the head and neck as a prognostic factor.
  
  
  METHODS
  A retrospective chart review of 22 patients treated in a tertiary academic center.
  
  
  RESULTS
  Metastases could be assessed clinically in the parotid gland and the neck in 50% and 59% of the patients, respectively. Histologic examination showed metastases in the parotid gland and the neck in 68% and 45.5%, respectively. Occult disease was 36% and 20% in the parotid gland and neck, respectively. The 1st echelon for metastasis was the parotid gland lymph nodes, whereas level II lymph nodes were the 1st echelon in the neck. Metastases to both the parotid gland and neck decreased the overall survival to 0, compared with 60% for metastases to the parotid gland and 100% for the neck.
  
  
  CONCLUSIONS
  SCC of the skin of the head and neck with regional metastases has a high incidence of occult metastases in the parotid gland and the neck. Patients with metastases in both sites have a poor prognosis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Carmel Medical Center, Haifa, Israel. geva_b@hotmail.com
authors.forename: Geva
authors.initials: G
authors.lastname: Barzilai
authors.forename: Elhanan
authors.initials: E
authors.lastname: Greenberg
authors.forename: Raanan
authors.initials: R
authors.lastname: Cohen-Kerem
authors.forename: Ilana
authors.initials: I
authors.lastname: Doweck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*