title: Predicting the pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck based on location of the primary.
abstract: BACKGROUND
  We aimed to analyze the distribution of regional nodal metastases according to primary tumor location in patients with cutaneous squamous cell carcinoma of the head and neck (SCCHN).
  
  
  METHODS
  Analysis of 295 neck dissections performed for patients with clinically evident regional metastases from cutaneous SCCHN between 1987 and 2009.
  
  
  RESULTS
  Level I involvement in the absence of level II or III only occurred in patients with facial primaries. In patients with clear nodes in level II-III, the risk of level IV-V involvement was 0.0% for external ear primaries, 2.7% for face and anterior scalp, and 15.8% for posterior scalp and neck.
  
  
  CONCLUSIONS
  In patients undergoing parotidectomy for metastatic cutaneous SCCHN with a clinically negative neck, the results of this study support selective neck dissection including level I-III for facial primaries, level II-III for anterior scalp and external ear primaries, and levels II-V for posterior scalp and neck primaries.
authors.affiliation: Sydney Head and Neck Cancer Institute and The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Ardalan
authors.initials: A
authors.lastname: Ebrahimi
authors.forename: Marc D
authors.initials: MD
authors.lastname: Moncrieff
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.forename: Kerwin F
authors.initials: KF
authors.lastname: Shannon
authors.forename: Kan
authors.initials: K
authors.lastname: Gao
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Milross
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000556:secondary / Q000601:surgery; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*