title: Anatomical restrictions in the surgical excision of scalp squamous cell carcinomas: does this affect local recurrence and regional nodal metastases?
abstract: Squamous cell carcinomas (SCCs) of the skin of the scalp have the potential for regional metastases. Microscopically, clearance may be less than the optimal dimensions. We report 101 SCCs of the scalp treated surgically under the care of a single oral and maxillofacial surgeon. Forty-two of the study patients had deep margins that were clear by less than 2mm, of whom five had margins that involved pericranium±skull. Our study demonstrated a local recurrence rate of 6% and a regional recurrence rate of 7%. All patients presented with relapse of the disease within 18 months of primary surgery. The evidence presented in this study suggests that in SCCs of the scalp, less than ideal surgical margin clearance, entirely due to anatomical restrictions, does not appear to substantially affect regional recurrence, but increases the risk of local recurrence.
authors.affiliation: Department of Oral and Maxillofacial Surgery, York Teaching Hospital, York, UK. Electronic address: gwjenkins@hotmail.co.uk.
authors.forename: G
authors.initials: G
authors.lastname: Jenkins
authors.affiliation: Department of Oral and Maxillofacial Surgery, York Teaching Hospital, York, UK.
authors.forename: A B
authors.initials: AB
authors.lastname: Smith
authors.affiliation: Department of Oral and Maxillofacial Surgery, York Teaching Hospital, York, UK.
authors.forename: A N
authors.initials: AN
authors.lastname: Kanatas
authors.affiliation: Department of Oral and Maxillofacial Surgery, York Teaching Hospital, York, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Houghton
authors.affiliation: Department of Oral and Maxillofacial Surgery, York Teaching Hospital, York, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Telfer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012535:Scalp / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: cutaneous squamous cell carcinoma; recurrence rates; scalp