title: Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck.
abstract: Nodal metastasis from cutaneous squamous cell carcinoma (SCC) is poorly predicted clinically and is associated with a high mortality rate.
  
  
  
  From 2010 to 2013, patients with high-risk cutaneous SCC were assessed with sentinel node biopsy (SNB) either at the time of primary cutaneous tumor resection or at secondary wide local excision.
  
  
  
  Of 57 patients, 8 (14%) had nodal metastasis. Significant predictors of metastasis are the number of high-risk factors (p = .008), perineural invasion (PNI; p = .05), and lymphovascular invasion (LVI; p = .05). During a mean of 19.4 months, 9 patients developed recurrence and 6 died of cutaneous SCC, indicating that over 1300 patients would be required for a randomized controlled trial with 80% power to detect a significant difference in disease-free survival.
  
  
  
  Lymph node metastasis occurs in 14% of patients with high-risk cutaneous SCC. Larger studies will be required to identify which "high-risk" factors should be considered as an indication for surgical assessment of the nodal basin. © 2015 Wiley Periodicals, Inc. Head Neck 38: E884-E889, 2016.
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Blenheim Head and Neck Cancer Centre, Oxford University Hospitals, Oxford, United Kingdom.
authors.forename: Sinclair M
authors.initials: SM
authors.lastname: Gore
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Douglas
authors.initials: D
authors.lastname: Shaw
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Melanoma Unit, Waitemata Health and Auckland Regional Head and Neck Service, University of Auckland, Auckland, New Zealand.
authors.forename: Richard C W
authors.initials: RC
authors.lastname: Martin
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Department of Surgery, Martini Hospital, Groningen, The Netherlands.
authors.forename: Wendy
authors.initials: W
authors.lastname: Kelder
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Department of Otolaryngology - Head and Neck Surgery, St. Joseph's Health Care, London, Ontario, Canada.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Roth
authors.affiliation: Nuclear Medicine and Diagnostic Ultrasound, Royal Prince Alfred Hospital Medical Centre, Newtown, New South Wales, Australia.|Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Uren
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Kan
authors.initials: K
authors.lastname: Gao
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Davies
authors.affiliation: Wollongong Hospital, Wollongong, New South Wales, Australia.
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Ashford
authors.affiliation: Liverpool Hospital, Liverpool, New South Wales, Australia.
authors.forename: Quan
authors.initials: Q
authors.lastname: Ngo
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Kerwin
authors.initials: K
authors.lastname: Shannon
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Sydney Medical School, University of Sydney, New South Wales, Australia.|Liverpool Hospital, Liverpool, New South Wales, Australia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000175:diagnosis*; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: head and neck; metastasis; sentinel node biopsy; skin cancer; squamous cell carcinoma