High-Risk Cutaneous Squamous Cell Carcinoma ofthe Head and Neck

[摘要] Nonmelanoma skin cancers (squamous cell and basal cellcarcinomas) occur at an epidemic rate in many countries with the worldwideincidence increasing. The sun-exposed head and neck are the most frequentsites for these cancers to arise and in most patients diagnosed witha cutaneous squamous cell carcinoma, local treatment is usually curative. However,a subset is diagnosed with a high-risk cutaneous squamous cell carcinoma. High-riskfactors include size (> 2 cm), thickness/depth of invasion (> 4 mm), recurrent lesions, the presence of perineuralinvasion, location near the parotid gland, and immunosuppression. Thesepatients have a higher risk (> 10–20%) of developing metastases to regional lymphnodes (often parotid nodes), and in some cases also of experiencinglocal morbidity (perineural invasion), based on unfavourable primarylesion and patient factors. Despite treatment, many patients developingmetastatic cutaneous squamous cell carcinoma experience mortality andmorbidity usually as a consequence of uncontrolled metastatic nodal disease. It istherefore important that clinicians treating nonmelanoma skin cancers have anunderstanding and awareness of these high-risk patients. The aim of this article is todiscuss the factors that define a high-risk patient and to present some of the issuespertinent to their management.

[学科分类] 基础医学