Department of Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle, United Kingdom.
Head Neck. 2011 Dec;33(12):1789-95. doi: 10.1002/hed.21583. Epub 2010 Nov 10.
Cutaneous squamous cell carcinoma (SCC) of the head and neck may metastasize in up to 5% of patients, with the parotid lymph nodes the most frequent site for spread. Metastases frequently show delayed presentation after the primary cancer had been treated. The optimum treatment should be surgery followed by adjuvant radiotherapy, with an appropriate parotidectomy, and preservation of the facial nerve if not involved by tumor and treatment to the neck. In a clinically N0 neck, levels I to III should be cleared for facial primaries, levels II to III for anterior scalp and external ear primaries, and levels II to V for posterior scalp primaries. Approximate 5-year disease-specific survival (DSS) after treatment was 70% to 75%. Patients with immunosuppression, in particular transplant recipients, are at high risk of developing aggressive metastatic cutaneous SCC. Modifications of the staging systems have demonstrated the prognostic benefits of accurately staging parotid and/or neck nodal disease.
头颈部皮肤鳞状细胞癌 (SCC) 可转移至多达 5%的患者，其中腮腺淋巴结是最常见的转移部位。转移灶常在原发肿瘤治疗后出现延迟表现。最佳治疗方法应为手术加辅助放疗，适当行腮腺切除术，如果肿瘤未累及面神经，应保留面神经，并治疗颈部。对于临床 N0 颈部，面部原发灶应清扫 I 至 III 区，前头皮和外耳原发灶应清扫 II 至 III 区，后头皮原发灶应清扫 II 至 V 区。治疗后约 5 年疾病特异性生存率 (DSS) 为 70%至 75%。免疫抑制患者，特别是移植受者，发生侵袭性转移性皮肤 SCC 的风险较高。分期系统的修改表明，准确分期腮腺和/或颈部淋巴结疾病具有预后益处。
