Gore Sinclair M, Shaw Douglas, Martin Richard C W, Kelder Wendy, Roth Kathryn, Uren Roger, Gao Kan, Davies Sarah, Ashford Bruce G, Ngo Quan, Shannon Kerwin, Clark Jonathan R
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.
Head Neck. 2016 Apr;38 Suppl 1:E884-9. doi: 10.1002/hed.24120. Epub 2015 Jul 15.
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.
皮肤鳞状细胞癌（SCC）的淋巴结转移在临床上难以预测，且与高死亡率相关。
2010年至2013年，对高危皮肤SCC患者在原发性皮肤肿瘤切除时或二次广泛局部切除时进行前哨淋巴结活检（SNB）评估。
57例患者中，8例（14%）发生淋巴结转移。转移的显著预测因素为高危因素数量（p = .008）、神经周围侵犯（PNI；p = .05）和淋巴管侵犯（LVI；p = .05）。在平均19.4个月期间，9例患者出现复发，6例死于皮肤SCC，这表明需要超过1300例患者进行一项具有80%检验效能的随机对照试验，以检测无病生存期的显著差异。
14%的高危皮肤SCC患者会发生淋巴结转移。需要开展更大规模的研究来确定哪些“高危”因素应被视为对淋巴结区域进行手术评估的指征。© 2015威利期刊公司。《头颈》38: E884 - E889，2016年。
