Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
Department of Dermatology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.
J Otolaryngol Head Neck Surg. 2021 Sep 7;50(1):54. doi: 10.1186/s40463-021-00529-7.
Head and neck cutaneous squamous cell carcinoma (HNCSCC) is a non-melanoma skin cancer that is mostly caused by solar ultraviolet radiation exposure. While it usually has an excellent prognosis, a subset of patients (5%) develops nodal metastasis and has poor outcomes. The aim of this study was to systematically review the literature and evaluate the prognostic factors of HNCSCC in order to better understand which patients are the most likely to develop metastatic disease.
A comprehensive literature search was performed on PubMed and EMBASE to identify the studies that evaluated the prognostic factors of HNCSCC. Prognostic factors were deemed significant if they had a reported p-value of < 0.05. Proportions of studies that reported a given factor to be statistically significant were calculated for each prognostic factor.
The search yielded a total of 958 citations. Forty studies, involving a total of 8535 patients, were included in the final analysis. The pre-operative/clinical prognostic factors with the highest proportion of significance were state of immunosuppression (73.3%) and age (53.3%); while post-operative/pathological prognostic factors of importance were number of lymph nodes involved with carcinoma (70.0%), margins involved with carcinoma (66.7%), and tumor depth (50.0%).
This systematic review is aimed to aid physicians in assessing the prognosis of HNCSCC and identifying the subsets of patients that are most susceptible to metastasis. It also suggests that immunosuppressed patients with a high-risk feature on biopsy, such as invasion beyond subcutaneous fat, could possibly benefit from a sentinel lymph node biopsy.
头颈部皮肤鳞状细胞癌（HNCSCC）是一种非黑色素瘤皮肤癌，主要由太阳紫外线辐射暴露引起。虽然它通常具有良好的预后，但有一部分患者（5%）会发生淋巴结转移，预后较差。本研究旨在系统地回顾文献并评估 HNCSCC 的预后因素，以便更好地了解哪些患者最有可能发生转移性疾病。
我们在 PubMed 和 EMBASE 上进行了全面的文献检索，以确定评估 HNCSCC 预后因素的研究。如果报告的预后因素的 p 值<0.05，则认为该预后因素具有统计学意义。计算了每个预后因素中报告给定因素具有统计学意义的研究比例。
检索共产生了 958 条引文。最终有 40 项研究，共涉及 8535 名患者，被纳入最终分析。术前/临床预后因素中，具有统计学意义的比例最高的是免疫抑制状态（73.3%）和年龄（53.3%）；而术后/病理预后因素中，重要的是受累淋巴结的数量（70.0%）、癌累及的边缘（66.7%）和肿瘤深度（50.0%）。
本系统综述旨在帮助医生评估 HNCSCC 的预后，并确定最易发生转移的患者亚组。它还表明，活检时具有高风险特征（如侵犯皮下脂肪以外的组织）的免疫抑制患者可能受益于前哨淋巴结活检。
