Imaging and sentinel lymph node biopsy in high risk head and neck cutaneous squamous cell carcinoma: a Chinese cohort study.

OBJECTIVE

To evaluate the most effective modalities for detecting lymph node metastasis and to ascertain whether these procedures influenced management decisions and correlated with disease-related outcomes in head and neck cutaneous squamous cell carcinoma (HNcSCC) based on a Chinese cohort.

METHODS

High-risk HNcSCC patients were retrospectively enrolled and categorized into three groups based on neck evaluation methods: ultrasound (U), ultrasound plus CT (UC), and ultrasound plus CT plus sentinel lymph node biopsy (UCS). The impact of these modalities on regional control and overall survival was analyzed using a Cox proportional hazards model.

RESULTS

The U, UC, and UCS groups comprised 91, 102, and 77 patients, respectively. In the multivariable analysis for regional control, patients in the UC group exhibited a hazard ratio of 1.48 [95%CI: 1.06-2.77] compared to the UCS group, while those in the U group demonstrated an HR of 1.43 [95%CI: 1.10-3.00]. Regarding overall survival, the multivariable analysis revealed that patients in the UC group had an HR of 1.67 [95%CI: 1.11-2.89] compared to the UCS group, with the U group also presenting an HR of 1.69 [95%CI: 1.21-3.12]. The UC group exhibited a management change rate of 6.8% attributable to the addition of CT, while sentinel lymph node biopsy led to a management change rate of 7.8% in the UCS group. Among the three modalities, SLNB demonstrated the highest diagnostic accuracy, with a sensitivity of 85.7% and a specificity of 100%.

CONCLUSION

The combination of ultrasound, CT, and SLNB resulted in improved prognostic outcomes for patients with high-risk HNcSCC.