Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck

Abstract

BackgroundSkin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm.MethodsThe medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines.ResultsAmong the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases.ConclusionIn our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

Sentinel lymph node biopsy for high‐risk cutaneous squamous cell carcinoma of the head and neck

“…Although SLNB is widely used as an important tool in the staging and management of melanoma, the potential for its use in cSCCA is less well understood. SLNB for cSCCA of the head and neck is feasible, as demonstrated in multiple prior studies . This study, however, is the largest single‐institution cohort of patients undergoing SLNB for head and neck cSCCA to date.…”

“…However, such data are not well established for cSCCA . It is not known whether SLNB at the time of primary cSCCA excision provides superior outcomes compared to primary tumor excision with observation.…”

Carcinoma de células escamosas de piel. Serie de casos

“…En esta serie el 4,2% de los casos tenía compromiso ganglionar clínico o microscópico al momento del diagnóstico. A pesar de que la localización en cabeza y cuello es la más frecuente, no realizamos estudio de linfonodo centinela (LNC) en pacientes con cuello porque no contamos con el examen de linfocintigrafía para identificar el primer ganglio de drenaje 31 y el uso único de azul patente para ello nos resulta inespecífico, por el gran número de ganglios que se tiñen 31 . Por el contrario, en extremidades el LNC nos resulta de fácil acceso solo con el colorante.…”

Symptom management and palliative care in advanced basal cell carcinoma

“…Being locally malignant over a long period of time, BCC can lead to infiltration and damage of adjacent bone, cartilage, vascular or neural structures. This can result in occurrence of ulcerations, severe bleeding and significant anatomical deformations that are particularly unpleasant for patients, as they usually concern the face and neck area of the skin [4,5]. This could lead to social stigmatization, loneliness and mental suffering of the patients, as well as numerous somatic complications.…”