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Review
. 2022 Sep;24(9):1145-1152.
doi: 10.1007/s11912-022-01249-5. Epub 2022 Apr 8.

Predictors of Nodal Metastasis in Cutaneous Head and Neck Cancers

Albert Y Han  1   2   3 , Maie A St John  4   5   6
Affiliations
Review

Predictors of Nodal Metastasis in Cutaneous Head and Neck Cancers

Albert Y Han et al. Curr Oncol Rep. 2022 Sep.

Abstract

Purpose of review: The complex and varied drainage patterns in the head and neck present a challenge in the regional control of cutaneous neoplasms. Lymph node involvement significantly diminishes survival, often warranting more aggressive treatment. Here, we review the risk factors associated with lymphatic metastasis, in the context of the evolving role of sentinel lymph node biopsy.

Recent findings: In cutaneous head and neck melanomas, tumor thickness, age, size, mitosis, ulceration, and specific histology have been associated with lymph node metastasis (LNM). In head and neck cutaneous squamous cell carcinomas, tumor thickness, size, perineural invasion, and immunosuppression are all risk factors for nodal metastasis. The risk factors for lymph node involvement in Merkel cell carcinoma are not yet fully defined, but emerging evidence indicates that tumor thickness and size may be associated with regional metastasis. The specific factors that predict a greater risk of LNM for cutaneous head and neck cancers generally include depth of invasion, tumor size, mitotic rate, ulceration, immunosuppression, and other histopathological factors.

Keywords: Cutaneous cancer; Melanoma; Parotid metastasis; Regional metastasis; Squamous cell carcinoma.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Predicted pattern of metastasis of head and neck cutaneous melanoma proposed by O’Brien et al. The orange area represents the “watershed area” from which unpredictable drainage can occur ( Adapted from O’Brien et al. American Journal of Surgery) [4]
See this image and copyright information in PMC

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