Forest et al reported the N1S3 staging system for cutaneous squamous cell carcinomas of the head and neck that metastasize to lymph nodes. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Sydney in Australia.
Patient selection: squamous cell carcinoma of the skin of the head and neck
Sites of metastasis evaluated:
(1) parotid gland: includes both lymph nodes within the gland and the gland itself
(2) lymph nodes in the neck
Parameters:
(1) number of metastatic foci <= 3 cm in diameter
(2) number of metastatic foci > 3 cm in diameter
Sites <= 3 cm |
Sites > 3 cm |
Stage |
0 |
0 |
0 |
1 |
0 |
I |
0 or 1 |
1 |
II |
>= 2 |
0 or 1 |
II |
NA |
>= 2 |
III |
where:
• Extracapsular spread (ECS) is associated with survival but tends to be seen with a larger metastasis.
Interpretation:
• The stage correlates with locoregional control and disease-specific survival.
• The higher the Stage the greater the need for more aggressive management.
Stage |
Locoregional Control at 6 Years |
Disease Specific Survival at 5 Years |
I |
75% |
90% |
II |
44% |
75% |
III |
34% |
42% |
Specialty: Hematology Oncology, Surgery, general, Dermatology