Veness et al identified a number of risk factors for lymph node metastases in a patient with cutaneous squamous cell carcinoma. The authors are from University of Sydney in Australia.
Patient selection: cutaneous squamous cell carcinoma in head or neck (does not include oral, pharynx or hypopharynx)
Parameters:
(1) thickness in mm
(2) location
(3) immunosuppression
(4) histologic grade
(5) recurrence
(6) perineural and/or lymphovascular invasion
|
Parameter |
Finding |
Points |
|
thickness in mm |
< 5 mm |
0 |
|
|
>= 5 mm |
1 |
|
location |
lymphatic drainage area for the parotid |
1 |
|
|
other |
0 |
|
immunosuppression |
absent |
0 |
|
|
present |
1 |
|
histologic grade |
well or moderately differentiated |
0 |
|
|
poorly differentiated |
1 |
|
recurrent cancer |
no |
0 |
|
|
yes |
1 |
|
perineural or lymphovascular spread |
no |
0 |
|
|
yes |
1 |
where:
• The parotid drainage area includes the temple, forehead, around the ear or on the cheek.
• The diameter of the squamous cell carcinoma is associated with risk of metastases, with risk increased when >= 2 cm. The diameter is also associated with the thickness of the lesion in mm.
total number of risk factors =
= SUM(points for all 6 parameters)
Interpretation:
• minimum risk factors: 0
• maximum risk factors: 6
• The risk of lymph node metastases increases with the number of risk factors.
Specialty: Hematology Oncology, Surgery, general, Dermatology
