Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck.
10.7181/acfs.2017.18.1.37
- Author:
Wan Cheol RYU
1
;
In Chang KOH
;
Yong Hae LEE
;
Jong Hyun CHA
;
Sang Il KIM
;
Chang Gyun KIM
Author Information
1. Department of Plastic and Reconstructive Surgery, Konyang Hospital, Konyang University School of Medicine, Daejeon, Korea. ihns@naver.com
- Publication Type:Original Article
- Keywords:
Skin neoplasm;
Head and neck;
Lymphoscintigraphy
- MeSH:
Carcinoma, Basal Cell;
Carcinoma, Squamous Cell;
Diagnosis;
Frozen Sections;
Head*;
Humans;
Lymph Nodes;
Lymphoscintigraphy;
Medical Records;
Mortality;
Neck*;
Neoplasm Metastasis;
Pathology;
Retrospective Studies;
Skin Neoplasms*;
Skin*
- From:Archives of Craniofacial Surgery
2017;18(1):37-43
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Skin 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. METHODS: The 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. RESULTS: Among 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. CONCLUSION: In 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.
