Cutaneous Squamous Cell Carcinoma of the Head and Neck: Pathological Features and What They Mean for Prognosis and Treatment
Abstract
:Simple Summary
Abstract
1. Introduction
2. Depth of Invasion
3. Surgical Margins
4. Positive Regional Node(s) and Extranodal Extension
5. PNI
6. LVI
7. Tumor Grade
8. Histologic Subtype
9. Premalignant Lesions
10. Molecular Markers
11. Conclusions and Future Directions
Author Contributions
Funding
Conflicts of Interest
References
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Feature | Threshold | Recommendations |
---|---|---|
DOI | 6 mm from adjacent uninvolved granular layer | No specific therapy recommendations |
Invasion beyond subcutaneous fat | ||
Margins | Positive | Re-excision if feasible, ART ± systemic therapy if not |
LVI | Present | Evaluate for nodal disease and treat appropriately |
ENE | Present | ART ± systemic therapy |
PNI | Clinical or radiographic | ART |
Microscopic | ART vs. observation | |
Grade | Poor differentiation | Evaluate margins and treat appropriately |
Subtype | Desmoplastic | ART vs. neoadjuvant cemiplimab |
Molecular markers | PD-L1, Podoplanin, EGFR | Evaluate for nodal/distant metastasis and treat appropriately |
Treatment Options | Indicated Feature(s) |
---|---|
ART | PNI |
Positive margins with unfavorable resection | |
Multiple lymph nodes or one node >3 cm | |
ENE | |
LVI | |
Poorly differentiated primary tumor | |
Desmoplastic subtype | |
Re-operation | Positive margins |
PNI if adequate margins are feasible | |
Immunotherapy | PNI |
Desmoplastic subtype | |
Other systemic therapy | Only as ART adjunct or if ART is infeasible |
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Ramesh, U.; Chiang, E.; Stafford, H.; Buell, J.; Materia, F.; Amit, M.; Yaniv, D. Cutaneous Squamous Cell Carcinoma of the Head and Neck: Pathological Features and What They Mean for Prognosis and Treatment. Cancers 2024, 16, 2866. https://doi.org/10.3390/cancers16162866
Ramesh U, Chiang E, Stafford H, Buell J, Materia F, Amit M, Yaniv D. Cutaneous Squamous Cell Carcinoma of the Head and Neck: Pathological Features and What They Mean for Prognosis and Treatment. Cancers. 2024; 16(16):2866. https://doi.org/10.3390/cancers16162866
Chicago/Turabian StyleRamesh, Uma, Elizabeth Chiang, Haleigh Stafford, Jane Buell, Frank Materia, Moran Amit, and Dan Yaniv. 2024. "Cutaneous Squamous Cell Carcinoma of the Head and Neck: Pathological Features and What They Mean for Prognosis and Treatment" Cancers 16, no. 16: 2866. https://doi.org/10.3390/cancers16162866