GUIDELINES FOR POSITIVE LYMPH NODE

SUSPICIOUS REGIONAL NODES

Workup

  • work up and biopsy suspicious nodes
  • regional LN dissection if biopsy is positive

Indications for Combined modality treatment → LND + ENI

  • 1+ node in parotid
  • 2+ node in neck
  • 3+ node in axilla or groin.
  • Extracapsular extension (ECE)
  • > 3 cm node (regarded as a marker for ECE)
  • Positive margins in lymphadenectomy specimen

Indications for Single modality of treatment → LND or ENI

  • LN ≤ 3 cm
    • 1 node in neck
    • 2 or less nodes in axilla or groin
Bibliography
1. Howle JR, Morgan GJ, Kalnins I, Palme CE, Veness MJ. Metastatic cutaneous squamous cell carcinoma of the scalp. ANZ J Surg. 2008 Jun;78(6):449-53.
2. Chen AM, Grekin RC, Garcia J, Bucci MK, Margolis LW.Radiation therapy for cutaneous squamous cell carcinoma involving the parotid area lymph nodes: dose and volume considerations.Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1377-80.
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