Multivariate analysis of potential risk factors for lymph node metastasis in patients with cutaneous squamous cell carcinoma of the head and neck

Marjolijn S. Haisma, Boudewijn E. C. Plaat, Hendrik P. Bijl, Jan L. N. Roodenburg, Gilles F. H. Diercks, Tonnis R. Romeijn, Jorrit B. Terra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)


Background: The current knowledge about potential risk factors for lymph node (LN) metastasis in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) is primarily based on studies that lack adjustment for confounding variables.

Objectives: We sought to identify independent risk factors for LN metastasis in patients with HNcSCC and to evaluate the impact of LN metastasis on prognosis.

Methods: Patients with primary HNcSCC were retrospectively included. Potential risk factors were analyzed by univariate and multivariate Cox regression models. Survival was compared using the Kaplan-Meier method.

Results: Three hundred thirty-six patients with 545 primary HNcSCCs were included. The median follow-up period was 43 months (range, 1-176 months). LN metastasis occurred in 55 patients (16.4%). The following independent risk factors of HNcSCC for the development of LN metastasis were identified: location on the ear, tumor diameter [50 mm, moderate and poor differentiation, and tumor thickness [2 mm. There was a significant decline in disease-specific survival and overall survival in patients with LN metastasis compared to patients without LN metastasis.

Limitations: The retrospective study design.

Conclusion: LN metastases from HNcSCC are common with diminished survival rates. This study confirmed some well-known risk factors, but also found moderate differentiation as an independent risk factor for LN metastasis.

Original languageEnglish
Pages (from-to)722-730
Number of pages9
JournalJournal of the American Academy of Dermatology
Issue number4
Publication statusPublished - Oct-2016


  • cutaneous squamous cell carcinoma
  • head and neck
  • lymph node metastasis
  • moderate differentiation
  • prognosis
  • risk factors
  • SKIN

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