{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:26:11Z","timestamp":1788780371283,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2010,1,5]],"date-time":"2010-01-05T00:00:00Z","timestamp":1262649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>A staging system was designed for metastatic cutaneous squamous cell carcinoma (SCC) that would incorporate the parotid as a regional level and facilitate a better prognostic discrimination between subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>A retrospective review of clinical and pathological information of patients treated for metastatic cutaneous SCC to the parotid and\/or neck was conducted. Potential prognostic factors were analyzed using univariate and multivariate analyses. A staging system was elaborated and externally validated.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Two hundred fifteen patients were included. All patients had surgery as their primary treatment; 148 had parotidectomy with neck dissection, 50 parotidectomy alone, and 18 neck dissection alone. One hundred seventy\u2010five patients received postoperative radiotherapy. On univariate analysis, the number of involved lymph nodes (<jats:italic>P<\/jats:italic> &lt; .001), maximal size (<jats:italic>P<\/jats:italic> = .01), and extracapsular spread (<jats:italic>P<\/jats:italic> = .003) were found to be significant predictors of survival. On Cox regression, the number of involved lymph nodes as single or multiple (<jats:italic>P<\/jats:italic> = .006) was significant. The N1S3 staging system incorporates involved lymph nodes from parotid and neck (single or multiple) and the size (&lt; or &gt;3 cm). This system demonstrates significant predictive capacity for locoregional control (<jats:italic>P<\/jats:italic> &lt; .001), disease\u2010specific survival (<jats:italic>P<\/jats:italic>&lt;.0001), and overall survival (<jats:italic>P<\/jats:italic>&lt;.0001). N1S3 was tested on a different cohort of 250 patients, and the results confirmed those obtained from our primary analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>The N1S3 system stages patients according to the number of involved lymph nodes and size, and incorporates parotid as 1 of the regional levels. These 2 predictors are easily applied on both clinical and pathological data. Cancer 2010. \u00a9 2010 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.24855","type":"journal-article","created":{"date-parts":[[2010,1,5]],"date-time":"2010-01-05T10:20:53Z","timestamp":1262686853000},"page":"1298-1304","source":"Crossref","is-referenced-by-count":98,"title":["N1S3: A revised staging system for head and neck cutaneous squamous cell carcinoma with lymph node metastases"],"prefix":"10.1002","volume":"116","author":[{"given":"Veronique\u2010Isabelle","family":"Forest","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Veness","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Milross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,1,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1992.tb07065.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1106"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3280586723"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70185-2"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20576"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21698"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318180642b"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10063"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200310000-00031"},{"key":"e_1_2_6_11_2","unstructured":"MoncrieffMD ClarkJR ForestVI et al.A comparison of the extent of treatment for metastatic cutaneous SCC and melanoma based on analysis patterns of lymphatic spread and post\u2010operative morbidity. Paper presented at: Australian & New Zealand Head and Neck Society Annual Scientific Meeting; September 4\u20106 2008; Melbourne Australia."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.551"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20417"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000158349.64337.ED"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2006.03.043"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200304000-00010"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.24855","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.24855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T19:13:19Z","timestamp":1760296399000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.24855"}},"subtitle":["Results of 2 Australian Cancer Centers"],"short-title":[],"issued":{"date-parts":[[2010,1,5]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2010,3]]}},"alternative-id":["10.1002\/cncr.24855"],"URL":"https:\/\/doi.org\/10.1002\/cncr.24855","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,1,5]]}}}