{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:27:46Z","timestamp":1789680466427,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Regional metastasis occurs in 5% of cutaneous squamous cell carcinoma (cSCC). The aim of this study is to assess the impact of margin status of regional metastases on survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of 401 patients with nodal metastases from cSCC. Margin status of nodal metastases was classified as clear (&gt;1\u2009mm), close (&lt;1\u2009mm), or involved. Cox regression and Kaplan\u2013Meier methods were used to assess associations with overall and disease\u2010specific survival (OS and DSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 401 patients with nodal metastases (median age 75, 85.3% male), 43.6% had involved margins, 27.4% had close margins, and 28.9% had clear margins. Involved margins were significantly associated with reduced OS and DSS on univariable analysis. Multivariable analysis confirmed that involved margins independently predicted worse DSS (HR 1.92, 95% CI 1.15\u20133.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Other independent prognostic factors included size of deposit (HR 1.02, 95% CI 1.01\u20131.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), number of deposits (HR 1.05, 95% CI 1.02\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the presence of perineural invasion (HR 1.84, 95% CI 1.14\u20132.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clear surgical margins during the removal of regional metastases of cSCC improves survival outcomes. This study highlights the importance of careful preoperative evaluation to achieve a complete (R0) surgical resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 135:2379\u20132384, 2025\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32006","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T03:30:34Z","timestamp":1736911834000},"page":"2379-2384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of surgical margins in managing regional metastases in cutaneous squamous cell carcinoma of the head and neck"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8484-9557","authenticated-orcid":false,"given":"Rachel","family":"Braude","sequence":"first","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9171-9878","authenticated-orcid":false,"given":"Timothy G.H.","family":"Manzie","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerwin","family":"Shannon","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Elliott","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wykes","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"},{"name":"Department of Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital, NSW Health Pathology  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Cheung","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Department of Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital, NSW Health Pathology  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu\u2010Hui","family":"Low","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse Sydney Head and Neck Cancer Institute  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney  Sydney Australia"},{"name":"Department of Otolaryngology \u2013 Head &amp; 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