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OS was considered the outcome of interest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study included 89 patients (M:F\u2009=\u20093.4:1; median age, 78\u00a0years; range, 22\u201399). Among the primary tumor characteristics, the most relevant prognostic factors were diameter\u2009\u2265\u20094\u00a0cm (hazard ratio [HR]\u2009=\u20092.56, <jats:italic>p<\/jats:italic>\u2009=\u20090.010) and depth of infiltration\u2009\u2265\u20096\u00a0mm (HR\u2009=\u20093.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.027). Cervical NM was associated with worse OS (HR\u2009=\u20092.09, <jats:italic>p<\/jats:italic>\u2009=\u20090.016) compared to purely intraparotid NM (5-year OS: 60.9% vs. 28.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.014). At multivariable analysis, age, immunosuppression, pT3-T4 categories and a high burden of nodal disease (&gt;\u20092 NM) confirmed to be independent risk factors, whereas adjuvant radiotherapy was independently associated with better outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study confirms the association of several independent prognosticators related to the patient, primary tumor, and nodal burden status. Patients with cervical NM should be considered at risk for harboring a higher number of metastatic lymph nodes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00405-021-06944-w","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T04:02:51Z","timestamp":1624593771000},"page":"1573-1584","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Regional disease in head and neck cutaneous squamous cell carcinoma: the role of primary tumor characteristics and number of nodal metastases"],"prefix":"10.1007","volume":"279","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-8603","authenticated-orcid":false,"given":"Alberto","family":"Grammatica","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Tomasoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Fior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Ulaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gualtieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simonetta","family":"Battocchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Deganello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Nicolai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Girardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Piazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"issue":"11","key":"6944_CR1","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1001\/jamadermatol.2017.3395","volume":"153","author":"B Mansouri","year":"2017","unstructured":"Mansouri B, Housewright CD (2017) The treatment of actinic keratoses\u2014the rule rather than the exception. 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