{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:17:07Z","timestamp":1790191027151,"version":"4.1.0"},"reference-count":91,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Non-melanoma skin cancer of the head and neck (NMSCHN) is one of the most common malignancies worldwide, and its incidence is growing at a significant rate. It has been found to be aggressive in its spread and has the capacity to metastasize to regional lymph nodes. Cutaneous squamous cell carcinoma (cSCC) has a considerably high mortality rate. It has remarkable characteristics: diameter &gt;2 cm, depth &gt;5 mm, high recurrence, perineural invasion, and locoregional metastases. Aggressive cSCC lesions most commonly metastasize to the parotid gland. Also, immunocompromised patients have a higher risk of developing this aggressive cancer along with the worst prognostic outcomes. It is very important to discuss and assess the risk factors, prognostic factors, and outcomes of patients with cSCC, which will give clinicians future directives for making modifications to their treatment plans. The successful treatment of aggressive cSCC of the head and neck includes early detection and diagnosis, surgery alone or adjuvant chemotherapy, and radiotherapy as required. Multimodal therapy options should be considered by clinicians for better outcomes of aggressive cSCC of the head and neck.<\/jats:p>","DOI":"10.3390\/curroncol30070487","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T01:05:01Z","timestamp":1689123901000},"page":"6634-6647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Aggressive Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Review"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4488-7101","authenticated-orcid":false,"given":"Neha","family":"Desai","sequence":"first","affiliation":[{"name":"JDC Healthcare, Houston, TX 77015, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukul K.","family":"Divatia","sequence":"additional","affiliation":[{"name":"Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniket","family":"Jadhav","sequence":"additional","affiliation":[{"name":"VCU School of Dentistry, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Wagh","sequence":"additional","affiliation":[{"name":"JDC Healthcare, Houston, TX 77034, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"ref_1","first-page":"885","article-title":"Metastatic cutaneous squamous cell carcinoma: An update","volume":"33","author":"Weinberg","year":"2007","journal-title":"Dermatol. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/j.1432-2277.2003.tb00278.x","article-title":"Association of human papillomavirus infections with cutaneous tumors in immunosuppressed patients","volume":"16","author":"Meyer","year":"2003","journal-title":"Transpl. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0190-9622(92)70001-V","article-title":"Biology of cutaneous squamous cell carcinoma","volume":"26","author":"Kwa","year":"1992","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6582","DOI":"10.1158\/1078-0432.CCR-14-1768","article-title":"Mutational landscape of aggressive cutaneous squamous cell carcinoma","volume":"20","author":"Pickering","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1001\/archdermatol.2010.19","article-title":"Incidence estimate of nonmelanoma skin cancer in the United States, 2006","volume":"146","author":"Rogers","year":"2010","journal-title":"Arch. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jaad.2005.02.059","article-title":"Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia I. Experience over 10 years","volume":"53","author":"Leibovitch","year":"2005","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1001\/archderm.1995.01690190048009","article-title":"Activated ras genes occur in human actinic keratoses, premalignant precursors to squamous cell carcinomas","volume":"131","author":"Spencer","year":"1995","journal-title":"Arch. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/S1470-2045(08)70178-5","article-title":"Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: A prospective study","volume":"9","author":"Brantsch","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/MOO.0b013e328343e811","article-title":"Management of the neck in metastatic cutaneous squamous cell carcinoma of the head and neck","volume":"19","author":"Clark","year":"2011","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.adengl.2011.12.012","article-title":"Cutaneous squamous cell carcinoma: Defining the high-risk variant","volume":"104","author":"Jimenez","year":"2013","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas (Engl. Ed.)"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/hed.24580","article-title":"Review of high-risk features of cutaneous squamous cell carcinoma and discrepancies between the American Joint Committee on Cancer and NCCN Clinical Practice Guidelines in Oncology","volume":"39","author":"Skulsky","year":"2017","journal-title":"Head Neck"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1002\/cncr.24208","article-title":"Metastatic cutaneous squamous cell carcinoma of the head and neck","volume":"115","author":"Oddone","year":"2009","journal-title":"Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jaad.2008.09.035","article-title":"Epidermolysis bullosa and the risk of life-threatening cancers: The National EB Registry experience, 1986\u20132006","volume":"60","author":"Fine","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1002\/cncr.21898","article-title":"High-risk cutaneous squamous cell carcinoma of the head and neck","volume":"106","author":"Veness","year":"2006","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/0190-9622(92)70144-5","article-title":"Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip: Implications for treatment modality selection","volume":"26","author":"Rowe","year":"1992","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1002\/hed.21583","article-title":"Cutaneous squamous cell carcinoma of the head and neck metastasizing to the parotid gland\u2014A review of current recommendations","volume":"33","author":"Ferlito","year":"2011","journal-title":"Head Neck"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0190-9622(99)70185-4","article-title":"Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens","volume":"40","author":"Jensen","year":"1999","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S0046-8177(88)80232-6","article-title":"Clinicopathologic features of cutaneous squamous cell carcinomas of the head and neck in patients with chronic lymphocytic leukemia\/small lymphocytic lymphoma","volume":"19","author":"Frierson","year":"1988","journal-title":"Hum. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1001\/archderm.138.6.758","article-title":"Aggressive squamous cell carcinomas in persons infected with the human immunodeficiency virus","volume":"138","author":"Nguyen","year":"2002","journal-title":"Arch. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1002\/hed.20321","article-title":"Effect of immunocompromise on metastatic cutaneous squamous cell carcinoma in the parotid and neck","volume":"28","author":"Southwell","year":"2006","journal-title":"Head Neck"},{"key":"ref_21","first-page":"502723","article-title":"Cutaneous squamous cell carcinoma of the head and neck","volume":"2011","author":"Gurudutt","year":"2011","journal-title":"J. Ski. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1177\/0194599814520686","article-title":"Head and neck cutaneous squamous cell carcinoma requiring parotidectomy: Prognostic indicators and treatment selection","volume":"150","author":"Sweeny","year":"2014","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1001\/archotol.128.5.521","article-title":"Parotidectomy in the treatment of aggressive cutaneous malignancies","volume":"128","author":"Lai","year":"2002","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2021166S","DOI":"10.5826\/dpc.11S2a166S","article-title":"Risk factors and diagnosis of advanced cutaneous squamous cell carcinoma","volume":"11","author":"Brancaccio","year":"2021","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_25","first-page":"bcr2014208176","article-title":"Marjolin\u2019s ulcer: A rare entity with a call for early diagnosis","volume":"2015","author":"Iqbal","year":"2015","journal-title":"Case Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1002\/hed.20417","article-title":"Patterns of lymph node spread of cutaneous squamous cell carcinoma of the head and neck","volume":"28","author":"Vauterin","year":"2006","journal-title":"Head Neck J. Sci. Spec. Head Neck"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.bjps.2006.03.043","article-title":"Parotid metastasis\u2014An independent prognostic factor for head and neck cutaneous squamous cell carcinoma","volume":"59","author":"Maitra","year":"2006","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/hed.10063","article-title":"Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland","volume":"24","author":"McNeil","year":"2002","journal-title":"Head Neck"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1097\/01.mlg.0000173202.56739.9f","article-title":"Lymph node metastases from cutaneous squamous cell carcinoma of the head and neck","volume":"115","author":"Moore","year":"2005","journal-title":"Laryngoscope"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1001\/archotol.124.5.582","article-title":"Regional lymph node metastasis from cutaneous squamous cell carcinoma","volume":"124","author":"Kraus","year":"1998","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1002\/hed.20576","article-title":"Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes","volume":"29","author":"Veness","year":"2007","journal-title":"Head Neck"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1002\/cncr.24855","article-title":"N1S3: A revised staging system for head and neck cutaneous squamous cell carcinoma with lymph node metastases","volume":"116","author":"Forest","year":"2010","journal-title":"Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0002-9610(99)80326-2","article-title":"Parotid and neck metastases from cutaneous squamous cell carcinoma of the head and neck","volume":"170","author":"Khurana","year":"1995","journal-title":"Am. J. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.jaad.2010.08.033","article-title":"A new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Creation and rationale for inclusion of tumor (T) characteristics","volume":"64","author":"Farasat","year":"2011","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_35","unstructured":"(2023, March 25). AJCC Cancer Staging Manual Seventh Edition. Available online: https:\/\/www.facs.org\/media\/kcal20pk\/ajcc-7e-complete-ajcc-cancer-staging-manual.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hurrell, M.J., Low, T.-H., Ebrahimi, A., Veness, M., Ashford, B., Porceddu, S., and Clark, J.R. (2022). Evolution of Head and Neck Cutaneous Squamous Cell Carcinoma Nodal Staging\u2014An Australian Perspective. Cancers, 14.","DOI":"10.3390\/cancers14205101"},{"key":"ref_37","first-page":"818","article-title":"Novel Additions to the AJCC\u2019s New Staging Systems for Skin Cancer","volume":"108","year":"2017","journal-title":"Actas Dermo-Sifiliogr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1002\/jso.24883","article-title":"Predictive value of the 8th edition American Joint Commission Cancer (AJCC) nodal staging system for patients with cutaneous squamous cell carcinoma of the head and neck","volume":"117","author":"Liu","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1002\/hed.26512","article-title":"Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi-institutional study","volume":"43","author":"Luk","year":"2021","journal-title":"Head Neck"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/hed.25599","article-title":"A critical analysis of the prognostic performance of the 8th edition American Joint Committee on Cancer staging for metastatic cutaneous squamous cell carcinoma of the head and neck","volume":"41","author":"Sood","year":"2019","journal-title":"Head Neck"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1016\/j.surg.2021.04.019","article-title":"Clinician perspectives on the factors influencing prognostic stratification by the American Joint Commission on Cancer Head and Neck Cutaneous Squamous Cell Carcinoma Staging","volume":"170","author":"Watts","year":"2021","journal-title":"Surgery"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1148\/radiology.182.3.1535890","article-title":"Central nodal necrosis and extracapsular neoplastic spread in cervical lymph nodes: MR imaging versus CT","volume":"182","author":"Yousem","year":"1992","journal-title":"Radiology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.nic.2004.07.006","article-title":"MR imaging of perineural tumor spread","volume":"14","author":"Ginsberg","year":"2004","journal-title":"Neuroimaging Clin. N. Am."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S0360-3016(00)01407-3","article-title":"Perineural spread of cutaneous squamous and basal cell carcinoma: CT and MR detection and its impact on patient management and prognosis","volume":"49","author":"Williams","year":"2001","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0145561316095010-1106","article-title":"Prognostic factors in metastatic cutaneous squamous cell carcinoma of the head and neck","volume":"95","author":"Bachar","year":"2016","journal-title":"Ear Nose Throat J."},{"key":"ref_46","first-page":"972497","article-title":"Outcomes of recurrent head and neck cutaneous squamous cell carcinoma","volume":"2011","author":"Dean","year":"2011","journal-title":"J. Ski. Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/hed.20256","article-title":"Parotid area lymph node metastases from cutaneous squamous cell carcinoma: Implications for diagnosis, treatment, and prognosis","volume":"27","author":"Hong","year":"2005","journal-title":"Head Neck"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1097\/00005537-200310000-00031","article-title":"Cutaneous head and neck squamous cell carcinoma metastatic to cervical lymph nodes (nonparotid): A better outcome with surgery and adjuvant radiotherapy","volume":"113","author":"Veness","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1097\/MLG.0b013e318180642b","article-title":"Cutaneous Squamous Cell Carcinoma Metastatic to Parotid-Area Lymph Nodes","volume":"118","author":"Hinerman","year":"2008","journal-title":"Laryngoscope"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1002\/hed.21574","article-title":"Outcome of patients treated surgically for lymph node metastases from cutaneous squamous cell carcinoma of the head and neck","volume":"33","author":"Givi","year":"2011","journal-title":"Head Neck"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/hed.20048","article-title":"Cutaneous metastatic squamous cell carcinoma to the parotid gland: Analysis and outcome","volume":"26","author":"Audet","year":"2004","journal-title":"Head Neck"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1200\/JCO.2005.02.155","article-title":"Mortality risk from squamous cell skin cancer","volume":"23","author":"Clayman","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/hed.21743","article-title":"Metastatic head and neck cutaneous squamous cell carcinoma: Defining a low-risk patient","volume":"34","author":"Ebrahimi","year":"2012","journal-title":"Head Neck"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1002\/cncr.21698","article-title":"Implications for clinical staging of metastatic cutaneous squamous carcinoma of the head and neck based on a multicenter study of treatment outcomes","volume":"106","author":"Andruchow","year":"2006","journal-title":"Cancer"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1001\/archotol.129.7.750","article-title":"Extent of parotid disease influences outcome in patients with metastatic cutaneous squamous cell carcinoma","volume":"129","author":"Palme","year":"2003","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1002\/hed.20360","article-title":"Squamous cell carcinoma of the parotid gland","volume":"28","author":"Ying","year":"2006","journal-title":"Head Neck"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.otohns.2005.01.036","article-title":"Pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck","volume":"132","author":"Barzilai","year":"2005","journal-title":"Otolaryngol. -Head Neck Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/00005537-200306000-00029","article-title":"Primary and metastatic cancer of the parotid: Comparison of clinical behavior in 232 cases","volume":"113","author":"Bron","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1046\/j.1445-2197.2003.02737.x","article-title":"Metastatic cutaneous squamous cell carcinoma to the parotid: The role of surgery and adjuvant radiotherapy to achieve best outcome","volume":"73","author":"Dona","year":"2003","journal-title":"ANZ J. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1046\/j.1440-1673.2001.01030.x","article-title":"Parotid lymph-node metastases from cutaneous squamous-cell carcinomas: Treatment outcome and prognostic factors following surgery and adjuvant radiotherapy","volume":"46","author":"Chua","year":"2002","journal-title":"Australas. Radiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1053\/ejso.2002.1330","article-title":"Treatment results of regional metastasis from cutaneous head and neck squamous cell carcinoma","volume":"29","author":"Jol","year":"2003","journal-title":"Eur. J. Surg. Oncol. (EJSO)"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1002\/hed.10079","article-title":"Supraomohyoid neck dissection in the management of cervical lymph node metastases of squamous cell carcinoma of the lower lip","volume":"24","author":"Gooris","year":"2002","journal-title":"Head Neck"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/(SICI)1097-0347(199808)20:5<369::AID-HED2>3.0.CO;2-W","article-title":"Carcinoma of the skin metastatic to the parotid area lymph nodes","volume":"20","author":"DelCharco","year":"1998","journal-title":"Head Neck"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jaad.2013.05.011","article-title":"An evolving paradigm for the workup and management of high-risk cutaneous squamous cell carcinoma","volume":"69","author":"Sherman","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1002\/hed.23843","article-title":"Outcomes of nodal metastatic cutaneous squamous cell carcinoma of the head and neck treated in a regional center","volume":"37","author":"Schmidt","year":"2015","journal-title":"Head Neck"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0007-1226(03)00028-6","article-title":"Multiprofessional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma","volume":"56","author":"Motley","year":"2003","journal-title":"Br. J. Plast. Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.jaad.2005.03.048","article-title":"Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia II. Perineural invasion","volume":"53","author":"Leibovitch","year":"2005","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1111\/j.1524-4725.2009.01182.x","article-title":"Innovative 19-Minute Rapid Cytokeratin Immunostaining of Nonmelanoma Skin Cancer in Mohs Micrographic Surgery","volume":"35","author":"Cherpelis","year":"2009","journal-title":"Dermatol. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/j.1524-4725.1994.tb00138.x","article-title":"Rapid cytokeratin stains enhance the sensitivity of Mohs micrographic surgery for squamous cell carcinoma","volume":"20","author":"Zachary","year":"1994","journal-title":"J. Dermatol. Surg. Oncol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1097\/01.MLG.0000158349.64337.ED","article-title":"Surgery and adjuvant radiotherapy in patients with cutaneous head and neck squamous cell carcinoma metastatic to lymph nodes: Combined treatment should be considered best practice","volume":"115","author":"Veness","year":"2005","journal-title":"Laryngoscope"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.1200\/JCO.2001.19.12.3010","article-title":"Combined interferon-alfa, 13-cis-retinoic acid, and alpha-tocopherol in locally advanced head and neck squamous cell carcinoma: Novel bioadjuvant phase II trial","volume":"19","author":"Shin","year":"2001","journal-title":"J. Clin. Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00000421-200004000-00015","article-title":"Oral 5-fluorouracil in squamous cell carcinoma of the skin in the aged","volume":"23","author":"Cartei","year":"2000","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1002\/hed.20462","article-title":"Phase II analysis of paclitaxel and capecitabine in the treatment of recurrent or disseminated squamous cell carcinoma of the head and neck region","volume":"29","author":"Bentzen","year":"2007","journal-title":"Head Neck"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1158\/1078-0432.CCR-11-1951","article-title":"A phase II study of gefitinib for aggressive cutaneous squamous cell carcinoma of the head and neck","volume":"18","author":"Lewis","year":"2012","journal-title":"Clin. Cancer Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1159\/000051637","article-title":"Epidermal growth factor receptor overexpression and genetic aberrations in metastatic squamous-cell carcinoma of the skin","volume":"202","author":"Shimizu","year":"2001","journal-title":"Dermatology"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/1523-1747.ep12264708","article-title":"Comparison of epidermal growth factor binding and receptor distribution in normal human epidermis and epidermal appendages","volume":"83","author":"Nanney","year":"1984","journal-title":"J. Investig. Dermatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.humpath.2007.07.004","article-title":"Epidermal growth factor receptor: A novel biomarker for aggressive head and neck cutaneous squamous cell carcinoma","volume":"39","author":"Low","year":"2008","journal-title":"Hum. Pathol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/MOO.0b013e32832924e0","article-title":"Metastatic cutaneous squamous cell carcinoma to the parotid and cervical lymph nodes: Treatment and outcomes","volume":"17","author":"Bumpous","year":"2009","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1097\/CAD.0b013e32809ef9e0","article-title":"Cutaneous squamous cell carcinoma responding serially to single-agent cetuximab","volume":"18","author":"Suen","year":"2007","journal-title":"Anti-Cancer Drugs"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1001\/archderm.143.7.889","article-title":"Treatment of recurrent squamous cell carcinoma of the skin with cetuximab","volume":"143","author":"Bauman","year":"2007","journal-title":"Arch. Dermatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1111\/j.1610-0387.2008.06861.x","article-title":"Combination of an EGFR blocker and a COX-2 inhibitor for the treatment of advanced cutaneous squamous cell carcinoma","volume":"6","author":"Jalili","year":"2008","journal-title":"JDDG J. Der Dtsch. Dermatol. Ges."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/S0360-3016(96)00430-0","article-title":"Combined postoperative radiotherapy and weekly cisplatin infusion for locally advanced head and neck carcinoma: Final report of a randomized trial","volume":"36","author":"Bachaud","year":"1996","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1002\/(SICI)1097-0142(20000215)88:4<876::AID-CNCR19>3.0.CO;2-Y","article-title":"Mature results of a phase III randomized trial comparing concurrent chemoradiotherapy with radiation therapy alone in patients with stage III and IV squamous cell carcinoma of the head and neck","volume":"88","author":"Adelstein","year":"2000","journal-title":"Cancer"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.oraloncology.2018.01.015","article-title":"Combination of post-operative radiotherapy and cetuximab for high-risk cutaneous squamous cell cancer of the head and neck: A propensity score analysis","volume":"78","author":"Palmer","year":"2018","journal-title":"Oral Oncol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.ijrobp.2012.09.030","article-title":"Phase 1 study of erlotinib plus radiation therapy in patients with advanced cutaneous squamous cell carcinoma","volume":"85","author":"Heath","year":"2013","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s40265-020-01302-2","article-title":"Cemiplimab: A review in advanced cutaneous squamous cell carcinoma","volume":"80","author":"Lee","year":"2020","journal-title":"Drugs"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1200\/JCO.19.03357","article-title":"Phase II study of pembrolizumab as first-line, single-drug therapy for patients with unresectable cutaneous squamous cell carcinomas","volume":"38","author":"Maubec","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_88","first-page":"679","article-title":"Chemotherapy in the management of advanced cutaneous squamous cell carcinoma in organ transplant recipients: Theoretical and practical considerations","volume":"30","author":"Martinez","year":"2004","journal-title":"Dermatol. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.mlg.0000200750.74249.79","article-title":"Lymphatic mapping and sentinel lymphadenectomy for 106 head and neck lesions: Contrasts between oral cavity and cutaneous malignancy","volume":"116","author":"Civantos","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.bjps.2021.08.041","article-title":"Sentinel lymph node biopsy in high-risk cutaneous squamous cell carcinoma of the head and neck","volume":"75","author":"Ilmonen","year":"2022","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"E884","DOI":"10.1002\/hed.24120","article-title":"Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck","volume":"38","author":"Gore","year":"2016","journal-title":"Head Neck"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/7\/487\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:10:36Z","timestamp":1760127036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/7\/487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,11]]},"references-count":91,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["curroncol30070487"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30070487","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,11]]}}}