Non-melanoma skin cancer (NMSC) represents the most common malignancy in the world, comprising exceedingly common lesions such as basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) and rare lesions such as Merkel cell carcinoma. Risk factors are widely recognized and include ultraviolet (UV) light exposure, radiation exposure, immunosuppression, and many others. As a whole, survival and functional outcomes are favorable, but each histopathological subtype of NMSC behaves differently. Treatment regimens for the primary site usually include wide surgical excision and neck dissection in cases of clinically involved metastatic lymph nodes. The elective management of draining nodal basins, however, is a contested topic. Nearly all subtypes, excluding BCC, have a significant risk of lymphatic metastases, and have been studied with regard to sentinel lymph node biopsy (SLNB) and elective neck dissection. To date, no studies have definitively established a true single standard of care, as exists for melanoma, for any of the NMSCs. As a result, the authors have sought to summarize the current literature and identify indications and management options for the management of the cervical lymphatics for each major subtype of NMSC. Further research remains critically necessary in order to develop complete treatment algorithms.
非黑色素瘤皮肤癌（NMSC）是全球最常见的恶性肿瘤，包括极为常见的基底细胞癌（BCC）和皮肤鳞状细胞癌（cSCC），以及罕见的默克尔细胞癌等病变。其风险因素已得到广泛认可，主要包括紫外线（UV）暴露、辐射暴露、免疫抑制等多种因素。总体而言，患者的生存率和功能预后较为良好，但NMSC的每种组织病理学亚型具有不同的生物学行为。原发灶的治疗方案通常包括广泛手术切除，若临床发现转移性淋巴结受累则需行颈部淋巴结清扫术。然而，引流淋巴结区域的选择性处理仍存在争议。除BCC外，几乎所有亚型均存在显著的淋巴转移风险，因此针对前哨淋巴结活检（SLNB）和选择性颈部淋巴结清扫术已开展相关研究。迄今为止，尚无研究能像黑色素瘤那样为任何NMSC亚型确立明确的单一治疗标准。鉴于此，本文作者旨在总结现有文献，针对NMSC各主要亚型的颈部淋巴系统处理，归纳其适应症及治疗方案选择。为建立完整的治疗规范体系，进一步的研究仍至关重要。
Lymph Node Metastases from Non-Melanoma Skin Cancer of the Head and Neck
肿瘤(癌症)患者之家