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Lymphatic drainage patterns of malignant skin tumors in the head and neck region: a single-center retrospective study

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Abstract

Background

This study aimed to clarify the relationship between primary site and lymphatic drainage pattern for malignant skin tumors in the head and neck region. Malignant melanoma and squamous cell carcinoma in the head and neck region are known to have poor prognosis because of lymph node metastasis. Nevertheless, numerous aspects of lymphatic drainage patterns remain elusive.

Methods

We statistically analyzed data of 47 patients with malignant skin tumors in the head and neck region. Information was collected on the patients' clinical characteristics, primary tumor site, and lymphatic drainage patterns.

Results

The parotid lymph nodes drained the greatest amount of lymph from skin tumors of the head and neck. Important lymphatic drainage pathways were the superficial cervical nodes for primary tumors in the buccal/nasal region, level IA and level IB nodes for primary tumors in the lip region, the occipital nodes, posterior auricular nodes, and level VA nodes in the parietal/occipital region, and the preauricular nodes in the auricular region.

Conclusion

These findings have considerable significance in terms of understanding lymphatic drainage patterns for malignant skin tumors in the head and neck and may be useful for clinical decision-making and when planning treatment. Further research and clinical applications are expected to contribute to an improved prognosis in patients with cutaneous head and neck malignancies.

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Data availability

The data that support the findings of this study are not openly available due to privacy reasons and are available from the corresponding author upon reasonable request. Data are stored at a controlled access data storage facility at Hokkaido University.

References

  1. Karia PS, Han J, Schmults CD et al (2013) Cutaneous squamous cell carcinoma: estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012. J Am Acad Dermatol 68:957–966

    Article  PubMed  Google Scholar 

  2. Robsahm TE, Helsing P, Veierød MB (2015) Cutaneous squamous cell carcinoma in Norway 1963–2011: increasing incidence and stable mortality. Cancer Med 4:472–480

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lomas A, Leonardi-Bee J, Bath-Hextall F (2012) A systematic review of the worldwide incidence of nonmelanoma skin cancer. Br J Dermatol 166:1069–1080

    Article  CAS  PubMed  Google Scholar 

  4. Berwick M, Garci A (2020) Epidemiology of skin cancer. In: Reichrath J (ed) Sunlight, vitamin D and skin cancer, 3rd edn. Springer, Cham, pp 142–191

    Google Scholar 

  5. Skanjeti A, Dhomps A, Paschetta C et al (2021) Lymphoscintigraphy for sentinel node mapping in head and neck cancer. Semin Nucl Med 51:39–49

    Article  PubMed  Google Scholar 

  6. Ogata D, Namikawa K, Nakano E et al (2023) Epidemiology of skin cancer based on Japan’s National Cancer Registry 2016–2017. Cancer Sci 114:2986–2992

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Cancer Information Service, National Cancer Center, Japan (2022) Cancer statistic update . Statistical information by cancer type; Skin [in Japanese]. https://ganjoho.jp/reg_stat/statistics/stat/cancer/13_skin.html. Accessed Jul 2023

  8. Roses DF, Harris MN, Grunberger I et al (1980) Selective surgical management of cutaneous melanoma of the head and neck. Ann Surg 192:629–632

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. O’Brien CJ, Uren RF, Thompson JF et al (1995) Prediction of potential metastatic sites in cutaneous head and neck melanoma using lymphoscintigraphy. Am J Surg 170:461–466

    Article  CAS  PubMed  Google Scholar 

  10. Suton P, Lukšić I, Müller D et al (2012) Lymphatic drainage patterns of head and neck cutaneous melanoma: does primary melanoma site correlate with anatomic distribution of pathologically involved lymph nodes? Int J Oral Maxillofac Surg 41:413–420

    Article  CAS  PubMed  Google Scholar 

  11. Pan WR, Suami H, Taylor GI (2008) Lymphatic drainage of the superficial tissues of the head and neck: an anatomical study and clinical implications. Plast Reconstr Surg 121:1614–1624

    Article  CAS  PubMed  Google Scholar 

  12. de Wilt JHW, Thompson JF, Uren RF et al (2004) Correlation between preoperative lymphoscintigraphy and metastatic nodal disease sites in 362 patients with cutaneous melanomas of the head and neck. Ann Surg 239:544–552

    Article  PubMed  PubMed Central  Google Scholar 

  13. Uren RF, Howman-Giles R, Thompson JF (2003) Patterns of lymphatic drainage from the skin in patients with melanoma. J Nucl Med 44:570–582

    PubMed  Google Scholar 

  14. Reynolds HM, Smith NP, Uren RF et al (2009) Three-dimensional visualization of skin lymphatic drainage patterns of the head and neck. Head Neck 31:1316–1325

    Article  PubMed  Google Scholar 

  15. Hayashi T, Furukawa H, Oyama A et al (2011) Sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in cutaneous head and neck/lip mucosa melanomas. Head Neck 34:758–761

    Article  PubMed  Google Scholar 

  16. Hayashi T, Furukawa H, Oyama A et al (2012) Dominant lymph drainage in the facial region: evaluation of lymph nodes of facial melanoma patients. Int J Clin Oncol 17:330–335

    Article  PubMed  Google Scholar 

  17. Maeda T, Yamamoto Y, Furukawa H et al (2017) Dominant lymph drainage patterns in the occipital and parietal regions: evaluation of lymph nodes in patients with skin cancer of the head. Int J Clin Oncol 22:774–779

    Article  CAS  PubMed  Google Scholar 

  18. Robbins KT, Shaha AR, Medina JE et al (2008) Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg 134:536–538

    Article  PubMed  Google Scholar 

  19. Wang Y, Ow TJ, Myers JN (2012) Pathways for cervical metastasis in malignant neoplasms of the head and neck region. Clin Anat 25:54–71

    Article  PubMed  Google Scholar 

  20. Werner JA, Dunne AA, Myers JN (2003) Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in the metastasis of squamous cell carcinoma. Head Neck 25:322–332

    Article  PubMed  Google Scholar 

  21. Robbins KT (1998) Classification of neck dissection: current concepts and future considerations. Otolaryngol Clin North Am 31:639–655

    Article  CAS  PubMed  Google Scholar 

  22. Civantos FJ, Zitsch RP, Schuller DE et al (2010) Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1–T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol 28:1395–1400

    Article  PubMed  PubMed Central  Google Scholar 

  23. Suami H, Taylor GI, Pan WR (2005) A new radiographic cadaver injection technique for investigating the lymphatic system. Plast Reconstr Surg 115:2007–2013

    Article  CAS  PubMed  Google Scholar 

  24. Seim NB, Wright CL, Agrawal A (2016) Contemporary use of sentinel lymph node biopsy in the head and neck. World J Otorhinolaryngol Head Neck Surg 25:117–125

    Article  Google Scholar 

  25. Alkureishi LW, Ross GL, Shoaib T et al (2010) Sentinel node biopsy in head and neck squamous cell cancer: 5-year follow-up of a European multicenter trial. Ann Surg Oncol 17:2459–2464

    Article  PubMed  Google Scholar 

  26. Vahabzadeh-Hagh AM, Blackwell KE, Abemayor E et al (2018) Sentinel lymph node biopsy in cutaneous melanoma of the head and neck using the indocyanine green SPY Elite system. Am J Otolaryngol 39:485–488

    Article  PubMed  Google Scholar 

  27. Passmore-Webb B, Gurney B, Yuen HM et al (2019) Sentinel lymph node biopsy for melanoma of the head and neck: a multicentre study to examine safety, efficacy, and prognostic value. Br J Oral Maxillofac Surg 57:891–897

    Article  CAS  PubMed  Google Scholar 

  28. Erman AB, Collar RM, Griffith KA et al (2012) Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma. Cancer 118:1040–1047

    Article  PubMed  Google Scholar 

  29. Kelly J, Fogarty K, Redmond HP (2009) A definitive role for sentinel lymph node mapping with biopsy for cutaneous melanoma of the head and neck. Surgeon 7:336–339

    Article  CAS  PubMed  Google Scholar 

  30. Wu MP, Sethi RKV, Emerick KS et al (2020) Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck. Laryngoscope 130:108–114

    Article  PubMed  Google Scholar 

  31. Janković I, Kovačević P, Janković D et al (2021) Lymphatic drainage map of the head and neck skin squamous cell carcinoma detected by sentinel lymph node biopsy. Eur Rev Med Pharmacol Sci 25:5228–5234

    PubMed  Google Scholar 

  32. Han AY, St. John MA (2022) Predictors of nodal metastasis in cutaneous head and neck cancers. Curr Oncol Rep 24:1145–1152

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Silberstein E, Sofrin E, Bogdanov-Berezovsky A et al (2015) Lymph node metastasis in cutaneous head and neck squamous cell carcinoma. Dermatol Surg 41:1126–1129

    Article  CAS  PubMed  Google Scholar 

  34. Creighton F, Bergmark R, Emerick K (2016) Drainage patterns to nontraditional nodal regions and level IIB in cutaneous head and neck malignancy. Otolaryngol Head Neck Surg 155(100):5–1011

    Google Scholar 

  35. O’Hara J, Ferlito A, Takes RP et al (2011) Cutaneous squamous cell carcinoma of the head and neck metastasizing to the parotid gland–—a review of current recommendations. Head Neck 33:1789–1795

    Article  PubMed  Google Scholar 

  36. Hayashi T, Sasaki S, Oyama A et al (2010) A false-negative sentinel lymph node in the parotid gland of a melanoma patient: a new algorithm for SLN biopsy in the parotid gland. Int J Clin Oncol 15:504–507

    Article  PubMed  Google Scholar 

  37. Som PM, Curtin HD, Mancuso AA (1999) An imaging-based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications. Arch Otolaryngol Head Neck Surg 125:388–396

    Article  CAS  PubMed  Google Scholar 

  38. Gregoire V, Ang K, Budach W et al (2014) Delineation of neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI RTOG TROG consensus guidelines. Radiother Oncol 110:172–181

    Article  PubMed  Google Scholar 

  39. Vauterin TJ, Veness MJ, Morgan GJ et al (2006) Patterns of lymph node spread of cutaneous squamous cell carcinoma of the head and neck. Head Neck 28:785–791

    Article  PubMed  Google Scholar 

  40. Mooney CP, Martin RCW, Dirven R et al (2019) Sentinel node biopsy in 105 high-risk cutaneous SCCs of the head and neck: results of a multicenter prospective study. Ann Surg Oncol 26:4481–4488

    Article  PubMed  Google Scholar 

  41. Veenstra HJ, Klop WM, Lohuis PJ et al (2014) Cadaver study on the location of suboccipital lymph nodes: guidance for suboccipital node dissection. Head Neck 36:682–686

    Article  PubMed  Google Scholar 

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Takuya Nishio, Taku Maeda, Kosuke Ishikawa, Naoki Murao & Yuhei Yamamoto

  2. Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan

    Kanako Fuyama

  3. Department of Plastic and Reconstructive Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan

    Takuya Nishio & Toshihiko Hayashi

Authors
  1. Takuya Nishio
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  2. Taku Maeda
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  3. Kosuke Ishikawa
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  7. Toshihiko Hayashi
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Correspondence to Toshihiko Hayashi.

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Nishio, T., Maeda, T., Ishikawa, K. et al. Lymphatic drainage patterns of malignant skin tumors in the head and neck region: a single-center retrospective study. Int J Clin Oncol 29, 582–591 (2024). https://doi.org/10.1007/s10147-024-02487-2

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  • DOI: https://doi.org/10.1007/s10147-024-02487-2

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