Abstract：
There is an urgent need for evidence-based management of cutaneous squamous cell carcinoma (cSCC), particularly \"high-risk\" tumours. We performed an online survey of skin cancer specialists to assess cSCC research priorities. Respondents were targeted via the international Skin Cancer OUTcomes consortium (SCOUT) and the UK regional Skin Cancer Outcomes North-East (SCONE) research interest group. Thirty-three respondents completed the survey ([46%; 16/33] were non-UK based). \'Defining a role for sentinel lymph node biopsy (SLNB) in high-risk cSCC\' was most commonly ranked either 1st or 2nd research priority by respondents (55%; 18/33), with near-total consensus that SLNB could be useful for the early identification of nodal metastasis in high-risk cSCC (97%; 30/31). On this specific research priority, 24 studies with longitudinal follow-up data were identified. Cumulatively, SLNB for cSCC had positivity and false omission rates of 7.0% and 3.1%, respectively, with false negative rates of 29.0%. Given the lack of consensus on a definition of \"high-risk\" cSCC, it was unsurprising that only two studies of SLNB for head & neck cSCC utilised comparable selection criteria; reporting the highest positivity rates (8.0%) and lowest false-omission rates (2.4%) and false-negative rates (21.4%) overall. There is multi-disciplinary interest in the role of SLNB for \"high-risk\" cSCC. It appears to perform best in head and neck cases. A consensus definition of \"high-risk\" cSCC is urgently required to refine the utility of SLNB and guide risk-directed management.
摘要：
迫切需要对皮肤鳞状细胞癌（cSCC）进行循证治疗，特别是“高风险”肿瘤。我们对皮肤癌专家进行了在线调查，以评估cSCC研究重点。受访者是通过国际皮肤癌成果联盟（SCOUT）和英国地区皮肤癌成果东北（SCONE）研究兴趣小组进行的。33名受访者完成了调查（[46％;16/33]是非英国的）。“定义前哨淋巴结活检（SLNB）在高风险cSCC中的作用”是受访者最常排名第一或第二的研究优先级（55％；18/33），在高风险的cSCC中，SLNB可用于早期识别淋巴结转移的几乎完全共识（97％；30/31）。关于这一具体的研究重点，确定了24项具有纵向随访数据的研究。累计,cSCC的SLNB阳性率和误漏率分别为7.0%和3.1%，分别,假阴性率为29.0%。鉴于对“高风险”cSCC的定义缺乏共识，毫不奇怪,只有两项针对头颈部cSCC的SLNB研究采用了可比较的选择标准;报告总体阳性率最高(8.0%),漏报率最低(2.4%)和假阴性率(21.4%).SLNB在“高风险”cSCC中的作用受到了多学科的关注。它似乎在头部和颈部病例中表现最好。迫切需要“高风险”cSCC的共识定义，以完善SLNB的效用并指导风险导向管理。
