In addition, the tumor boundaries are difficult to assess because there are deep tumor extensions are responsible for the particular frequency of local recurrence at the lodge (about 15%).
The node is more common for the EC flag than any other location.
The rate of lymph node metastases at diagnosis is about 10% in several studies, and also about 10% during the surveillance.
Metastases are mainly parotid, jugulocarotidiennes high and medium, and more rarely jugulocarotidiennes low and sub-mental.
When there are nodes jugulocarotidiennes, there are still parotid lymph nodes, which systematically justifies a superficial parotidectomy in addition to cervical lymph node dissection in patients N +.
Distant metastases are rare but not exceptional (1-5%).
Given the important age of patients who often die of intercurrent diseases, they do not seem to alter survival.
The occurrence of a second or more skin cancer is very common in patients at risk (27%).
The main prognostic factors are the size and infiltration of the tumor, its central location (conch root of the helix, tragus) and lymph node spread, even if these factors affect the survival not given the advanced age of the patients.