Introduction
Cutaneous squamous cell carcinoma (cSCC) of the head and neck represents a common skin cancer, with rising incidence rates. Recurrence and metastasis remain primary concerns for both patients and clinicians. This study aims to evaluate the impact of consistency within the surgical team, histological subtyping, and tumor size on the success of achieving tumor-free resection margins (R0 status) in head and neck cSCC cases.

Materials and Methods
Retrospective review of 171 head and neck cSCC resections between 2018 and 2024, examining factors such as consistency within the surgical team, histological subtyping, tumor size and initial histopathological verification (external versus in-house). Clinical records, histopathological findings and follow-up data were analyzed.

Results
In 171 analyzed cSCC resections, factors influencing the number of re-resections needed to achieve R0 status included surgical experience, consistency within the surgical team, and tumor size. Histological subtyping and depth of invasion had no significant impact on this outcome. Initial histological verification performed externally was more frequently correlated with R1 status in the first resection. Ultrasound at the initial presentation showed suspicious findings in the parotid gland in 9% of cases and in other lymph nodes of the head and neck in 7.6% requiring further ultrasound monitoring.

Discussion
These findings highlight the importance of ultrasound in initial and follow-up assessments for optimal outcomes in head and neck cSCC. Additionally, the importance of consistency within the surgical team is to be emphasized. Future research should explore the importance of ultrasound at initial presentation and follow-up and strategies to improve resection success.

Nein