Mooney CP, et al. - Given the use of sentinel node biopsy (SNB) in a wide range of malignancies, but not in cutaneous squamous cell carcinoma (cSCC), to assess for regional nodal metastasis. Researchers offered SNB at the time of primary cSCC excision or secondary wide local excision to patients presenting with high-risk cSCC of the head and neck with clinically N0 necks. Complete lymph node dissection was undertaken in patients with positive sentinel nodes, and follow up at regular intervals was done in all the patients for up to 5 years. In this study, SNB was done on 105 lesions, and the positive result was noted in 10 sentinel nodes (9.5%). Findings revealed the significant correlation of nodal metastases with reduced disease-specific survival. Four or more high-risk features or tumors with a concurrent invasion deeper than 5 mm and PN were the significant predictors of metastasis. Findings support the safety and feasibility of performing SNB as a staging technique for high-risk cSCC.