“…6,21 A large study conducted by Brantsch et al with 615 patients designated tumor depth and histological differentiation as risk factors for metastatic disease, with 75% of lesions being <2 cm, confirming the opinion held by Veness et al, that even small lesions have a significant metastatic potential. 8,22 Lymphatic metastases were identified in 23.3% of the patients, which is slightly higher than previously reported rate, ranging from 0.3% to 20.7%. The incidence reflects the practice environment of the authors, since the patients referred to our comprehensive cancer center are more likely to suffer from aggressive or advanced disease.…”