Node-positive cutaneous squamous cell carcinoma of the head and neck: Survival, high-risk features, and adjuvant chemoradiotherapy outcomes

Misha Amoils; Carolyn S Lee; John Sunwoo; Sumaira Z Aasi; Wendy Hara; Jinah Kim; Davud Sirjani; A Dimitrios Colevas; Anne Lynn S Chang; Vasu Divi

doi:10.1002/hed.24692

Node-positive cutaneous squamous cell carcinoma of the head and neck: Survival, high-risk features, and adjuvant chemoradiotherapy outcomes

Head Neck. 2017 May;39(5):881-885. doi: 10.1002/hed.24692. Epub 2017 Mar 2.

Authors

Affiliations

¹ Department of Otolaryngology, Stanford University Medical Center, Stanford, California.
² Department of Dermatology, Stanford University Medical Center, Stanford, California.
³ Department of Radiation Oncology, Stanford University Medical Center, Stanford, California.
⁴ Department of Dermatopathology, Stanford University Medical Center, Stanford, California.
⁵ Department of Oncology, Stanford University Medical Center, Stanford, California.

PMID: 28252823
DOI: 10.1002/hed.24692

Abstract

Background: Data lacks to guide treatment of regionally metastatic cutaneous head and neck squamous cell carcinoma (HNSCC).

Methods: We conducted a retrospective review of 80 patients treated for regionally metastatic cutaneous HNSCC. The effect of various clinicopathologic variables on overall survival (OS) was investigated, in addition to outcomes by treatment modality.

Results: On multivariate regression, cutaneous primary >2 cm (p = .03) and extracapsular spread (ECS; p = .01) were significantly associated with decreased OS. Location of regional metastasis (neck vs parotid vs both) had no effect on OS (p = .2), nor did the presence of a cutaneous primary at the time of presentation (p = .9). The 3-year survival was 43%, 52%, and 49% for surgery alone, adjuvant radiation, and adjuvant chemoradiation, respectively. Fifty-one percent of patients had a recurrence of their disease.

Conclusion: Regionally metastatic cutaneous HNSCC is an aggressive disease associated with high recurrence rates. Patients with tumors >2 cm and ECS have poorer OS despite adjuvant therapy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 881-885, 2017.

Keywords: cutaneous squamous cell carcinoma; head and neck neoplasms; high-risk disease; regional metastases; survival outcomes.

MeSH terms

Aged
Carcinoma, Squamous Cell / mortality*
Carcinoma, Squamous Cell / pathology*
Carcinoma, Squamous Cell / therapy
Chemoradiotherapy, Adjuvant
Female
Head and Neck Neoplasms / mortality*
Head and Neck Neoplasms / pathology*
Head and Neck Neoplasms / therapy
Humans
Lymph Nodes / pathology
Male
Middle Aged
Neoplasm Recurrence, Local / epidemiology*
Retrospective Studies
Skin Neoplasms / mortality*
Skin Neoplasms / pathology*
Skin Neoplasms / therapy
Squamous Cell Carcinoma of Head and Neck
Survival Rate
Treatment Outcome