Regional Metastasis in Head and Neck Cutaneous Squamous Cell Carcinoma: An Update on the Significance of Extra-Nodal Extension and Soft Tissue Metastasis

Shaheen Hasmat*, Craig Mooney, Kan Gao, Carsten E. Palme, Ardalan Ebrahimi, Sydney Ch’ng, Ruta Gupta, Tsu Hui Low, Jonathan Clark

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    15 Citations (Scopus)

    Abstract

    Background: Soft tissue metastases (STMs) are reported to predict worse prognosis than extra-nodal extension (ENE) in metastatic head and neck cutaneous squamous cell carcinoma. This study aimed to update the authors’ previous analysis of STM in a larger series. Methods: The study analyzed 535 cases of consecutive cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007. A Cox proportional hazard model was used to determine the effect of STM, with adjustment for other relevant prognostic factors. Overall survival (OS) and disease-specific survival (DSS) were the primary end points. Results: Of the 535 patients, 275 (51.4%) had STM. After adjustment for the effects of age, tumor location, number of metastatic deposits, and adjuvant radiotherapy, both STM (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.08–2.22; p = 0.018) and ENE (HR, 1.56; 95% CI 1.10–2.22; p = 0.013) were shown to be independent predictors of reduced OS, with similar size of effect. Conclusion: In metastatic cSCC of the head and neck, STM is an independent predictor of reduced survival and has an impact on survival similar to that of ENE.

    Original languageEnglish
    Pages (from-to)2840-2845
    Number of pages6
    JournalAnnals of Surgical Oncology
    Volume27
    Issue number8
    DOIs
    Publication statusPublished - 1 Aug 2020

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