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Published on: April 22, 2019
Metastatic head and neck cutaneous squamous cell carcinoma: defining a low-risk patient
Ardalan Ebrahimi1, Jonathan R Clark, Balazs B Lorincz
1Sydney Head and Neck Cancer Institute, The Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Sydney, Australia. ardalan100@hotmail.com
Background:
The purpose of this study was to determine whether there is a "low-risk" subset of patients with regional metastatic head and neck cutaneous squamous cell carcinoma (SCC) suitable for treatment with surgery alone and omission of adjuvant radiotherapy.
Methods:
We conducted a retrospective analysis of 168 patients with a single parotid gland or neck nodal metastasis ≤3 cm in size from cutaneous SCC treated with curative intent by surgery ± adjuvant radiotherapy.
Results:
Disease-specific survival for the 33 patients treated with surgery alone was 97% at 5 years. In the subset of 19 patients without extracapsular nodal spread (ECS), there was 1 regional recurrence which was successfully salvaged yielding a 5-year disease-specific survival of 100%.
Conclusion:
In head and neck cutaneous SCC, the subset with a single node ≤3 cm in size without ECS are at low risk of regional failure and death from cutaneous cancer. These patients may be suitable for single-modality therapy with surgery alone.
