Metastatic Head and Neck Non-Melanoma Skin Cancer: A Retrospective Analysis of Clinico-Pathologic Features and...

Area of Science:

• Oncology
• Dermatology
• Head and Neck Surgery

Background:

• Non-melanoma skin cancer (NMSC) is the most common global malignancy.
• Cutaneous squamous cell carcinoma (cSCC) of the head and neck carries a significant risk of metastasis.
• Limited comparative data exists on synchronous versus metachronous metastatic behavior in head and neck NMSC.

Purpose of the Study:

• To evaluate clinicopathological characteristics of synchronous and metachronous head and neck NMSC metastasis.
• To compare reconstructive implications between synchronous and metachronous metastatic patterns.
• To identify factors influencing metastatic behavior in head and neck NMSC.

Main Methods:

• Retrospective observational study of 46 patients with metastatic head and neck NMSC.
• Stratification into synchronous and metachronous metastasis groups.
• Analysis of clinical, histopathological, metastatic site, and surgical data; statistical comparison using chi-square and t-tests.

Main Results:

• Synchronous and metachronous metastases occurred equally (50% each).
• Perineural and lymphovascular invasion were more common in synchronous metastases.
• Metachronous cases, often in older patients, required more complex reconstructions and showed late-onset potential (over 4 years post-treatment).

Conclusions:

• Head and neck NMSC, especially on the lower lip, can have late metastatic potential.
• Current surveillance guidelines may be insufficient for high-risk patients.
• Risk-adapted, extended surveillance is recommended to improve long-term outcomes.