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Open Access 01-01-2012 | Head and Neck Oncology

Cutaneous Head and Neck Squamous Cell Carcinoma with Regional Metastases: The Prognostic Importance of Soft Tissue Metastases and Extranodal Spread

Authors: Wendy Kelder, MD, PhD, Ardalan Ebrahimi, MBBS (Hons), FRACS, Veronique-Isabelle Forest, MSc, FRCSC, Kan Gao, BEng, Rajmohan Murali, MBBS, MD, FRCPA, Jonathan R. Clark, MBBS FRACS

Published in: Annals of Surgical Oncology | Issue 1/2012

Abstract

Background

Extranodal spread (ENS) is an established adverse prognostic factor in metastatic cutaneous squamous cell carcinoma (cSCC); however, the clinical significance of soft tissue metastases (STM) is unknown. The aim of this study was to evaluate the prognosis of patients with STM from head and neck cSCC, and to compare this with that of node metastases with and without ENS.

Methods

Patients with cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007 were included. Metastatic nodes >3 cm in size were an exclusion criterion. A Cox proportional hazard model was used to determine the effect of STM adjusting for other relevant prognostic factors.

Results

The population included 164 patients with a median follow-up of 26 months. There were 8 distant and 37 regional recurrences. There were 22 were cancer-specific deaths, and 29 patients died. STM was a significant predictor of reduced overall (hazard ratio 3.3; 95% confidence interval 1.6–6.4; P = 0.001) and disease-free survival (hazard ratio 2.4; 95% confidence interval 1.4–4.1; P = 0.001) when compared to patients with node disease with or without ENS. After adjusting for covariates, STM and number of involved nodes were significant independent predictors of overall and disease-free survival.

Conclusions

In metastatic cSCC of the head and neck, the presence of STM is an independent predictor of reduced survival and is associated with a greater adverse effect than ENS alone.

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Title: Cutaneous Head and Neck Squamous Cell Carcinoma with Regional Metastases: The Prognostic Importance of Soft Tissue Metastases and Extranodal Spread
Authors: Wendy Kelder, MD, PhD
Ardalan Ebrahimi, MBBS (Hons), FRACS
Veronique-Isabelle Forest, MSc, FRCSC
Kan Gao, BEng
Rajmohan Murali, MBBS, MD, FRCPA
Jonathan R. Clark, MBBS FRACS
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1986-7

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Cutaneous Head and Neck Squamous Cell Carcinoma with Regional Metastases: The Prognostic Importance of Soft Tissue Metastases and Extranodal Spread

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

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