Purpose/Objective(s): Metastatic spread to parotid area lymph nodes (PALN) occurs in 1-3% of patients with cutaneous squamous cell carcinoma (SCCa) of the head and neck. We present the University of Florida experience in using radiation therapy (RT) to treat patients with PALN metastases from a skin primary. parotids in 117 patients received irradiation for non-melanotic skin carcinoma metastatic to PALN. Patients were staged by the O'Brien staging system. Of the 121 parotids receiving RT, 17 (14%) were treated preoperatively, 87 (72%) postoperatively, and 17 with RT alone. Results: Five-year actuarial probabilities of local (parotid) control, local-regional control, disease-free survival, and overall survival were 78%, 74%, 70%, and 54%, respectively. Statistically significant differences were seen between groups for local (parotid) control, local-regional control, and disease-free survival when patients were separated by P-stage. A statistically significant decrease in local control was seen in patients treated with positive surgical margins (92% vs. 76%), and in local-regional control for patients treated with preoperative RT or RT alone compared to postoperative RT (59% and 47% vs. 83%, respectively). The 5-year actuarial probability of freedom from distant metastases was 92%. Three (2.6%) patients suffered severe complications. Conclusions: PALN metastases from a cutaneous head and neck primary site are best treated with surgery and postoperative RT. Our data support the hypothesis that the O'Brien staging system is superior to the American Joint Committee on Cancer (AJCC) system for the staging of cutaneous metastases to PALN. Positive surgical margins confer a worse prognosis in terms of local-regional control and disease-free survival. Patients treated with preoperative RT appear to have a worse prognosis than those treated postoperatively, likely a result of patient selection and the surgeon's inability to accurately assess viable tumor extent after preoperative RT. Severe complications are uncommon following surgery and RT for PALN metastases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.