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Despite multimodality treatment metastatic cHNSCC involving the parotid shows moderate rates of recurrence. Immunosuppressed patients with this disease have a particularly poor prognosis, demonstrating lower rates of CSS with similar rates of LRC compared to their immunocompetent counterparts.

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Objectives Extent of parotidectomy and neck dissection for metastatic cutaneous squamous cell carcinoma (cSCC) to the parotid is debated. We describe our experience, analyzing outcomes (overall survival and regional recurrence) associated with surgical extent and adjuvant treatment. Study Design A retrospective cohort study of parotidectomy with or without neck dissection for metastatic cSCC. Setting A tertiary referral cancer center in Australia. Subjects and Methods The study group consisted of patients with metastatic cSCC involving the parotid gland who underwent a curative-intent parotidectomy (superficial or total), with or without neck dissection, between 2003 and 2014. Demographic and clinical data, treatment modalities, and outcome parameters were collected from the electronic institutional database. Results Of 78 patients, 65 underwent superficial parotidectomy. Median follow-up was 6.5 years. Sixty-four patients (82%) patients received adjuvant radiotherapy. Cervical lymph nodes were involved in 6 (24%) elective neck dissections. Involved preauricular, facial, external jugular, and occipital nodes occurred in 36.9%. Adjuvant radiotherapy was associated with improved 5-year survival-50% (95% CI, 36%-69%) versus 20% (95% CI, 6%-70%)-and improved 2-year regional control: 89% (95% CI, 67%-100%) versus 40% (95% CI, 14%-100%). The ipsilateral parotid bed recurrence rate was 3.7% for those who received adjuvant radiotherapy and 27% for those who did not receive radiotherapy. Conclusion This study supports surgery plus adjuvant radiotherapy as a standard of care for metastatic cSCC. The low incidence of parotid bed recurrence with this approach suggests that routine elective deep lobe resection may not be required.

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BACKGROUND:The incidence of p16 overexpression and the role of human papillomavirus (HPV) in cutaneous head and neck squamous cell carcinoma (cHNSCC) are unclear. METHODS: One hundred forty-three patients with cHNSCC lymph node metastases involving the parotid gland were evaluated for p16 expression by immunohistochemistry. The detection of 18 high-risk HPV subtypes was performed with HPV RNA in situ hybridization for a subset of 59 patients. The results were correlated with clinicopathological features and outcomes. RESULTS: The median follow-up time was 5.3 years. No differences were observed in clinicopathological factors with respect to the p16 status. p16 was positive, weak, and negative in 45 (31%), 21 (15%), and 77 cases (54%), respectively. No high-risk HPV subtypes were identified, regardless of the p16 status. The p16 status was not prognostic for overall (hazard ratio, 1.08; 95% confidence interval [CI], 0.85-1.36; P 5 .528), cancer-specific (hazard ratio, 1.12; 95% CI, 0.77-1.64; P 5 .542), or progression-free survival (hazard ratio, 1.03; 95% CI, 0.83-1.29; P 5 .783). Distant metastasis-free survival, freedom from locoregional failure, and freedom from local failure were also not significantly associated with the p16 status. CONCLUSIONS: p16 positivity is common but not prognostic in cHNSCC lymph node metastases. High-risk HPV subtypes are not associated with p16 positivity and do not appear to play a role in this disease. HPV testing, in addition to the p16 status in the unknown primary setting, may provide additional information for determining a putative primary site. Cancer 2016;122:1201-8. V C 2016 American Cancer Society.KEYWORDS: head and neck cancer, human p16 protein, papillomavirus infections, skin neoplasms, squamous cell neoplasms, unknown primary neoplasms. INTRODUCTIONCutaneous head and neck squamous cell carcinoma (cHNSCC) is a common malignancy in Caucasians living in areas of high ultraviolet exposure. 1,2 The majority of cutaneous squamous cell carcinomas (cSCCs) can be considered low-risk and are cured by local treatment, most often excision. 3,4 However, despite surgery, a proportion of patients with aggressive tumor biology will develop locoregional and/or distant recurrences, which are associated with a poor prognosis. Pathologic features such as grade, perineural invasion, and anatomic location are currently used to identify those primary high-risk lesions at increased risk for nodal metastases. 3,4 Working at a tertiary referral center, we manage a disproportionate number of node-positive cHNSCCs. The incidence and relevance of p16 positivity in cSCC became an issue when we were revising our unknown primary (UKP) management policy to reflect the increasing incidence of p16-positive/human papillomavirus (HPV)-associated oropharyngeal cancer and the increasing role of robotic surgery in the management of UKP/oropharyngeal cancer.The p16 status has been used to direct management in patients with cervical squamous cell carcinoma lymph node metastases from a UKP because p16 positi...

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Introduction The global COVID‐19 pandemic forced the cancellation of the TROG 2020 face to face Annual Scientific Meeting (ASM). It was instead delivered as a live virtual meeting with 6 days of planning. Here, we report the participants’ experience of this live virtual meeting. Method Participants were invited to complete custom‐developed, pre‐ and post‐meeting surveys to assess their expectations of and satisfaction with the live virtual format. Speakers and moderators were also invited to complete a custom‐developed satisfaction survey. The working parties of TROG (head/neck/skin, genitourinary, breast and lung) were also sampled. Results In total, 188/273 (69%) registered participants logged in to the live virtual meeting. The online engagement for each of the oral sessions ranged from 53 to 66%. There were 102 and 57 responders to the online pre‐ and post‐meeting surveys, respectively. The majority of pre‐meeting responders indicated a significant level of employer support to attend the virtual meeting. Post‐meeting satisfaction exceeded pre‐meeting expectations (‘very much’ and ‘quite a bit’; 86% vs. 54%; P < 0.0001). The majority indicated they would be ‘quite a bit’ or ‘very much’ interested in future live virtual meetings. Conclusion The TROG 2020 ASM was conducted as a live virtual meeting. Participant satisfaction and future interest in a live virtual meeting was high, indicating this is a viable platform for other CCTG’s faced with the decision to deliver virtual content at times of global public health threats.