Metastatic cutaneous squamous cell carcinoma to the parotid: the role of surgery and adjuvant radiotherapy to achieve best outcome

Dona, E.; Veness, Michael J.; Çakır, Burcu; Morgan, Gary J.

doi:10.1046/j.1445-2197.2003.02737.x

Cited by 61 publications

(57 citation statements)

References 37 publications

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“…Despite these misgivings, previous studies have highlighted the importance of adjuvant radiotherapy in conferring better regional control and improved survival compared with either surgery alone or radiotherapy alone. [12][13][14][15][16][17] In a series of patients with metastatic cSCC to cervical lymph nodes, the 5-year disease-free survival rate was improved significantly in patients who underwent surgery and received adjuvant radiotherapy compared with patients who underwent surgery alone (73% vs 18%; P ¼ .001), and locoregional control also was improved (77% vs 15%). 14 Jol et al also reported a decreased locoregional failure rate in patients who underwent surgery and adjuvant radiotherapy compared with patients who underwent surgery alone (17% vs 44%).…”

Section: >3mentioning

confidence: 97%

“…[12][13][14][15][16][17] Recurrence reflects clinical progression of residual microscopic cSCC either after surgery alone or after surgery and adjuvant radiotherapy. The objective of adjuvant radiotherapy is to decrease the risk of regional recurrence by eradicating microscopic cSCC.…”

Section: Original Articlementioning

confidence: 99%

“…By using a large database of patients who were treated with curative intent, we developed a simple model using competing risks analysis that allows clinicians to assign a 3-tiered risk score. This current study builds on our extensive previous research [14][15][16][17] and re-emphasizes the improved outcome with the addition of adjuvant radiotherapy.…”

mentioning

confidence: 99%

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Metastatic cutaneous squamous cell carcinoma of the head and neck

Oddone

Morgan

Palme

et al. 2009

Cancer

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118

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BACKGROUND:The authors propose a prognostic score model using a prospective study of patients with regional metastatic cutaneous squamous cell carcinoma of the head and neck.METHODS:Two‐hundred fifty patients were analyzed using a competing risks model to identify risk factors for survival. A risk score was obtained using the significant coefficients from the regression model, and cutoff points were determined that separated the score into 3 risk groups (low risk, moderate risk, and high risk).RESULTS:At a median follow‐up of 54 months (range, 1.3‐212 months) 70 of 250 patients (28%) developed recurrent disease: Most were regional recurrences (51 of 70 patients; 73%) in the treated lymph node basin. After regional recurrence, a majority (73%) died of disease. The following 4 variables were associated significantly with survival: immunosuppression (hazard ratio [HR], 3.13; 95% confidence interval [CI], 1.39‐7.05), treatment (HR, 0.32; 95% CI, 0.16‐0.66), extranodal spread (HR, 9.92; 95% CI, 1.28‐77.09), and margin status (HR, 1.85; 95% CI, 1.85‐3.369); and those 4 variables (immuosuppression, treatment, extranodal spread, and margin status) were used to calculate the ITEM score. The 5‐year risk of dying from disease for patients with high‐risk (>3.0), moderate‐risk (>2.6‐3.0), and low‐risk (≤2.6) ITEM scores were 56%, 24%, and 6%, respectively. Fifty‐six of 250 patients (22%) died from another cause.CONCLUSIONS:Patients who underwent surgery and received adjuvant radiotherapy had a better outcome compared with patients who underwent surgery alone. Patients who had moderate‐ or high‐risk ITEM scores, usually because of extranodal spread and involved excision margins, had a poor outcome. The authors recommend considering these patients for inclusion in adjuvant chemoradiotherapy trials. Cancer 2009. © 2009 American Cancer Society.

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Section: >3mentioning

confidence: 97%

Section: Original Articlementioning

confidence: 99%

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Metastatic cutaneous squamous cell carcinoma of the head and neck

Oddone

Morgan

Palme

et al. 2009

Cancer

Self Cite

118

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“…Residual microscopic disease is treated by high dose adjuvant radiotherapy. Eddy et al, recommend that the facial nerve is only sacrificed if it is grossly involved by tumor [20] .…”

Section: Discussionmentioning

confidence: 99%

Parotid squamous cell carcinoma: Outcome of multidisplinary management

Aboziada

Eisbruch

2012

JST

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Purpose: To evaluate the origin and outcome of parotid squamous cell carcinoma (SCC). Methods:Fifty nine patients were identified with parotid SCC through the hospital data-base, patients' charts, imaging studies and computerized notes. Results:Fifty of the patients were diagnosed as metastatic SCC from skin primary cancer to parotid lymph nodes; 28% were immunocompromized and 9 patients were diagnosed as primary SCC of the parotid gland, none was immunocompromized. Forty seven patients with metastatic SCC were treated with surgery and post-operative radiotherapy. The rate of neck lymph node metastases was 54%. The median follow up of these patients was 33 months and the 3-year actuarial cause specific survival was 91%. The 3-year actuarial local recurrence free survival (LRFS) and disease free survival rate were 79% and 77% respectively. Positive surgical margin after parotidectomy was the only factor that had statistically significant poor LRFS. Patients with primary parotid SCC had DFS of 100%. Conclusion:The most common site of the primary tumor was a cutaneous SCC of the face. All patients should be considered for facial nerve sparing radical parotidectomy and adjuvant radiotherapy. Neck dissection or elective neck irradiation for ipsilateral neck is recommended due to high occult LN metastasis.

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“…[64][65][66][67] To date, however, no prospective study has demonstrated a survival benefit where elective neck dissection is added to management of high-risk cSCC of the head and neck in the N0 setting. 67 Studies report rates of occult nodal metastasis of 10 to 60%.…”

Section: Elective Neck Dissectionmentioning

confidence: 99%

High-risk Cutaneous Squamous Cell Carcinoma

Fitzgerald¹,

O’Neill²

2017

International Journal of Head and Neck Surgery

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Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer worldwide. Cutaneous squamous cell carcinoma can potentially be treated fully with minimal morbidity when detected early; however, certain subtypes of cSCC have been shown to confer a poorer prognosis for patients. In these high-risk tumors, increased incidence of recurrence, as well as metastasis to local lymph nodes and distant sites, is seen as a result of certain patient characteristics and pathological features. While guidelines regarding the management of high-risk cSCC have been produced, no clear consensus management or prognostic algorithms exist. In this review, we discuss current definitions of high-risk cSCC, recommendations regarding the management of cSCC, and current guidelines.

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Metastatic cutaneous squamous cell carcinoma to the parotid: the role of surgery and adjuvant radiotherapy to achieve best outcome

Cited by 61 publications

References 37 publications

Metastatic cutaneous squamous cell carcinoma of the head and neck

Metastatic cutaneous squamous cell carcinoma of the head and neck

Parotid squamous cell carcinoma: Outcome of multidisplinary management

High-risk Cutaneous Squamous Cell Carcinoma

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