Outcomes of Cutaneous Squamous Cell Carcinoma in the Head and Neck Region With Regional Lymph Node Metastasis

Sahovaler, Axel; Krishnan, Ramya; Yeh, David H.; Zhou, Qi; Palma, David A.; Fung, Kevin; Nichols, Anthony C.; MacNeil, Danielle

doi:10.1001/jamaoto.2018.4515

Cited by 52 publications

(50 citation statements)

References 63 publications

(86 reference statements)

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“…For patients with cSCC in the head and neck region with regional metastases, a recent meta-analysis performed by Sahovaler et al (20 observational studies and 1 randomised phase III study [62] improved disease-specific survival (DSS) and OS of adjuvant RT. In this meta-analysis, PNI was not associated with poorer OS, while extracapsular extension was [63].…”

Section: Postoperative Adjuvant Rtmentioning

confidence: 54%

“…The risk of bias is significant in these articles, being based mostly on a retrospective design, also patients with worse prognosis and comorbidities may not have received adjuvant RT [63], and the possibility that patients who received adjuvant RT may not have had clear surgical margins and may have had other poor prognostic factors [15]. The great variation in results, however, suggests that a subset of patients may derive benefit from adjuvant RT.…”

Section: Postoperative Adjuvant Rtmentioning

confidence: 99%

“…Meta-analysis (20 observational studies and 1 randomised phase III study) [63] Randomised phase III study [62] Retrospective studies [31,56,64] Strength of consensus: 85%…”

Section: Grade Of Recommendation: Bmentioning

confidence: 99%

See 2 more Smart Citations

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Stratigos

Garbe²,

Dessinioti

et al. 2020

European Journal of Cancer

232

371

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Section: Postoperative Adjuvant Rtmentioning

confidence: 54%

Section: Postoperative Adjuvant Rtmentioning

confidence: 99%

See 1 more Smart Citation

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Stratigos

Garbe²,

Dessinioti

et al. 2020

European Journal of Cancer

232

371

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“…Lymph node metastases occurs in a small subset of patients with cutaneous NMSC, and recommendations for management are based largely on retrospective data at single-center institutions. [20][21][22] Currently, there is still much heterogeneity regarding the utility of sentinel lymph node biopsy (SLNB) or regional lymphadenectomy in cutaneous SCC. 9 One study showed an 18.4% positive rate of locoregional disease with patients who underwent SLNB, but there was no difference in disease-specific survival compared to patients who did not have an SLNB.…”

Section: Discussionmentioning

confidence: 99%

Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck

Sullivan

Andresen

Kendell

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: Survival outcomes for advanced non-melanoma skin cancers of the head and neck treated with surgical resection are not well described in the literature. We aimed to describe outcomes for T3 and T4 cutaneoous squamous cell carcinoma of the head or neck treated with surgical resection at 1 tertiary academic medical center. Methods: We analyzed a retrospective cohort of patients diagnosed with T3 or T4 cutaneous squamous cell carcinoma (SCC) of the head or neck from 2005 to 2016 treated with definitive surgical resection. Survival outcomes were examined using Kaplan-Meier analysis, and multivariate analysis was completed with Cox proportional hazard model. Results: Forty-three patients met inclusion criteria. The mean age at diagnosis was 74.7 years (SD = 10.2), and 34 (79.1%) patients were male. Twelve (27.9%) patients were immunosuppressed. Radical resection, defined as temporal bone resection, orbital exenteration, calvarial resection, mandibulectomy, or maxillectomy, was performed in 25 (58.1%) cases. Final surgical margins were positive in 19 (44.2%) cases. Patients with tumors of the scalp/neck had a 1-year survival probability of 85.7%, and the probability of survival 1 year after a neck dissection was greater than 93%. Conclusion: Anatomical subsites, specifically scalp/neck tumors, tended to have worse overall survival. Positive final margins tended to indicate a worse prognosis, and overall survival and recurrence were not significantly different among patients who underwent radical surgical resection compared to soft tissue resection.

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“…4,6,7 There have been attempts to determine the point at which the benefit of electively treating clinically negative neck lymph nodes exceed treatment-related morbidity. [8][9][10][11][12][13][14] Unfortunately, however, the risk factors known to increase the likelihood for regional neck metastasis, especially tumor diameter of 2 cm or more and depth of invasion, are not sufficiently predictive to help decide whether a potentially morbid surgery encompassing parotidectomy and neck dissection is needed. [1][2][3][4] Besides the typical pathways for metastatic spread, the parotid intraglandular lymph nodes (IGLNs) represent the first metastatic relay for cSCCHN of the face and scalp.…”

Section: Introductionmentioning

confidence: 99%

Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma

Dür

Salmina²,

Borner

et al. 2020

The Laryngoscope

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Objectives: Parotid lymph node metastases are common in head and neck cutaneous squamous cell carcinoma (cSCCHN). Here we evaluate the diagnostic, prognostic, and therapeutic implications of intraglandular lymph node (IGLN) metastases in cSCCHN. Study Design: Retrospective study in a tertiary referral university cancer institute. Methods: We included patients with cSCCHN who underwent parotidectomy and neck dissection (ND), with or without synchronous resection of the skin primary, between January 1999 and January 2018. The characteristics of cSCCHN with or without IGLN involvement were compared. Results: Altogether, 68 patients were included. Of the 29 (42.6%) patients classified as cN0, eight were upstaged pN+ and had concomitant IGLN involvement. Of 21 patients with pN0 disease, IGLN metastases were absent in only three cases, resulting in a specificity and sensitivity of parotid metastases to diagnose occult nodal neck metastases of 14.29% and 100%, respectively. The positive and negative predictive values were 14.29% and 100%, respectively. Univariate analyses only displayed a significantly higher rate of moderately and poorly differentiated primaries in patients with IGLN metastases (P = .015). Only advanced T-stages were significantly associated with neck recurrences. Conclusion: IGLN status in advanced cSCCHN is potentially predictive for occul nodal neck metastases. Our results suggest that ND in patients with histopathologically negative IGLNs and clinically negative neck lymph nodes may not be necessary given the high negative predictive value of IGLN status in this group of patients. Therefore, accurate diagnostic evaluation of IGLN involvement is mandatory.

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Outcomes of Cutaneous Squamous Cell Carcinoma in the Head and Neck Region With Regional Lymph Node Metastasis

Cited by 52 publications

References 63 publications

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck

Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma

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