Head and Neck Cutaneous Squamous Cell Carcinoma Requiring Parotidectomy Prognostic Indicators and Treatment Selection OTOLARYNGOLOGY-HEAD AND NECK SURGERY Sweeny, L., Zimmerman, T., Carroll, W. R., Schmalbach, C. E., Day, K. E., Rosenthal, E. L. 2014; 150 (4): 610-617


Evaluate characteristics and risk factors for patients with advanced cutaneous squamous cell carcinoma (cSCC).Retrospective case series.Tertiary care center.Chart review of patients with cSCC undergoing a parotidectomy (2003-2012).Of 218 patients identified, 49% presented with a new primary lesion (n = 107) and 51% with a recurrence (n = 111). Parotid lymph nodes were positive in 52% of patients; 81% had a concurrent neck dissection, and 28% had cervical lymph node metastases. In 18% of patients, both parotid and cervical nodes were positive, while 44% were both parotid and cervical node negative; 33% had positive parotid and negative cervical nodes, and only 5% had negative parotid and positive cervical nodes. The overall 2- and 5-year survival rates were 0.71 and 0.58. Overall 5-year survival was lower for patients presenting with recurrent (0.49) versus new primary disease (0.69; P = .04). In addition, decreased overall 5-year survival rates were associated with cervical lymph node involvement (0.47 vs. 0.62; P = .01). There was no difference in overall survival when stratified by parotid lymph node involvement (P = .85), margin status (P = .67), perineural invasion (P = .42), facial nerve sacrifice (P = .92), or type of parotid operation performed (P = .51).In this study, cervical, but not parotid, lymph node involvement was associated with poor outcomes in patients with advanced cSCC requiring a parotidectomy. In patients without evidence of cervical or parotid lymph node involvement, a neck dissection may be spared, given there is a 5% chance of occult disease.

View details for DOI 10.1177/0194599814520686

View details for Web of Science ID 000333682700017

View details for PubMedID 24474713