Metastatic head and neck cutaneous squamous cell carcinoma: defining a low-risk patient

Head Neck. 2012 Mar;34(3):365-70. doi: 10.1002/hed.21743. Epub 2011 Apr 5.


Background: The purpose of this study was to determine whether there is a "low-risk" subset of patients with regional metastatic head and neck cutaneous squamous cell carcinoma (SCC) suitable for treatment with surgery alone and omission of adjuvant radiotherapy.

Methods: We conducted a retrospective analysis of 168 patients with a single parotid gland or neck nodal metastasis ≤3 cm in size from cutaneous SCC treated with curative intent by surgery ± adjuvant radiotherapy.

Results: Disease-specific survival for the 33 patients treated with surgery alone was 97% at 5 years. In the subset of 19 patients without extracapsular nodal spread (ECS), there was 1 regional recurrence which was successfully salvaged yielding a 5-year disease-specific survival of 100%.

Conclusion: In head and neck cutaneous SCC, the subset with a single node ≤3 cm in size without ECS are at low risk of regional failure and death from cutaneous cancer. These patients may be suitable for single-modality therapy with surgery alone.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / secondary*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Factors
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate
  • Treatment Outcome