Prognostic significance of disease-free interval in head and neck cutaneous squamous cell carcinoma with nodal metastases

Head Neck. 2013 Aug;35(8):1138-43. doi: 10.1002/hed.23096. Epub 2012 Nov 14.


Background: The purpose of this study was to determine whether the disease-free interval (DFI) between treatment of primary head and neck cutaneous squamous cell carcinoma (SCC) and the development of regional metastases is an independent prognostic factor.

Methods: A retrospective analysis of 229 patients with metastatic nodal head and neck cutaneous SCC, treated with curative intent by surgery ± adjuvant radiotherapy was conducted.

Results: After adjusting for the effect of nodal staging, extracapsular spread, involved margins, adjuvant radiotherapy, and immunosuppression, a short DFI (≤9 months vs >9 months) was a significant predictor of disease-related mortality (hazard ratio [HR], 3.0; 95% confidence interval [CI], 1.4-6.5; p = .004) and locoregional relapse (HR, 2.0; 95% CI, 1.1-4.0; p = .044).

Conclusion: The DFI is a potentially powerful independent prognostic factor in patients with regional metastases secondary to head and neck cutaneous SCC. It provides information before definitive treatment that may ultimately assist clinicians in applying a risk-adapted management paradigm.

Keywords: cutaneous squamous cell carcinoma; disease-free interval; head and neck neoplasms; lymph node metastases; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy*
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy*
  • Squamous Cell Carcinoma of Head and Neck
  • Young Adult


  • Antineoplastic Agents