Positive survival trend in metastatic head and neck cutaneous squamous cell carcinoma over four-decades: Multicenter study

Head Neck. 2019 Nov;41(11):3826-3832. doi: 10.1002/hed.25912. Epub 2019 Aug 12.

Abstract

Background: This study assessed changes over time of survival of head and neck cutaneous squamous cell carcinoma (HNcSCC) with lymph node metastases.

Methods: A multicenter analysis of 1301 patients with metastatic HNcSCC treated between 1980 and 2017. Differences in disease-specific survival (DSS) and overall survival (OS) by decade were assessed using multivariate Cox regression.

Results: Over the study period, we noted an increase in the proportion of patients aged over 80 years (3.9%-31.7%; P < .001) and immunosuppression (1.9%-9.9%; P = .03). After adjusting for number and size of metastatic nodes, extranodal extension, perineural invasion, immunosuppression, treatment, and institution, there was a reduction in risk of cancer-related mortality from 0.47 in 1990-1999 (P = .04) to 0.30 in 2000-2009 (P < .001) when compared to 1980-1989. This remained stable at 0.30 in 2010-2017 (P = .001). OS remained stable after 1990.

Conclusion: Despite an aging and more frequently immunosuppressed population, fewer patients are dying from metastatic HNcSCC.

Keywords: carcinoma; chemoradiation; head and neck; surgery; survival.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / secondary*
  • Squamous Cell Carcinoma of Head and Neck / therapy
  • Survival Rate
  • Time Factors
  • Young Adult