The significance of regional metastasis location in head and neck cutaneous squamous cell carcinoma

Craig P Mooney; Jonathan R Clark; Kerwin Shannon; Carsten E Palme; Ardalan Ebrahimi; Kan Gao; Sydney Ch'ng; Michael Elliott; Ruta Gupta; Tsu-Hui Hubert Low

doi:10.1002/hed.26744

The significance of regional metastasis location in head and neck cutaneous squamous cell carcinoma

Head Neck. 2021 Sep;43(9):2705-2711. doi: 10.1002/hed.26744. Epub 2021 May 21.

Authors

Craig P Mooney^{1

2}, Jonathan R Clark^{1

2

3}, Kerwin Shannon¹, Carsten E Palme^{1

2}, Ardalan Ebrahimi^{1

4}, Kan Gao¹, Sydney Ch'ng^{1

2

3}, Michael Elliott^{1

2}, Ruta Gupta^{1

2

5}, Tsu-Hui Hubert Low^{1

2}

Affiliations

¹ Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
² Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
³ Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.
⁴ Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.
⁵ Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, New South Wales, Australia.

PMID: 34019319
DOI: 10.1002/hed.26744

Abstract

Background: Regional metastasis of head and neck cutaneous squamous cell carcinoma (HNcSCC) can be seen in either parotid and/or cervical lymph nodes. The aim of this study was to assess whether there was a difference in prognosis between parotid and cervical nodal metastases.

Methods: Patients with regional metastasis from HNcSCC were identified from an institutional database. Disease-specific (DSS) and overall survival (OS) were calculated using the Kaplan-Meier method and Cox proportional hazards models.

Results: Five hundred and thirty-five patients were identified with median follow-up of 26.4 months (3-255 months). Two hundred and thirty-five patients had parotid metastasis, 96 patients had neck metastasis, and 204 patients had both. On multivariable analysis, any regional metastasis to the neck when compared to parotid alone conferred worse DSS (HR 1.8, p = 0.007) and OS (HR 1.3, p = 0.024).

Conclusion: Regional metastasis of HNcSCC to the neck confers worse outcomes compared to metastasis to the parotid alone.

Keywords: head and neck cancer; metastasis; parotid cancer; skin cancer; squamous cell cancer.

MeSH terms

Carcinoma, Squamous Cell* / pathology
Carcinoma, Squamous Cell* / therapy
Head and Neck Neoplasms* / therapy
Humans
Lymph Nodes / pathology
Neoplasm Staging
Prognosis
Retrospective Studies
Skin Neoplasms* / pathology
Squamous Cell Carcinoma of Head and Neck