Factors Associated with Recurrence and Regional Adenopathy for Head and Neck Cutaneous Squamous Cell Carcinoma

Brianna N. Harris, Ahmed Bayoumi, Shyam Rao, Michael Moore, D Gregory Farwell, Arnaud Bewley

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: Cutaneous squamous cell carcinoma (CSCC) is one of the most common malignancies worldwide. With advanced CSCC of the head and neck, there is conflicting evidence on what constitutes high-risk disease. Our objective is to evaluate which factors are predictive of recurrence and nodal spread and survival. Study Design: Case series with chart review. Setting: Tertiary academic institution. Subjects and Methods: Patients with advanced head and neck CSCC treated with primary resection identified by chart review. Results: A total of 212 patients met inclusion criteria, with a mean age of 70.4 years; 87.3% were men. Mean tumor diameter was 3.65 cm, with an average depth of invasion of 1.38 cm. The mean follow-up time was 35 months (median, 21.5), and over that period 67 recurrences were recorded, 49 of which were local. The 5-year Kaplan-Meier estimate of disease-free survival for the cohort was 53.2%. On Cox multivariate analysis, recurrent disease, perineural invasion (PNI), and poorly differentiated histology were independent predictors of recurrence. On multinomial logistic regression, patients with primary tumors on the ear, cheek, temple, or lip, as well as those with PNI, were more likely to present with nodal metastasis. Conclusion: For advanced CSCCs of the head and neck, patients with recurrent disease, PNI, and poorly differentiated tumors are at highest risk for local recurrence. Patients with tumors or the ear, cheek, temple, or lip, as well as those with PNI, are at increased risk of harboring nodal disease.

Original languageEnglish (US)
Pages (from-to)863-869
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume156
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • cutaneous squamous cell carcinoma
  • recurrence
  • regional adenopathy
  • skin cancer

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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