Outcomes of nodal metastatic cutaneous squamous cell carcinoma of the head and neck treated in a regional center

Background Given its metastatic potential and high incidence, cutaneous squamous cell carcinoma of the head and neck (SCCHN) has significant morbidity and mortality. Methods We conducted a retrospective review of prospectively collected data for 113 consecutive patients with nodal metastatic cutaneous SCCHN treated surgically with curative intent in a regional center. Survival curves were generated by the Kaplan–Meier method. Results Five‐year overall survival (OS), disease‐specific survival (DSS), and disease‐free survival (DFS) were 80%, 83%, and 75%, respectively. Twenty‐six patients (23%) relapsed, with 92% of relapses occurring within 2 years of surgery. Immunosuppression ( p  = .008) and N classification ( p  = .043) predicted decreased DFS on univariate analysis. On multivariate analysis, only immunosuppression independently predicted DFS ( p  = .034). Conclusion This study validates the current N classification system, supports the adverse effect of immunosuppression, and suggests that intense follow‐up for 2 years postsurgery is warranted. Survival at this regional center is comparable to that achieved at metropolitan tertiary cancer centers. © 2015 Wiley Periodicals, Inc. Head Neck 37: 1808–1815, 2015