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Parotid and cervical nodal status predict prognosis for patients with head and neck metastatic cutaneous squamous cell carcinoma
Author(s) -
Ch'ng Sydney,
Maitra Aloka,
Allison Robert S.,
Chaplin John M.,
Gregor Reinhold T.,
Lea Rodney,
Tan Swee T.
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21092
Subject(s) - medicine , proportional hazards model , oncology , multivariate analysis , head and neck squamous cell carcinoma , head and neck cancer , radiation therapy , pathological , parotid gland , basal cell , surgery , pathology
Background and Objectives The appreciation of parotid involvement being an independent prognostic factor for metastatic cutaneous squamous cell carcinoma (SCC) is relatively new. A more comprehensive clinical staging system that separates parotid (P) from neck (N) disease, and further stratifies the N category has been proposed [O'Brien et al., Head Neck 2002; 24: 417–422]. This paper presents the clinical outcome of patients with head and neck metastatic cutaneous SCC treated at the four major head & neck surgical oncology centers in New Zealand and tests the proposed staging system, with modifications for pathological staging. Methods Patients treated with a curative intent from 1990 to 2005 were identified and re‐staged. Survival rates were calculated using the Kaplan–Meier method, and curves were compared with the log‐rank test. Multivariate analysis using the Cox regression model was performed to assess the impact of each proposed P and N sub‐group, and other parameters. Results and Conclusions One hundred and seventy patients were identified. The 5‐year disease‐specific survival rate was 69%, and the loco‐regional recurrence rate was 36%. The presence of parotid ( P < 0.01) or neck ( P = 0.01) disease, immunosuppression ( P < 0.01) and the uptake of radiotherapy ( P < 0.01) impacted significantly on survival. Increasing P or N category worsened the prognosis significantly. J. Surg. Oncol. 2008;98:101–105. © 2008 Wiley‐Liss, Inc.