Better outcome for parotid versus neck metastasis of head and neck cutaneous squamous cell carcinoma: a new report on reemerging data

Revista Brasileira de Otorrinolaringologia

article

Fábio Muradás Girardi¹  Vivian Petersen Wagner²  Manoela Domingues Martins³  Aliende Lengler Abentroth¹  Luiz Alberto Hauth¹ 

[1] Centro de Oncologia Integrada do Hospital Ana Nery;Universidade de Campinas, Departamento de Diagnóstico Oral;Universidade Federal do Rio Grande do Sul, Departamento de Patologia Oral, BrazilUniversidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Departamento de Medicina Oral

关键词: Carcinoma squamous cell;    Skin neoplasms;    Lymphatic metastasis;    Prognosis;    Treatment outcome;   

DOI  :  10.1016/j.bjorl.2019.10.007

学科分类：医学（综合）

来源: Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial

【 摘 要 】

Introduction: Regional metastases of cutaneous head and neck squamous cell carcinoma occur in approximately 5 % of cases, being the most important prognostic factor in survival, currently with no distinction between parotid and neck metastasis. Objective: The purpose of this study was to evaluate the prognostic features among patients with head and neck cutaneous squamous cell carcinoma exhibiting regional metastasis. Methods: A retrospective analysis of patients with cutaneous squamous cell carcinoma who underwent parotidectomy and/or neck dissection from 2011 to 2018 at a single institution tertiary center was performed. Patient demographics, clinical, surgical and pathological information, adjuvant treatments, and outcome at last follow-up were collected. Outcomes included disease recurrence and death due to the disease. Prognostic value of clinic pathological features associated with disease-specific survival was obtained. Results: Thirty-eight cases of head and neck cutaneous squamous cell carcinoma with parotid and/or neck metastasis were identified. Overall, 18 (47.3 %) patients showed parotid metastasis alone, 12 (31.5 %) exhibited neck metastasis alone and 8 (21.0 %) had both. A primary tumor in the parotid zone (Hazard Ratio --- HR = 5.53; p = 0.02) was associated with improved disease-specific survival. Poorer disease-specific survival was observed in patients with higher primary tumor diameter (HR = 1.54; p = 0.002), higher depth of invasion (HR = 2.89; p = 0.02), invasion beyond the subcutaneous fat (HR = 5.05; p = 0.002), neck metastasis at first presentation (HR = 8.74; p < 0.001), number of positive lymph nodes (HR = 1.25; p = 0.004), and higher TNM stages (HR = 7.13; p = 0.009). Patients presenting with isolated parotid metastasis during all follow-ups had better disease-specific survival than those with neck metastasis or both (HR = 3.12; p = 0.02).

【 授权许可】

CC BY