OBJECTIVE: Evaluate characteristics and risk factors for patients with advanced cutaneous squamous cell carcinoma (cSCC). STUDY DESIGN: Retrospective case series. SETTING: Tertiary care center. PATIENTS AND METHODS: Chart review of patients with cSCC undergoing a parotidectomy (2003-2012). RESULTS: Of 218 patients identified, 49% presented with a new primary lesion (n = 107) and 51% with a recurrence (n = 111). Parotid lymph nodes were positive in 52% of patients; 81% had a concurrent neck dissection, and 28% had cervical lymph node metastases. In 18% of patients, both parotid and cervical nodes were positive, while 44% were both parotid and cervical node negative; 33% had positive parotid and negative cervical nodes, and only 5% had negative parotid and positive cervical nodes. The overall 2- and 5-year survival rates were 0.71 and 0.58. Overall 5-year survival was lower for patients presenting with recurrent (0.49) versus new primary disease (0.69; P = .04). In addition, decreased overall 5-year survival rates were associated with cervical lymph node involvement (0.47 vs. 0.62; P = .01). There was no difference in overall survival when stratified by parotid lymph node involvement (P = .85), margin status (P = .67), perineural invasion (P = .42), facial nerve sacrifice (P = .92), or type of parotid operation performed (P = .51). CONCLUSIONS: In this study, cervical, but not parotid, lymph node involvement was associated with poor outcomes in patients with advanced cSCC requiring a parotidectomy. In patients without evidence of cervical or parotid lymph node involvement, a neck dissection may be spared, given there is a 5% chance of occult disease.
OBJECTIVE: Evaluate characteristics and risk factors for patients with advanced cutaneous squamous cell carcinoma (cSCC). STUDY DESIGN: Retrospective case series. SETTING: Tertiary care center. PATIENTS AND METHODS: Chart review of patients with cSCC undergoing a parotidectomy (2003-2012). RESULTS: Of 218 patients identified, 49% presented with a new primary lesion (n = 107) and 51% with a recurrence (n = 111). Parotid lymph nodes were positive in 52% of patients; 81% had a concurrent neck dissection, and 28% had cervical lymph node metastases. In 18% of patients, both parotid and cervical nodes were positive, while 44% were both parotid and cervical node negative; 33% had positive parotid and negative cervical nodes, and only 5% had negative parotid and positive cervical nodes. The overall 2- and 5-year survival rates were 0.71 and 0.58. Overall 5-year survival was lower for patients presenting with recurrent (0.49) versus new primary disease (0.69; P = .04). In addition, decreased overall 5-year survival rates were associated with cervical lymph node involvement (0.47 vs. 0.62; P = .01). There was no difference in overall survival when stratified by parotid lymph node involvement (P = .85), margin status (P = .67), perineural invasion (P = .42), facial nerve sacrifice (P = .92), or type of parotid operation performed (P = .51). CONCLUSIONS: In this study, cervical, but not parotid, lymph node involvement was associated with poor outcomes in patients with advanced cSCC requiring a parotidectomy. In patients without evidence of cervical or parotid lymph node involvement, a neck dissection may be spared, given there is a 5% chance of occult disease.
Authors: Joshua Lubov; Mathilde Labbé; Krystelle Sioufi; Grégoire B Morand; Michael P Hier; Manish Khanna; Khalil Sultanem; Alex M Mlynarek Journal: J Otolaryngol Head Neck Surg Date: 2021-09-07
Authors: Kevin J Kovatch; Joshua D Smith; Andrew C Birkeland; John E Hanks; Rasha Jawad; Scott A McLean; Alison B Durham; Ashok Srinivasan; Jonathan B McHugh; Gregory J Basura Journal: OTO Open Date: 2019-09-13
Authors: Stephanie Flukes; Sallie Long; Shivangi Lohia; Christopher A Barker; Lara A Dunn; Jennifer Cracchiolo; Ian Ganly; Snehal Patel; Marc A Cohen Journal: OTO Open Date: 2021-01-08