Liyona Kampel1, Alexandra Dorman1, Gilad Horovitz1, Anton Warshavsky1, Orit Gutfeld2, Nidal Muhanna3. 1. Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Department of Radiation Oncology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. nidalm@tlvmc.gov.il.
Abstract
PURPOSE: Regionally metastatic cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is usually managed surgically; however, the role of parotidectomy remains controversial. Herein we elucidate the controversy and present our experience. METHODS: We retrospectively analyzed disease variables, extent of parotidectomy, and pathologic characteristics in association to outcome measures of all advanced CSCCHN patients who underwent definitive surgical resection from 2008 to 2018. RESULTS: Sixty-seven patients were enrolled, of whom 47 (70%) underwent parotidectomy; 27 superficial and 20 that included deep lobe resection. Parotidectomy had improved 5-year overall survival (OS) and disease-free survival (DFS) when neck was clinically involved (67.6% vs. 22.2%, P = 0.003 and 75.8% vs. 33.3% P = 0.002, respectively). Elective parotidectomy did not confer survival benefit for patients with no clinical involvement of the parotid gland (41.7% vs. 35%, P = 0.977). Recurrent disease was predictive for parotid metastases (P = 0.034). Thirty-nine patients received adjuvant radiotherapy, which significantly improved OS and DFS versus surgery alone (70.7% vs. 38.1%, P = 0.004 and 77.8% vs. 57.9%, P = 0.014, respectively). CONCLUSION: Parotidectomy was associated with improved survival of cervically spread CSCCHN.
PURPOSE: Regionally metastatic cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is usually managed surgically; however, the role of parotidectomy remains controversial. Herein we elucidate the controversy and present our experience. METHODS: We retrospectively analyzed disease variables, extent of parotidectomy, and pathologic characteristics in association to outcome measures of all advanced CSCCHN patients who underwent definitive surgical resection from 2008 to 2018. RESULTS: Sixty-seven patients were enrolled, of whom 47 (70%) underwent parotidectomy; 27 superficial and 20 that included deep lobe resection. Parotidectomy had improved 5-year overall survival (OS) and disease-free survival (DFS) when neck was clinically involved (67.6% vs. 22.2%, P = 0.003 and 75.8% vs. 33.3% P = 0.002, respectively). Elective parotidectomy did not confer survival benefit for patients with no clinical involvement of the parotid gland (41.7% vs. 35%, P = 0.977). Recurrent disease was predictive for parotid metastases (P = 0.034). Thirty-nine patients received adjuvant radiotherapy, which significantly improved OS and DFS versus surgery alone (70.7% vs. 38.1%, P = 0.004 and 77.8% vs. 57.9%, P = 0.014, respectively). CONCLUSION: Parotidectomy was associated with improved survival of cervically spread CSCCHN.
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