Affiliation:
1. Department of Otolaryngology—Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School Boston Massachusetts USA
2. Department of Surgery Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
3. Department of Medicine Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
Abstract
AbstractBackgroundUnderstanding the impact of surgical treatment on regionally metastatic cutaneous squamous cell carcinoma (cSCC).MethodsRetrospective series of 145 patients undergoing parotidectomy and neck dissection for regionally metastatic cSCC to the parotid. Overall survival (OS), disease‐specific survival (DSS), and disease‐free survival (DFS) analyzed over 3 years. Multivariate analysis was completed using Cox proportional hazard models.ResultsOS was 74.5%, DSS was 85.5% and DFS was 64.8%. On multivariate analysis, immune status (HR = 3.225[OS], 5.119[DSS], 2.071[DFS]) and lymphovascular invasion (HR = 2.380[OS], 5.237[DSS], 2.595[DFS]) were predictive for OS, DSS, and DFS. Margin status (HR = 2.296[OS], 2.499[DSS]) and ≥18 resected nodes (HR = 0.242[OS], 0.255[DSS]) were predictive of OS and DSS, while adjuvant therapy was predictive of DSS (p = 0.018).ConclusionsImmunosuppression and lymphovascular invasion portended worse outcomes in patients with metastatic cSCC to the parotid. Microscopically positive margins and <18 nodes resected are associated with worse OS and DSS, while patients receiving adjuvant therapy had improved DSS.