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Cutaneous squamous cell carcinoma metastatic to parotid - analysis of prognostic factors and treatment outcome.doc

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Cutaneous squamous cell carcinoma metastatic to parotid - analysis of prognostic factors and treatment outcome

Gohetal.WorldJournalofSurgicalOncology2012,10:117 /content/10/1/117 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH OpenAccess Cutaneoussquamouscellcarcinomametastatic toparotid-analysisofprognosticfactorsand treatmentoutcome 1 RobinYeongHongGoh ,RonBova1,2andGeraldBFogarty1,3,4* Abstract Background:Cutaneoussquamouscellcarcinoma(cSCC)comprises20%ofallskincanceroftheheadandneck. Aminoritywillmetastasizetoregionalparotidlymphnodes.ThisstudyevaluatestheStVincent’sHospital,Sydney experiencebetween1996and2006. Methods:Aretrospectivereviewwasperformedofpatientswhowereevaluatedinourmultidisciplinaryheadand neckclinicwithmetastaticcSCCtoparotid,andalltreatmentandpathologicdetailswerereviewed.Statistical analysis,includingunivariateandmultivariateanalyses,wereperformedusingCoxproportionalhazardsregression mode,overallanddisease-specificsurvivalwereestimatedbytheKaplan-Meiermethod. Results:Sixty-sevenpatientswereidentified.Some90%weremale,andwithameanageof72.8years.Onedied onthefirstpostoperativeday.Theremaining66patientsreceivedradiotherapy.Forthese66patients,thetwo-year andfive-yearoverallsurvivalratewas0.83and0.72,respectively.Thetwo-yearandfive-yeardisease-freesurvival ratewas0.91and0.83respectively.Overallsurvivalwasonlysignificantlycorrelatedtotheextentofparotidectomy (superficialversustotal;P=0.0256).Marginstatuswasavailablein59patients.Theonlyparameterthatsignificantly correlatedwithdisease-freesurvivalwasmarginstatus(close/negativeversuspositiveP=0.0348).Otherparameters ofimmunesuppression,perineuralinvasion,extracapsularextension,degreeoftumourdifferentiation,numberof positivenodes,extentofneckdissectionandradiotherapydosagedelivereddidnotconferprognosticsignificance. Conclusions:Thisstudyconfirmedtheassociationofadverseprognosticimplicationofpositivemarginson disease-freesurvival.Immunecompromisewasnotasignificantfactorinthissmallgroup.Furtherstudiesare warrantedinthispopulation. Keywords:Audit,Headandneck,Immunesuppression,Metastasis,Necklymphnodes,Parotidectomy,