Prognostic Indicators and Outcomes following Surgical Management of Metastatic Cutaneous Squamous Cell Carcinoma of the Head and Neck

Abstract Introduction Metastatic cutaneous SCC carries a poor prognosis with 5-year survival of 25-57%. The aim of this study is to examine the outcomes following surgery with adjuvant therapy for management of metastatic cSCC in a UK based population. Methods This is a retrospective review of patients with metastatic cSCC of the Head and Neck who underwent primary surgery at a regional center during a 6-year period. Overall and disease specific survival were calculated using Kaplan-Meier and log-rank tests. Results were reported as hazard ratios (HR) with 95% confidence intervals. Results Forty-five patients met the inclusion criteria. The mean time to discovery of metastases was 9.3 months (range, 0-40 months). Only two patients (4%) had discovery of metastases after 2 years, with none after 3.3 years. The overall 5-year survival was 31% (95% CI 15% - 48%) with 2-year survival at 48% (95% CI 31% - 63%). The median OS survival was 722 days (95% CI 607 - 1359). Patients aged >80 years having a decreased OS. Conclusion This is the largest UK based study documenting the overall and disease specific survival associated with metastatic cutaneous SCC of the Head and Neck. Our overall survival is comparable to similar studies, but remains poor. Total number of involved nodes, and lymph node ratio were not statistically significant.