Predictors of distant metastatic recurrence in head and neck cutaneous squamous cell carcinoma with lymph node metastases treated with curative intent: A multicenter study

Ebrahimi, A; Gupta, R; McDowell, L; Magarey, MJR; Smith, PN; Schulte, KM; Perriman, DM; Veness, M; Porceddu, S; Low, TH; Fowler, A; Clark, JR

Author(s): Ebrahimi, A; Gupta, R; McDowell, L; Magarey, MJR; Smith, PN; Schulte, KM; Perriman, DM; Veness, M; Porceddu, S; Low, TH; Fowler, A; Clark, JR;
Details: Publication Year 2025-01,Volume 47,Issue #1,Page 254-262
Journal Title: Head & Neck
Publication Type: Research article
Abstract: BACKGROUND: We aimed to identify predictors of distant metastatic recurrence (DMR) in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) with nodal metastases treated with curative intent. METHODS: Predictors of DMR were identified using Cox regression in a multicenter study of 1151 patients. RESULTS: The 5-year risk of DMR was 9.6%. On multivariate analysis, immunosuppression (HR 2.93; 95% CI: 1.70-5.05; p < 0.001), nodal size >6 cm [versus ≤3 cm (HR 2.77; 95% CI: 1.09-7.03; p = 0.032)], ≥5 nodal metastases [versus 1-2 (HR 2.79; 95% CI: 1.63-4.78; p < 0.001)], and bilateral disease (HR 3.11; 95% CI: 1.40-6.90; p = 0.005) predicted DMR. A DMR risk score was developed that stratified risk from 6.6% (no risk factors) to 100% (≥3 risk factors) (p < 0.001). CONCLUSIONS: The risk of DMR in nodal metastatic HNcSCC increases with immunosuppression, nodal size >6 cm, ≥5 nodal metastases, and bilateral disease. A simple DMR risk score estimated prior to treatment may be clinically useful.
Publisher: Wiley
Keywords: Humans; Male; Female; Middle Aged; *Lymphatic Metastasis; *Skin Neoplasms/pathology/therapy/mortality; Aged; *Head and Neck Neoplasms/pathology/therapy; *Carcinoma, Squamous Cell/therapy/pathology/secondary; *Neoplasm Recurrence, Local/pathology; Squamous Cell Carcinoma of Head and Neck/therapy/pathology/secondary/mortality; Adult; Retrospective Studies; Aged, 80 and over; Risk Factors; Prognosis; Proportional Hazards Models; cutaneous squamous cell carcinoma; distant metastases; head and neck cancer; lymph node metastasis
Department(s): Radiation Oncology; Surgical Oncology
Publisher's Version: https://doi.org/10.1002/hed.27912
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-12-19 06:56:16

Last Modified: 2024-12-19 06:56:23