Analysis and Review of Outcomes for Cutaneous Squamous Cell Carcinoma Involving the Parotid. (23rd August 2013)

• Record Type: Journal Article
• Authors: Zimmerman, Terence; Sweeny, Larissa; Carroll, William R.; Day, Kristine E.; Rosenthal, Eben L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P55
• Page End: P55
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a67
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: An in depth analysis of outcomes following parotidectomy for a cutaneous squamous cell carcinoma. Methods: Retrospective review (2003‐2012). Results: Forty‐nine percent of 218 patients presented with a primary lesion (n = 107), and 51% presented with a recurrence (n = 111). Parotid lymph nodes were positive in 52% of patients; 81% had a concurrent neck dissection, and 28% had cervical lymph node metastases. Eighteen percent had both positive parotid and cervical lymph nodes. The majority of margins were negative (49%), with 19% being < 2mm. Preoperative radiation therapy did not decrease the incidence of cervical ( P = 0.27) or parotid ( P = 0.37) lymph node involvement, perineural invasion ( P = 0.08), positive margins ( P = 0.31), facial nerve sacrifice ( P = 0.43), or rate of recurrence ( P = 0.87). The overall 2‐ and 5‐year survival rates were 0.71 and 0.58. Overall 5‐year survival was lower for patients presenting with recurrent (0.49) vs. primary disease (0.69; P = 0.04). In addition, decreased overall 5‐year survival rates were associated with cervical lymph involvement (0.47 vs. 0.62; P = 0.01) and preoperative radiation therapy (0.39 vs. 0.67; P = 0.037). Interestingly, there was no difference in overall survival when stratified by parotid lymph node involvement ( P = 0.85), margin status ( P = 0.67), perineural invasion ( P = 0.42), temporal bone resection ( P = 0.14), facial nerve sacrifice ( P = 0.92), or type of parotid operation performed ( P = 0.51). Conclusions: In this patient population, cervical, but not parotid, lymph node involvement was associated with poor outcomes. Furthermore, radiation therapy prior to a definitive operation resulted in worse outcomes and did not decrease the incidence lymph node metastases.