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Objectives <p>The primary objective of this study was to identify potential prognostic factors influencing disease control and survival outcomes in patients with neck metastases (NLM) and/or intraparotid metastases (PLM) arising from cutaneous squamous cell carcinoma (cSCC) of the head and neck. A secondary aim was to compare patients with isolated NLM, isolated PLM, and concurrent NLM/PLM.</p> Study design and methods <p>An observational, retrospective multicenter study included 68 patients with nodal metastatic cSCC treated at the Head and Neck Units of Bologna, Modena, and Pescara (2014–2024). Clinical, pathological, and treatment variables were analyzed for associations with survival using univariate and multivariate Cox regression models (IBM SPSS).</p> Results <p>The cohort included 30 patients with isolated NLM (44%), 14 with isolated PLM (21%), and 24 with both NLM and PLM (35%). At 5 years, DFS was 33.8%, DSS 70.6%, and OS 69.1%. DFS was reduced by extranodal extension (ENE) in PLM (HR 3.95, 95% CI 1.65–9.48, p = .002). DSS was negatively influenced by perineural invasion (HR 4.53, 95% CI 1.02–34.44, p= 0.016), NLM ENE (HR 5.60, 95% CI 1.72–18.19, p = 0.004), and PLM ENE (HR 8.90, 95% CI 2.51–18.90, p &lt; 0.001). OS was independently worsened by PNI (HR 6.16, 95% CI 1.20–31.39, p = 0.029), NLM ENE (HR 5.18, 95% CI 1.67–16.03, p= 0.004), and PLM ENE (HR 7.03, 95% CI 2.24–22.07, p &lt; 0.001). Female sex (36% in isolated PLM vs 3% in isolated NLM, p = .004) and immunosuppression (67% in patients with both NLM and PLM, p = 0.02) were significantly associated with nodal dissemination pattern, but not with survival.</p> Conclusion <p>This study highlights the prognostic relevance of PNI, ENE, advanced nodal stage, and lack of adjuvant RT in nodal metastatic cSCC. Immunosuppression and female sex appear more related to higher nodal dissemination patterns than to survival.</p>

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Survival rates in head and neck cutaneous squamous cell carcinoma with nodal metastases: a multicenter study

  • 期刊论文

  • 发表日期：

    2026年1月6日

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  • Matteo Fermi,
  • Pierre Guarino,
  • Francesco Chiari,
  • Edoardo Serafini,
  • Daria Maria Filippini,
  • Giuseppe Ferrulli,
  • Margherita Basso,
  • Francesco Mattioli,
  • Claudio Donadio Caporale,
  • Daniele Marchioni,
  • Livio Presutti,
  • Gabriele Molteni

摘要

Objectives

The primary objective of this study was to identify potential prognostic factors influencing disease control and survival outcomes in patients with neck metastases (NLM) and/or intraparotid metastases (PLM) arising from cutaneous squamous cell carcinoma (cSCC) of the head and neck. A secondary aim was to compare patients with isolated NLM, isolated PLM, and concurrent NLM/PLM.

Study design and methods

An observational, retrospective multicenter study included 68 patients with nodal metastatic cSCC treated at the Head and Neck Units of Bologna, Modena, and Pescara (2014–2024). Clinical, pathological, and treatment variables were analyzed for associations with survival using univariate and multivariate Cox regression models (IBM SPSS).

Results

The cohort included 30 patients with isolated NLM (44%), 14 with isolated PLM (21%), and 24 with both NLM and PLM (35%). At 5 years, DFS was 33.8%, DSS 70.6%, and OS 69.1%. DFS was reduced by extranodal extension (ENE) in PLM (HR 3.95, 95% CI 1.65–9.48, p = .002). DSS was negatively influenced by perineural invasion (HR 4.53, 95% CI 1.02–34.44, p= 0.016), NLM ENE (HR 5.60, 95% CI 1.72–18.19, p = 0.004), and PLM ENE (HR 8.90, 95% CI 2.51–18.90, p < 0.001). OS was independently worsened by PNI (HR 6.16, 95% CI 1.20–31.39, p = 0.029), NLM ENE (HR 5.18, 95% CI 1.67–16.03, p= 0.004), and PLM ENE (HR 7.03, 95% CI 2.24–22.07, p < 0.001). Female sex (36% in isolated PLM vs 3% in isolated NLM, p = .004) and immunosuppression (67% in patients with both NLM and PLM, p = 0.02) were significantly associated with nodal dissemination pattern, but not with survival.

Conclusion

This study highlights the prognostic relevance of PNI, ENE, advanced nodal stage, and lack of adjuvant RT in nodal metastatic cSCC. Immunosuppression and female sex appear more related to higher nodal dissemination patterns than to survival.