Poor Outcomes in Head and Neck Non-Melanoma Cutaneous Carcinomas

ABSTRACT

Head and neck nonmelanoma cutaneous carcinomas (NMCC) may have poor outcomes, such as metastasis and recurrence. It remains unclear which patients are at increased risk for poor outcomes. We characterize a population of NMCC seen in a head and neck surgical practice. We sought to identify predictors of poor outcome in head and neck NMCC.

A retrospective cohort study of 161 patients with head and neck NMCC who presented to a university based otolaryngology-head and neck surgery practice over a 13 year period was performed. The study group included 127 men and 34 women, age range: 33 - 92 years.

Subjects and Methods: Tumor characteristics of the study population were recorded, and statistical analysis and Kaplan- Meier survival calculations were performed to determine predictors of poor outcomes.

113 squamous cell carcinomas (SCC) and 48 basal cell carcinomas (BCC) were identified. Among SCC patients, there was a 44% incidence of metastasis and a 47% incidence of recurrence. Among BCC patients, there was a 10% incidence of metastasis and a 50% incidence of recurrence. Twenty percent of SCC patients had a history of immunosuppression. Among SCC patients with immunosuppression, 83% had metastasis or recurrence. Survival for SCC patients with metastatic disease was significantly worse than patients without metastases. The presence of parotid metastases in SCC conferred a survival advantage when compared to other sites of metastases.

The incidence of poor outcomes in NMCC was higher in our series than reported in the literature. Survival patterns of our study parallel those of similar studies in the literature.