Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

cSCC-HN Recurrence Post-Surgery Means Poor Survival

JAMA Dermatology; ePub 2019 Feb 27; Sun, Chin, et al

Patients with cutaneous squamous cell carcinoma on the head and neck (cSCC-HN) who experience disease recurrence after definitive treatment with surgery and postoperative radiotherapy have poor survival, irrespective of immune status, according to a recent study.

Researchers conducted a multi-institutional study of 205 patients treated at 3 US locations in which they underwent surgical resection and postoperative radiotherapy for primary or recurrent stage I to IV (nonmetastatic) cSCC-HN between January 1, 1995, and December 31, 2014. Patients with any disease recurrence, defined as local, regional, and/or distant failure, were included. They found:

  • Of total patients in the original cohort, 72 patients (63 men and 9 women; median age, 71 years [range, 43-91 years]) developed disease recurrence after surgery and postoperative radiotherapy.
  • 40 patients (55.6%) were immunosuppressed, and 32 patients (44.4%) were immunocompetent.
  • Locoregional recurrence was the most common first pattern of failure for both groups (31 immunosuppressed patients [77.5%]; 21 immunocompetent patients [65.6%]).
  • After any recurrence, 1-year overall survival was 43.2%, and median survival was 8.4 months.

Sun L, Chin R-I, Gastman B, et al. Association of disease recurrence with survival outcomes in patients with cutaneous squamous cell carcinoma of the head and neck treated with multimodality therapy. [Published online ahead of print February 27, 2019]. JAMA Dermatology. doi:10.1001/jamadermatol.2018.5453.