title: Head and neck skin involvement by non-cutaneous head and neck cancers: free flap reconstruction.
abstract: BACKGROUND
  Patients with skin involvement from head and neck cancer have a poor prognosis, with a median survival time of 2 months.
  
  
  RESULTS
  During a 9 year period, 31 patients with skin involvement above the clavicle by non-cutaneous malignant tumours of the head and neck were treated. In 19 males and 12 females with a mean age of 62 years, the parotid gland (32%) and the oral cavity (29%) were the commonest sites of primary disease and 77% of the cases were squamous cell carcinomas. Twenty-six had recurrent disease, 20 had received previous radiotherapy and all underwent surgical resection with free flap reconstruction, the commonest being the radial forearm (78%). Complete histological clearance was achieved in 53% of the cases, and adjuvant post-operative irradiation was given to 60%. With this form of management, palliation was extended to a mean survival of 23 months. Six patients are currently alive and disease free at a mean follow up of 4.5 years.
  
  
  CONCLUSIONS
  Patients with head and neck skin involvement by non-cutaneous head and neck malignancies have a very poor prognosis, but surgical resection combined with free microvascular flap reconstruction and planned post-operative radiotherapy, can offer good long-term palliation.
authors.affiliation: Head & Neck Unit, Department of Plastic & Reconstructive Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Stavrianos
authors.forename: M
authors.initials: M
authors.lastname: Ragbir
authors.forename: N R
authors.initials: NR
authors.lastname: McLean
authors.forename: C G
authors.initials: CG
authors.lastname: Kelly
authors.forename: J V
authors.initials: JV
authors.lastname: Soames
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012878:Skin Neoplasms / Q000556:secondary / Q000601:surgery; D013524:Surgical Flaps