Cutaneous metastatic squamous cell carcinoma to the parotid gland: analysis and outcome.
BACKGROUND
Our aim was to review the presentation, treatment, and outcome of patients with metastatic cutaneous squamous cell carcinoma involving the parotid gland at a tertiary referral center.


METHODS
We performed a retrospective chart review of the cancer registry at the Princess Margaret Hospital, Toronto, from 1970 to 2001. All patients had a previously untreated metastatic cutaneous head and neck squamous cell carcinoma involving the parotid gland. A minimal follow-up of 1 year was mandatory for inclusion in the study.


RESULTS
Fifty-six white patients (43 men and 13 women), with a median age of 76 years (range, 49-97 years), were eligible for inclusion. The disease in all patients was retrospectively staged according to a new system. Twenty patients had P1 disease, 14 had P2, and 22 had P3. Therapy included surgery and adjuvant external beam radiation in 37 patients, single-modality external beam radiation in 12, and surgery alone in seven patients. The overall recurrence rate was 29%. The disease-specific survival was significantly worse in patients treated with external beam radiation alone (p <.05). Tumor size >6 cm (p <.01) and the presence of facial nerve involvement (p <.01) were poor prognostic factors.


CONCLUSIONS
Metastatic cutaneous squamous cell carcinoma to the parotid gland is an aggressive neoplasm that requires combination therapy. The presence of a lesion in excess of 6 cm or with facial nerve involvement is associated with a poor prognosis.
Princess Margaret Hospital, Wharton Head and Neck Centre 3-951, 610 University Avenue, Toronto, Ontario M4S 1C6, Canada.
Nathalie
N
Audet
Carsten E
CE
Palme
Patrick J
PJ
Gullane
Ralph W
RW
Gilbert
Dale H
DH
Brown
Jonathan
J
Irish
Peter
P
Neligan
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000556:secondary* / Q000628:therapy*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome