title: Effect of immunocompromise on metastatic cutaneous squamous cell carcinoma in the parotid and neck.
abstract: BACKGROUND
  Our aim was to examine the effect of a compromised immune state on the outcomes in patients treated for metastatic cutaneous squamous cell carcinoma (SCC).
  
  
  METHODS
  A retrospective analysis of patients with metastatic cutaneous SCC to the parotid and neck treated at Greenlane Hospital between 1992 and 2002 was conducted. Outcomes were compared between immune-competent and immunocompromised patients. A logistic regression analysis of likely risk factors for poor outcome was done.
  
  
  RESULTS
  Forty-nine patients were identified, nine of whom were immunocompromised. All patients were treated by parotidectomy and/or neck dissection. The facial nerve was sacrificed in 42% of the patients. Thirty-seven patients underwent postoperative radiotherapy (76%). Recurrence was significantly more common in the immunocompromised group (56% vs 28%), with higher rates of local and distant recurrence. Survival at 1 and 2 years was reduced.
  
  
  CONCLUSIONS
  Immunocompromise has a significant impact on the outcome of metastatic cutaneous SCC to the parotid and neck, affecting recurrence and survival.
authors.affiliation: Head and Neck Department, Department of Otorhinolaryngology/Head and Neck Surgery, Auckland City Hospital, Park Rd Private Bag 92024, Auckland 1, New Zealand.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Southwell
authors.forename: John M
authors.initials: JM
authors.lastname: Chaplin
authors.forename: Robert L
authors.initials: RL
authors.lastname: Eisenberg
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: McIvor
authors.forename: Randall P
authors.initials: RP
authors.lastname: Morton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009520:New Zealand / Q000453:epidemiology; D010306:Parotid Gland / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology