title: Metastatic head and neck cutaneous squamous cell carcinoma: defining a low-risk patient.
abstract: BACKGROUND
  The purpose of this study was to determine whether there is a "low-risk" subset of patients with regional metastatic head and neck cutaneous squamous cell carcinoma (SCC) suitable for treatment with surgery alone and omission of adjuvant radiotherapy.
  
  
  METHODS
  We conducted a retrospective analysis of 168 patients with a single parotid gland or neck nodal metastasis ≤3 cm in size from cutaneous SCC treated with curative intent by surgery ± adjuvant radiotherapy.
  
  
  RESULTS
  Disease-specific survival for the 33 patients treated with surgery alone was 97% at 5 years. In the subset of 19 patients without extracapsular nodal spread (ECS), there was 1 regional recurrence which was successfully salvaged yielding a 5-year disease-specific survival of 100%.
  
  
  CONCLUSIONS
  In head and neck cutaneous SCC, the subset with a single node ≤3 cm in size without ECS are at low risk of regional failure and death from cutaneous cancer. These patients may be suitable for single-modality therapy with surgery alone.
authors.affiliation: Sydney Head and Neck Cancer Institute, The Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Sydney, Australia. ardalan100@hotmail.com
authors.forename: Ardalan
authors.initials: A
authors.lastname: Ebrahimi
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.forename: Balazs B
authors.initials: BB
authors.lastname: Lorincz
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Milross
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Veness
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D016896:Treatment Outcome