title: Predictors of outcome in patients with metastatic cutaneous head and neck squamous cell carcinoma involving cervical lymph nodes: Improved survival with the addition of adjuvant radiotherapy.
abstract: BACKGROUND
  The purpose of this study was to compare the outcome of surgery against surgery plus radiotherapy in patients with metastatic cutaneous head and neck squamous cell carcinoma (HNSCC) to cervical nodes.
  
  
  METHODS
  We conducted a 28-year retrospective analysis of 122 patients whom were treated for metastatic cutaneous HNSCC involving the cervical nodes (levels I-V).
  
  
  RESULTS
  After surgery alone, 11 patients (55%) developed recurrence compared with 23 patients (23%) after surgery plus radiotherapy. On multivariate analysis, the following variables were significantly associated with disease-free survival (DFS): immunosuppression (p = .002), treatment modality (p < .001), extracapsular spread (p = .009), and pathological nodal stage (p = .04). Patients undergoing surgery plus radiotherapy had a significantly better 5-year DFS (74% vs 34%; p = .001) and 5-year overall survival (OS; 66% vs 27%; p = .003) compared with surgery alone.
  
  
  CONCLUSIONS
  In patients with metastatic cutaneous HNSCC involving cervical nodes, survival was significantly improved with the addition of radiotherapy.
authors: Department of Radiation Oncology, Head and Neck Cancer Service, Westmead Hospital, University of Sydney, Sydney, New South Wales, 2145, Sydney, Australia.
authors: Jeffrey T
authors: JT
authors: Wang
authors: Carsten E
authors: CE
authors: Palme
authors: Gary J
authors: GJ
authors: Morgan
authors: Val
authors: V
authors: Gebski
authors: Allen Y
authors: AY
authors: Wang
authors: Michael J
authors: MJ
authors: Veness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome; D055815:Young Adult