title: Prognostic significance of disease-free interval in head and neck cutaneous squamous cell carcinoma with nodal metastases.
abstract: BACKGROUND
  The purpose of this study was to determine whether the disease-free interval (DFI) between treatment of primary head and neck cutaneous squamous cell carcinoma (SCC) and the development of regional metastases is an independent prognostic factor.
  
  
  METHODS
  A retrospective analysis of 229 patients with metastatic nodal head and neck cutaneous SCC, treated with curative intent by surgery ± adjuvant radiotherapy was conducted.
  
  
  RESULTS
  After adjusting for the effect of nodal staging, extracapsular spread, involved margins, adjuvant radiotherapy, and immunosuppression, a short DFI (≤9 months vs >9 months) was a significant predictor of disease-related mortality (hazard ratio [HR], 3.0; 95% confidence interval [CI], 1.4-6.5; p = .004) and locoregional relapse (HR, 2.0; 95% CI, 1.1-4.0; p = .044).
  
  
  CONCLUSIONS
  The DFI is a potentially powerful independent prognostic factor in patients with regional metastases secondary to head and neck cutaneous SCC. It provides information before definitive treatment that may ultimately assist clinicians in applying a risk-adapted management paradigm.
authors.affiliation: Sydney Head and Neck Cancer Institute, The Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Ardalan
authors.initials: A
authors.lastname: Ebrahimi
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.forename: Nazanin
authors.initials: N
authors.lastname: Ahmadi
authors.forename: Carsten E
authors.initials: CE
authors.lastname: Palme
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Morgan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Veness
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D000077195:Squamous Cell Carcinoma of Head and Neck; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents