title: Outcomes after surgery and postoperative radiotherapy for perineural spread of head and neck cutaneous squamous cell carcinoma.
abstract: Queensland, Australia, has the highest rates of cutaneous squamous cell carcinoma (SCC). Perineural invasion (PNI) is associated with reduced local control and survival.
  
  
  
  A retrospective review of a prospective database of patients with clinical PNI from cutaneous SCC of the head and neck (SCCHN) treated with surgery and postoperative radiotherapy (PORT) between 2000 and 2011 and a minimum of 24 months follow-up. Patients were excluded if immunosuppressed, had non-SCC histology, or were treated palliatively.
  
  
  
  Fifty patients (mean age, 60 years) with median follow-up of 50 months were included in this study. A total of 54.8% of known primary tumors had incidental PNI. Ten percent had nodal disease at presentation. MRI neurogram was positive in 95.8%. Recurrence-free survival (RFS) at 5-years was 62%. Five-year disease-specific survival (DSS) and overall survival (OS) were 75% and 64%, respectively. There were no perioperative deaths.
  
  
  
  This report demonstrates that long-term survival is achievable in patients with clinical PNI from cutaneous SCCHN after surgery and PORT. © 2015 Wiley Periodicals, Inc. Head Neck 38: 824-831, 2016.
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Australia.|QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Warren
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Australia.
authors.forename: Benedict
authors.initials: B
authors.lastname: Panizza
authors.affiliation: School of Medicine, University of Queensland, Australia.|Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Sandro V
authors.initials: SV
authors.lastname: Porceddu
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Mitesh
authors.initials: M
authors.lastname: Gandhi
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Parag
authors.initials: P
authors.lastname: Patel
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Wood
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Nagle
authors.affiliation: Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Redmond
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D003391:Cranial Nerves; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: head and neck; perineural invasion; skin cancer; skull base surgery; squamous cell carcinoma