title: Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient.
abstract: OBJECTIVE
  Immunosuppressed solid organ transplant recipients (SOTRs) have an increased risk of developing cutaneous squamous cell carcinomas (cSCCs) with metastatic potential. This study sought to determine the rate of regional lymph node involvement in a large cohort of solid organ transplant patients with cutaneous head and neck squamous cell carcinoma.
  
  
  METHODS
  A retrospective chart review was performed on solid organ transplant patients with head and neck cutaneous squamous cell carcinoma treated at a tertiary academic medical center from 2005 to 2015.
  
  
  RESULTS
  130 solid organ transplant patients underwent resection of 383 head and neck cutaneous squamous cell carcinomas. The average age of the patient was 63. Seven patients (5%) developed regional lymph node metastases (3 parotid, 4 cervical lymph nodes). The mean time from primary tumor resection to diagnosis of regional lymphatic disease was 6.7months. Six of these patients underwent definitive surgical resection followed by adjuvant radiation; one patient underwent definitive chemoradiation. 6 of the 7 patients died of disease progression with a mean survival of 15months. The average follow up time was 3years (minimum 6months).
  
  
  CONCLUSIONS
  Solid organ transplant recipients with cutaneous squamous cell carcinoma of the head and neck develop regional lymph node metastasis at a rate of 5%. Regional lymph node metastasis in this population has a poor prognosis and requires aggressive management and surveillance.
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: Eamon.McLaughlin@uphs.upenn.edu.
authors.forename: Eamon J
authors.initials: EJ
authors.lastname: McLaughlin
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Miller
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Thuzar M
authors.initials: TM
authors.lastname: Shin
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Sobanko
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cannady
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Miller
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Newman
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D006801:Humans; D016867:Immunocompromised Host; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate / Q000639:trends
keywords: Cutaneous squamous cell carcinoma; Head and neck; Lymph node; Metastasis; Solid organ transplant