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Does Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck Warrant Adjuvant Treatment After Surgical Resection?

  • Theresa Guo
  • Ana Ponce KiessEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

The head and neck is the most common region of invasive cutaneous squamous cell carcinoma (SCC); however evidence is limited in defining the best treatment for advanced and recurrent disease. While there is good evidence that surgical resection of disease can offer improved outcomes, the role of adjuvant radiation and chemotherapy is less clear. We discuss recurrent cutaneous SCC of the head and neck within the context of current treatment guidelines, evidence behind defining risk for recurrent disease or disease related mortality, and evidence underlying adjuvant radiation and chemotherapy for these patients. Based on current evidence, we recommend adjuvant radiotherapy for high-risk cutaneous SCC of the head and neck in the setting of extensive perineural invasion or nodal metastases (evidence quality low; weak recommendation). In addition, based on recent data from a randomized study, we generally do not recommend adjuvant chemotherapy for high-risk cutaneous SCC (evidence quality moderate; weak recommendation).

Keywords

Cutaneous squamous cell carcinoma Adjuvant therapy Recurrent Radiotherapy Non-melanoma skin cancer 

References

  1. 1.
    Alam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med. 2001;344(13):975–83.PubMedCrossRefGoogle Scholar
  2. 2.
    Network. NCC. Squamous Cell Skin Cancer (Version 1.2019). 2018. https://www.nccn.org/professionals/physician_gls/pdf/squamous.pdf. Accessed 9.2018, 2018.
  3. 3.
    Goepfert H, Dichtel WJ, Medina JE, Lindberg RD, Luna MD. Perineural invasion in squamous cell skin carcinoma of the head and neck. Am J Surg. 1984;148(4):542–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Moore BA, Weber RS, Prieto V, et al. Lymph node metastases from cutaneous squamous cell carcinoma of the head and neck. Laryngoscope. 2005;115(9):1561–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Harris BN, Bayoumi A, Rao S, Moore MG, Farwell DG, Bewley AF. Factors associated with recurrence and regional adenopathy for head and neck cutaneous squamous cell carcinoma. Otolaryngol Head Neck Surg. 2017;156(5):863–9.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Manyam BV, Garsa AA, Chin RI, et al. A multi-institutional comparison of outcomes of immunosuppressed and immunocompetent patients treated with surgery and radiation therapy for cutaneous squamous cell carcinoma of the head and neck. Cancer. 2017;123(11):2054–60.PubMedCrossRefGoogle Scholar
  7. 7.
    Rowe DE, Carroll RJ, Day CL Jr. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol. 1992;26(6):976–90.PubMedCrossRefGoogle Scholar
  8. 8.
    Wermker K, Kluwig J, Schipmann S, Klein M, Schulze HJ, Hallermann C. Prediction score for lymph node metastasis from cutaneous squamous cell carcinoma of the external ear. Eur J Surg Oncol. 2015;41(1):128–35.PubMedCrossRefGoogle Scholar
  9. 9.
    de Lima Vazquez V, Sachetto T, Perpetuo NM, Carvalho AL. Prognostic factors for lymph node metastasis from advanced squamous cell carcinoma of the skin of the trunk and extremities. World J Surg Oncol. 2008;6:73.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Cherpelis BS, Marcusen C, Lang PG. Prognostic factors for metastasis in squamous cell carcinoma of the skin. Dermatol Surg. 2002;28(3):268–73.PubMedGoogle Scholar
  11. 11.
    Khan K, Mykula R, Kerstein R, et al. A 5-year follow-up study of 633 cutaneous SCC excisions: rates of local recurrence and lymph node metastasis. J Plast Reconstr Aesthet Surg. 2018;71(8):1153–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Oddone N, Morgan GJ, Palme CE, et al. Metastatic cutaneous squamous cell carcinoma of the head and neck: the Immunosuppression, Treatment, Extranodal spread, and Margin status (ITEM) prognostic score to predict outcome and the need to improve survival. Cancer. 2009;115(9):1883–91.PubMedCrossRefGoogle Scholar
  13. 13.
    Jensen P, Hansen S, Moller B, et al. Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens. J Am Acad Dermatol. 1999;40(2 Pt 1):177–86.PubMedCrossRefGoogle Scholar
  14. 14.
    Gordon Spratt EA, Carucci JA. Skin cancer in immunosuppressed patients. Facial Plast Surg. 2013;29(5):402–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Manyam BV, Gastman B, Zhang AY, et al. Inferior outcomes in immunosuppressed patients with high-risk cutaneous squamous cell carcinoma of the head and neck treated with surgery and radiation therapy. J Am Acad Dermatol. 2015;73(2):221–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Lott DG, Manz R, Koch C, Lorenz RR. Aggressive behavior of nonmelanotic skin cancers in solid organ transplant recipients. Transplantation. 2010;90(6):683–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Veness MJ, Morgan GJ, Palme CE, Gebski V. Surgery and adjuvant radiotherapy in patients with cutaneous head and neck squamous cell carcinoma metastatic to lymph nodes: combined treatment should be considered best practice. Laryngoscope. 2005;115(5):870–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Givi B, Andersen PE, Diggs BS, Wax MK, Gross ND. Outcome of patients treated surgically for lymph node metastases from cutaneous squamous cell carcinoma of the head and neck. Head Neck. 2011;33(7):999–1004.PubMedCrossRefGoogle Scholar
  19. 19.
    Sapir E, Tolpadi A, McHugh J, et al. Skin cancer of the head and neck with gross or microscopic perineural involvement: patterns of failure. Radiother Oncol. 2016;120(1):81–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Strassen U, Hofauer B, Jacobi C, Knopf A. Management of locoregional recurrence in cutaneous squamous cell carcinoma of the head and neck. Eur Arch Otorhinolaryngol. 2017;274(1):501–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Coombs AC, Butler A, Allison R. Metastatic cutaneous squamous cell carcinoma of the parotid gland: prognostic factors. J Laryngol Otol. 2018;132(3):264–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Jambusaria-Pahlajani A, Miller CJ, Quon H, Smith N, Klein RQ, Schmults CD. Surgical monotherapy versus surgery plus adjuvant radiotherapy in high-risk cutaneous squamous cell carcinoma: a systematic review of outcomes. Dermatol Surg. 2009;35(4):574–85.PubMedCrossRefGoogle Scholar
  23. 23.
    Fahradyan A, Howell AC, Wolfswinkel EM, Tsuha M, Sheth P, Wong AK. Updates on the management of Non-Melanoma Skin Cancer (NMSC). Healthcare (Basel). 2017;5(4).  https://doi.org/10.3390/healthcare5040082.PubMedCentralCrossRefGoogle Scholar
  24. 24.
    Burton KA, Ashack KA, Khachemoune A. Cutaneous squamous cell carcinoma: a review of high-risk and metastatic disease. Am J Clin Dermatol. 2016;17(5):491–508.PubMedCrossRefGoogle Scholar
  25. 25.
    Wang JT, Palme CE, Morgan GJ, Gebski V, Wang AY, Veness MJ. 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. Head Neck. 2012;34(11):1524–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Hinerman RW, Indelicato DJ, Amdur RJ, et al. Cutaneous squamous cell carcinoma metastatic to parotid-area lymph nodes. Laryngoscope. 2008;118(11):1989–96.PubMedCrossRefGoogle Scholar
  27. 27.
    Han A, Ratner D. What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion? Cancer. 2007;109(6):1053–9.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Garcia-Serra A, Hinerman RW, Mendenhall WM, et al. Carcinoma of the skin with perineural invasion. Head Neck. 2003;25(12):1027–33.PubMedCrossRefGoogle Scholar
  29. 29.
    Jackson JE, Dickie GJ, Wiltshire KL, et al. Radiotherapy for perineural invasion in cutaneous head and neck carcinomas: toward a risk-adapted treatment approach. Head Neck. 2009;31(5):604–10.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Tang C, Fischbein NJ, Murphy JD, et al. Stereotactic radiosurgery for retreatment of gross perineural invasion in recurrent cutaneous squamous cell carcinoma of the head and neck. Am J Clin Oncol. 2013;36(3):293–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Tanvetyanon T, Padhya T, McCaffrey J, et al. Postoperative concurrent chemotherapy and radiotherapy for high-risk cutaneous squamous cell carcinoma of the head and neck. Head Neck. 2015;37(6):840–5.PubMedCrossRefGoogle Scholar
  32. 32.
    Goyal U, Prabhakar NK, Davuluri R, Morrison CM, Yi SK. Role of concurrent systemic therapy with adjuvant radiation therapy for locally advanced cutaneous head and neck squamous cell carcinoma. Cureus. 2017;9(10):e1784.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Porceddu SV, Bressel M, Poulsen MG, et al. Postoperative concurrent chemoradiotherapy versus postoperative radiotherapy in high-risk cutaneous squamous cell carcinoma of the head and neck: the randomized phase III TROG 05.01 trial. J Clin Oncol. 2018;36(13):1275–83.PubMedCrossRefGoogle Scholar
  34. 34.
    Brodland DG, Zitelli JA. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. 1992;27(2 Pt 1):241–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins UniversityBaltimoreUSA
  2. 2.Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins UniversityBaltimoreUSA

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