Cutaneous metastatic squamous cell carcinoma to the parotid gland: analysis and outcome

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Abstract
Background.: Our aim was to review the presentation, treatment, and outcome of patients with metastatic cutaneous squamous cell carcinoma involving the parotid gland at a tertiary referral center.Methods.: We performed a retrospective chart review of the cancer registry at the Princess Margaret Hospital, Toronto, from 1970 to 2001. All patients had a previously untreated metastatic cutaneous head and neck squamous cell carcinoma involving the parotid gland. A minimal follow‐up of 1 year was mandatory for inclusion in the study.Results.: Fifty‐six white patients (43 men and 13 women), with a median age of 76 years (range, 49–97 years), were eligible for inclusion. The disease in all patients was retrospectively staged according to a new system. Twenty patients had P1 disease, 14 had P2, and 22 had P3. Therapy included surgery and adjuvant external beam radiation in 37 patients, single‐modality external beam radiation in 12, and surgery alone in seven patients. The overall recurrence rate was 29%. The disease‐specific survival was significantly worse in patients treated with external beam radiation alone (p < .05). Tumor size >6 cm (p < .01) and the presence of facial nerve involvement (p < .01) were poor prognostic factors.Conclusions.: Metastatic cutaneous squamous cell carcinoma to the parotid gland is an aggressive neoplasm that requires combination therapy. The presence of a lesion in excess of 6 cm or with facial nerve involvement is associated with a poor prognosis. © 2004 Wiley Periodicals, Inc. Head Neck 26: 727–732, 2004