Lymph node metastasis in cutaneous squamous cell carcinoma of the head and neck

• Published in: BMC cancer 2024-05, Vol.24 (1), p.656-10, Article 656
• Main Authors: Fang, Qigen, Yuan, Junhui, Zhang, Xu, Dai, Liyuan, Luo, Ruihua
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; AJCC; Bayesian analysis; Cancer; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Chemotherapy; Cutaneous squamous cell carcinoma; Dissection; Female; Head & neck cancer; Head and neck cancer; Head and neck carcinoma; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Health aspects; Humans; Intraparotid lymph node; Lymph nodes; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - pathology; Lymphatic system; Male; Mathematical models; Medical prognosis; Metastases; Metastasis; Middle Aged; Neck; Neoplasm Staging; O'Brien stage; Oncology, Experimental; Patient outcomes; Patients; Periparotid lymph node; Physiological aspects; Prognosis; Radiation therapy; Retrospective Studies; Skin Neoplasms - mortality; Skin Neoplasms - pathology; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - surgery; Surgery; Survival analysis
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12384-6

The study aimed to assess the impact of parotid lymph nodes (LNs) on the prognosis of patients with cutaneous squamous cell carcinomas of the head and neck (HNcSCC), and to develop an alternative LN assessment method to enhance locoregional control (LRC) and overall survival (OS) stratification. We retrospectively enrolled patients with surgically treated HNcSCC. Primary outcome variables were LRC and OS. The influence of parotid LNs and different LN assessment methods on prognosis was analyzed using Cox models, and comparisons were made using the C-index, Akaike Information Criterion, and Bayesian Information Criterion. A total of 126 patients were included. Both intraparotid and periparotid LN statuses significantly linked with prognosis. The presence of extranodal extension (ENE) in cervical LNs, rather than parotid LNs, was predictive of decreased LRC and OS. In the Cox analysis, only N3 of the AJCC N classification, when compared to N0, showed reduced LRC and OS. In comparison to N0P1, only N0P3/N1P1 and N2P2/N2P3 of the O'Brien staging system tended to predict poorer LRC, with no subgroup emerging as an independent predictor for OS. The proposed LN assessment method, based on the number of metastatic LNs and ENE status in cervical LNs, demonstrated superior performance in terms of C-index, Akaike Information Criterion, and Bayesian Information Criterion compared to other systems. Parotid LNs were significant determinants of prognosis in metastatic HNcSCC. The novel LN assessment method proposed (1-2 vs. 3-4 vs. 5 + or ENE) displayed similar survival stratification to the AJCC N and O'Brien staging systems.