Outcomes after surgery and postoperative radiotherapy for perineural spread of head and neck cutaneous squamous cell carcinoma

Timothy A Warren, Benedict Panizza, Sandro V Porceddu, Mitesh Gandhi, Parag Patel, Martin Wood, Christina M Nagle, Michael Redmond

Background Queensland, Australia has the highest rates of cutaneous squamous cell carcinoma (SCC). Perineural invasion (PNI) is associated with reduced local control and survival. Methods A retrospective review of a prospective database of patients with clinical PNI from cutaneous SCC of the head and neck (CSCCHN) treated with surgery and post-operative radiotherapy between 2000-2011 and a minimum of 24 months follow-up. Patients were excluded if immunosuppressed, had non-SCC histology or treated palliatively. Results 50 patients (mean age 60 years) with median follow-up of 50 months were included. 54.8% of known primary tumors had incidental PNI. 10% had nodal disease at presentation. MR neurogram was positive in 95.8%. Recurrence-free survival at 5-years was 62%. 5-year disease-specific survival and overall survival were 75% and 64%, respectively. There were no peri-operative deaths. Conclusion This report demonstrates that long-term survival is achievable in patients with clinical PNI from CSCCHN following surgery and post-operative radiotherapy. This article is protected by copyright. All rights reserved.