The role of parotidectomy for advanced cutaneous squamous cell carcinoma of the head and neck

Kampel, Liyona; Dorman, Alexandra; Horovitz, Gilad; Warshavsky, Anton; Gutfeld, Orit; Muhanna, Nidal

doi:10.1007/s00405-020-06574-8

Cited by 7 publications

(21 citation statements)

References 18 publications

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“…The indication for superficial parotidectomy was metastatic cutaneous SCC to the parotid gland in the absence of clinical, radiological or intra-operative evidence of deep lobe involvement, 19 or patients with cervical lymph node involvement with a primary tumour within the area of drainage of the parotid gland. 20…”

Section: Resultsmentioning

confidence: 99%

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Superficial versus total parotidectomy for metastatic cutaneous squamous cell carcinoma and melanoma of the head and neck: a systematic review

et al. 2022

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Objective The extent of parotidectomy in the management of regional metastatic disease is controversial. This systematic review aimed to appraise data from studies evaluating superficial and total parotidectomy in metastatic cutaneous squamous cell carcinoma and cutaneous malignant melanoma of the head and neck. Method A systematic search of PubMed, Embase and Cochrane Library was performed. The protocol was registered with Prospero (CRD42020217962). Results A total of five studies evaluated cutaneous malignant melanoma. Only one compared outcomes of superficial and total parotidectomy: they found higher parotid area recurrence following superficial parotidectomy. Seven studies reported outcomes following cutaneous squamous cell carcinoma; some studies found higher regional recurrence and reduced survival in total parotidectomy, but there was likely selection bias in these studies. Others found no difference in survival between superficial and total parotidectomy. Conclusion The effect of the extent of parotidectomy on outcomes is unclear in cutaneous malignant melanoma and cutaneous squamous cell carcinoma. This systematic review highlights the need for well-designed studies to direct better care.

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Section: Resultsmentioning

confidence: 99%

“…18,23 Other authors found no difference in survival between superficial parotidectomy and total parotidectomy. 20 Two studies reported that the survival outcomes were not affected by the extent of parotidectomy; however, there were no specific data or survival analyses available to support these conclusions. 21,22…”

Section: Discussionmentioning

confidence: 99%

Superficial versus total parotidectomy for metastatic cutaneous squamous cell carcinoma and melanoma of the head and neck: a systematic review

et al. 2022

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“…As such, total parotidectomy is recommended for patients with metastatic cSCC to parotid gland. Conversely, there is no role of elective parotidectomy in cSCC of head and neck with absence of metastatic disease to parotid gland, even in the advanced or high-risk disease ( 15 ). Based on the evidence detailed above, left nerve-sparing total parotidectomy is indicated in the present case in view of radiological and pathological evidence of left parotid metastasis pre-operatively.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous squamous cell carcinoma with secondary parotid metastasis: a case report

Liang¹,

Cheng²,

Sulaiman³

et al. 2023

AME Case Rep

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Background Majority of cutaneous squamous cell carcinoma (cSCC) originate in the head and neck region, with 1–3% have been found to have parotid or periparotid lymph nodes metastases. The significance of secondary parotid metastases from cSCC lies in its propensity of cervical lymph node spread and distant metastases leading to a dismal prognosis, and therefore the importance of early diagnosis and prompt treatment. Case Description An 85-year-old gentleman with prior history of right temporal squamous cell carcinoma (SCC) presented with a new onset left cheek cSCC. He underwent complete excision with clear margin. Four months following initial surgery, he developed ulcerative mass at left angle of mandible. CT scan revealed an underlying left parotid gland tumor, which was confirmed to be SCC by fine needle aspiration cytology (FNAC). He was then surgically treated with nerve-sparing total parotidectomy, modified radical neck dissection, soft tissue reconstruction using free anterolateral thigh fasciocutaneous flap and adjuvant radiotherapy with satisfactory outcomes. Conclusions Although rare, metastatic cutaneous SCC to parotid gland represents a unique group of locally advanced cutaneous SCC. Multimodal treatment approach consisting of total parotidectomy, ipsilateral neck dissection and adjuvant radiotherapy has been shown to improve the locoregional control of the disease and limit the propensity to distant metastasis.

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“…74,75 However, few reports have been published, and no survival benefit was measured in clinically node negative cSCCHN. 76 As a consequence, elective parotidectomy may be recommended only if an involvement of the neck nodes is suspected, according to current evidences. 19 We measured a pooled SLNB positive rate of 5.6%, demonstrating an overall low incidence of lymph node metastases.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, some authors proposed elective parotidectomy for the management of advanced cSCCHN due to the high rate of occult parotid metastases (up to 37%) 74,75 . However, few reports have been published, and no survival benefit was measured in clinically node negative cSCCHN 76 . As a consequence, elective parotidectomy may be recommended only if an involvement of the neck nodes is suspected, according to current evidences 19…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in high‐risk cutaneous squamous cell carcinoma of the head and neck: Systematic review and meta‐analysis

et al. 2022

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The aim of our study was to better define the role of sentinel lymph node biopsy (SLNB) in high-risk cutaneous squamous cell carcinoma of the head and neck (cSCCHN). A systematic review and meta-analysis was performed according to the PRISMA statement. Seven-hundred and five patients were included from 20 studies. The pooled SLN identification rate was 98.8% (95% CI: 97.0-99.8). The median number of SLN excised was 3.6 (n = 371, 95%CI: 2.0-4.4). The pooled SLNB positive rate and cumulative regional recurrence rate (RRR) in negative SLNB were 5.6% (95%CI: 2.6-9.6) and 2.9% (95%CI: 0.5-7.2), respectively. The high SLN identification rate demonstrates SLNB feasibility in cSCCHN. The low SLNB positive rate and the relatively high RRR raise some doubts concerning its clinical utility. Further studies are mandatory to define predictors of lymph node metastases able to better select patients that may benefit from a SLNB.

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The role of parotidectomy for advanced cutaneous squamous cell carcinoma of the head and neck

Cited by 7 publications

References 18 publications

Superficial versus total parotidectomy for metastatic cutaneous squamous cell carcinoma and melanoma of the head and neck: a systematic review

Superficial versus total parotidectomy for metastatic cutaneous squamous cell carcinoma and melanoma of the head and neck: a systematic review

Cutaneous squamous cell carcinoma with secondary parotid metastasis: a case report

Sentinel lymph node biopsy in high‐risk cutaneous squamous cell carcinoma of the head and neck: Systematic review and meta‐analysis

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