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Inicio Acta Otorrinolaringológica Española Results of surgical treatment of lymph node metastases in patients with cutaneou...
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Vol. 75. Issue 3.
Pages 169-176 (May - June 2024)
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Vol. 75. Issue 3.
Pages 169-176 (May - June 2024)
Original article
Results of surgical treatment of lymph node metastases in patients with cutaneous squamous cell carcinoma of the head and neck
Resultados del tratamiento quirúrgico de las metástasis ganglionares en pacientes con carcinomas escamosos cutáneos de cabeza y cuello
Xavier Leóna,b,
Corresponding author
xleon@santpau.cat

Corresponding author.
, Susana Lópezc, María Pérezc, Cristina Valeroa, Anna Holgadoa, Miquel Quera,b, Carmen Vegac
a Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
c Servicio de Cirugía Plástica. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Tables (4)
Table 1. Classification criteria for nodal metastases of cutaneous squamous cell carcinoma of the head and neck according to the proposal by O’Brien et al.9
Table 2. Characteristics of the patients included in the study.
Table 3. Specific survival at 5 years according to the characteristics of the patients included in the study.
Table 4. Regional involvement categories according to the 8th edition of the TNM8 classification and staging derived from the classification proposed by O’Brien et al.,9 and specific survival at 5 years for each of the categories.
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Abstract
Introduction

Out of all cutaneous squamous cell carcinomas originating in the head and neck (HNCSCC), 2–4% are associated with parotid or cervical lymph node metastasis. The aim of this study is to analyse the prognostic factors of patients with HNCSCC with lymph node involvement treated surgically. Additionally, we aim to compare the prognostic capacity of the classification of these patients according to the 8th edition of the TNM, and an alternative classification proposed by O'Brien et al.

Patients and methods

Retrospective review of 65 patients with HNCSCC with lymph node metastasis treated surgically during the period 2000–2020.

Results

During the study period we carried out 13 neck dissections and 52 parotidectomies + neck dissection in patients with lymph node metastases from a HNCSCC. The great majority of patients (89.2%) received post-operative radiotherapy. The 5 year disease-specific survival was 69.9%, and the overall survival it was 42.8%. The classification proposed by O'Brien et al., based on the parotid or cervical location of the lymph node metastases, and the size and number of the metastatic lymph nodes, had a better prognostic capacity than the TNM classification.

Conclusions

The surgical treatment of lymph node metastases in patients with HNCSCC achieved a high disease control. The classification based on the location, size and number of lymph node metastases proposed by O'Brien et al had better prognostic capacity than the TNM classification.

Keywords:
Cutaneous squamous cell carcinoma
Head and neck
Lymph node metastases
Parotidectomy
Neck dissection
Extracapsular spread
Prognostic classification
O’Brien
Resumen
Introducción

Un 2–4% de los carcinomas escamosos cutáneos localizados a nivel de cabeza y cuello (CECCC) dan lugar a la aparición de metástasis a nivel parotídeo o cervical. El objetivo del presente estudio es analizar los factores pronósticos de los pacientes con CECCC con afectación ganglionar tratados de forma quirúrgica, y comparar la capacidad pronóstica de la clasificación patológica de estos pacientes de acuerdo con la 8ª edición del TNM y un método alternativo propuesto por O’Brien y cols.

Pacientes y métodos

Revisión retrospectiva de 65 pacientes con CECCC con afectación ganglionar tratados de forma quirúrgica durante el periodo 2000–2020.

Resultados

Durante el periodo de estudio se llevaron a cabo 13 vaciamientos cervicales y 52 parotidectomías + vaciamiento cervical en pacientes con metástasis ganglionares de CECCC. Una mayoría de pacientes (89.2%) recibieron radioterapia postoperatoria. La supervivencia específica a los 5 años fue del 69,9%, y la supervivencia global del 42,8%. El método de clasificación propuesto por O’Brien y cols, basado en la localización parotídea o cervical de la metástasis ganglionar, el tamaño y el número de adenopatías metastásicas, contó con una mejor capacidad pronóstica que la clasificación de la 8ª edición del TNM.

Conclusiones

El tratamiento quirúrgico de las metástasis ganglionares en pacientes con CECCC consiguió un elevado control de la enfermedad. La clasificación basada en la localización y el tamaño de las metástasis ganglionares propuesta por O’Brien y cols tuvo mejor capacidad pronóstica que la 8ª edición del TNM.

Palabras clave:
Carcinoma escamoso cutáneo
Cabeza y cuello
Metástasis ganglionar
Parotidectomía
Vaciamiento cervical
Ruptura capsular
Clasificación pronóstica
O’Brien

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