Poor Outcomes in Head and Neck Non-Melanoma Cutaneous Carcinomas

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Objectives: Head and neck nonmelanoma cutaneous carcinomas (NMCC) may have poor outcomes, such as metastasis and recurrence. It remains unclear which patients are at increased risk for poor outcomes. We characterize a population of NMCC seen in a head and neck surgical practice. We sought to identify predictors of poor outcome in head and neck NMCC. Study Design: A retrospective cohort study of 161 patients with head and neck NMCC who presented to a university based otolaryngology-head and neck surgery practice over a 13 year period was performed. The study group included 127 men and 34 women, age range: 33 - 92 years. Subjects and Methods: Tumor characteristics of the study population were recorded, and statistical analysis and Kaplan- Meier survival calculations were performed to determine predictors of poor outcomes. Results: 113 squamous cell carcinomas (SCC) and 48 basal cell carcinomas (BCC) were identified. Among SCC patients, there was a 44% incidence of metastasis and a 47% incidence of recurrence. Among BCC patients, there was a 10% incidence of metastasis and a 50% incidence of recurrence. Twenty percent of SCC patients had a history of immunosuppression. Among SCC patients with immunosuppression, 83% had metastasis or recurrence. Survival for SCC patients with metastatic disease was significantly worse than patients without metastases. The presence of parotid metastases in SCC conferred a survival advantage when compared to other sites of metastases. Conclusion: The incidence of poor outcomes in NMCC was higher in our series than reported in the literature. Survival patterns of our study parallel those of similar studies in the literature.