Parotid Metastasis Predicts Survival in Head Carcinoma

New staging system separates parotid from neck metastatic disease

FRIDAY, Dec. 22 (HealthDay News) -- The staging of parotid gland metastasis separately from neck metastasis may help predict survival among patients with head and neck cutaneous squamous cell carcinoma, according to the results of a study published in the December issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Sydney Ch'ng, M.D., of the Wellington School of Medicine and Health Sciences in Wellington, New Zealand, and colleagues restaged 67 patients with metastatic head and neck cutaneous squamous cell carcinoma using a newly proposed system that separates parotid disease from neck disease. The current TNM (tumor, node, metastasis) staging system does not consider the extent of nodal metastasis.

Patients with P3 cancer (defined as a metastatic node greater than 6 cm or disease involving the skull base or facial nerves) had significantly worse survival than their counterparts with P1 (metastatic node less than or equal to 3 cm) or P2 (metastatic node greater than 3 and less than or equal to 6 cm) cancers. Patients who had both parotid and neck disease fared worse than those who had parotid or neck disease alone, the report indicates.

"Results of our study confirm that the extent of parotid disease significantly influences survival," the study authors conclude. "It underscores the need for revision of the current TNM staging for cutaneous squamous cell carcinoma in the head and neck, to take into account the presence and extent of metastatic parotid disease."

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