2016 AHNS Annual Meeting

Rate Of Regional Nodal Metastases Of Cutaneous Squamous Cell Carcinoma In The Immunosuppressed Patient

Presentation:	P717
Topic:	Skin Cancers
Type:	Poster
Date:	Posters
Session:	Posters
Authors:	Eamon J McLaughlin, MD, Thuzar M Shin, MD, PhD, Joseph F Sobanko, MD, Steven B Cannady, MD, Christopher J Miller, MD, Jason G Newman, MD imipramin cancer imipramin 25 mg imipramin tablete
Institution(s):	Hospital of the University of Pennsylvania

Background: Patients who are immunosuppressed following solid organ transplant have an increased risk of developing cutaneous malignancies, the most common being squamous cell carcinoma. These tumors tend to have more aggressive characteristics and higher rates of local recurrence. As such they are treated aggressively and patients are followed at short intervals. However, the rate of regional lymph node metastasis previously reported in the literature has ranged from 5-25%. Therefore the decision of how to manage a clinically N0 neck with these high-risk tumors is not well understood.

Objective: To determine the rate of regional lymph node involvement in solid organ transplant patients with cutaneous head and neck squamous cell carcinoma.

Methods: This is a retrospective chart review of all solid organ transplant patients with head and neck cutaneous squamous cell carcinoma treated at our institution from 2005 to 2015.

Results: 153 solid organ transplant patients underwent resection of 428 head and neck cutaneous squamous cell carcinomas. The average age of the patient was 63. Seven patients (4.5%) developed regional lymph node metastases (1 parotid, 6 cervical lymph nodes). The mean time from primary tumor resection to diagnosis of regional lymphatic disease was 9 months. Six of these 7 patients underwent definitive treatment for the regional disease (5 underwent surgical resection followed by adjuvant radiation, 1 patient underwent definitive chemoradiation). 5 of the 7 patients died of disease progression with a mean survival of 13 months. The average follow up time was 3 years.

Conclusions: In this study of immunosuppressed patients with cutaneous squamous cell carcinoma we found a rate of regional lymph node involvement similar to that which has been previously described in the immuncompetent host. However, these patients with regional lymph node involvement had a 70% disease specific mortality. Despite the low rate of lymph node metastases in these patients, aggressive work up, management, and monitoring of this subset of patients is warranted in light of their very poor prognosis.

AHNS Annual Meeting

July 16-20, 2016
Washington State Convention Center
Seattle, WA

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