{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:37:06Z","timestamp":1790087826437,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cutaneous squamous cell carcinoma of the head and neck (<jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content>) metastatic to the parotid has a moderate risk of recurrence despite multimodality treatment. Immunosuppression is associated with lower rates of long\u2010term cure. Our aim was to review outcomes of current management in a tertiary centre with a view to targeting future strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of clinico\u2010pathological data and outcomes for patients with metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> involving the parotid gland, undergoing radical surgery and adjuvant radiotherapy during 2000\u20132014 was conducted. The Kaplan\u2013Meier method was used to determine time\u2010to\u2010event outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and thirty\u2010two patients met the inclusion criteria. Median follow\u2010up was 5.0\u00a0years. Five\u2010year overall (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>), cancer\u2010specific (<jats:styled-content style=\"fixed-case\">CSS<\/jats:styled-content>) and progression free survival (<jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content>) were 44% (95% Confidence Interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 34\u201353%), 64% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 52\u201374%) and 37% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 28\u201347%) respectively. Locoregional control (<jats:styled-content style=\"fixed-case\">LRC<\/jats:styled-content>) was 68% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 55\u201377%) at 5\u00a0years. Immunosuppressed patients fared worse (compared with immune\u2010competent) with five\u2010year <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CSS<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> of 14% versus 53% (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a03.19; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.91\u20135.34), 40% versus 71% (Hazard Ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>)\u00a0=\u00a02.92; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.38\u20136.19) and 10% versus 46% (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a02.51; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.52\u20134.14) respectively. On multivariate analysis, immune status strongly predicted <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), <jats:styled-content style=\"fixed-case\">CSS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), <jats:styled-content style=\"fixed-case\">DMFS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), but not <jats:styled-content style=\"fixed-case\">LRC<\/jats:styled-content>. Largest lymph node size was the only significant factor predictive for <jats:styled-content style=\"fixed-case\">LRC<\/jats:styled-content> on multivariate analysis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite multimodality treatment metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> involving the parotid shows moderate rates of recurrence. Immunosuppressed patients with this disease have a particularly poor prognosis, demonstrating lower rates of <jats:styled-content style=\"fixed-case\">CSS<\/jats:styled-content> with similar rates of <jats:styled-content style=\"fixed-case\">LRC<\/jats:styled-content> compared to their immunocompetent counterparts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12484","type":"journal-article","created":{"date-parts":[[2016,6,22]],"date-time":"2016-06-22T16:14:56Z","timestamp":1466612096000},"page":"668-676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Outcomes of cutaneous squamous cell carcinoma of the head and neck with parotid metastases"],"prefix":"10.1111","volume":"60","author":[{"given":"Lachlan J","family":"McDowell","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology and Cancer Imaging Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze\u2010Jian","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology and Cancer Imaging Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Bressel","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics and Clinical Trials Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Estall","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology and Cancer Imaging Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kleid","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Corry","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology and Cancer Imaging Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith L","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology and Cancer Imaging Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,21]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare.Non\u2010melanoma skin cancer: general practice consultations hospitalisations and mortality.Canberra 2008."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000246783"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24586"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(92)70144-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.124.5.582"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000173202.56739.9f"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23155"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21332"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1106"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21698"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10063"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.129.7.750"},{"key":"e_1_2_6_14_1","unstructured":"National Comprehensive Cancer Network.Squamous Cell Skin Cancer 2015[cited 13 September 2015]. 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