{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:51:36Z","timestamp":1789649496624,"version":"4.0.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Metastatic cutaneous squamous cell carcinoma of the head and neck (<jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content>) is more common in older patients. It is postulated that the age\u2010related decline in immunity plays a role in cancer predisposition and prognosis. We aimed to investigate the effect of age on outcomes in <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> and compare these with the outcomes of patients with <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> and known immunosuppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> treated with curative intent were identified from a prospectively collated database of head and neck cancers at the Sydney Head and Neck Cancer Institute. Patients with <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> with known immunosuppression provided a comparison group for analysis of disease\u2010specific outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort includes 418 immunocompetent patients with metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> (median age: 73\u2009years (interquartile range: 65\u201381\u2009years)) and the control cohort includes 24 patients with metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> and immunosuppression (median age: 51\u2009years (interquartile range: 42\u201362\u2009years)). Increasing age was not associated with poorer disease\u2010free or disease\u2010specific survival. Patients in older age groups (70 years and over) had better disease\u2010specific outcomes than patients with long\u2010term immunosuppression. Patterns of disease failure did not differ between different age groups. The number of positive nodes and extra\u2010capsular spread were the only significant prognostic variables in multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the context of metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content>, age should not be considered as a marker of poor prognosis. Age should not be considered a surrogate marker of immune function considering the poorer outcomes seen in patients with immunosuppression. Older patients with metastatic <jats:styled-content style=\"fixed-case\">cHNSCC<\/jats:styled-content> should be considered candidates for standard treatment if otherwise medically fit.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13757","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T23:53:22Z","timestamp":1478562802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Age is not a predictor of prognosis in metastatic cutaneous squamous cell carcinoma of the head and neck"],"prefix":"10.1111","volume":"88","author":[{"given":"Joel A.","family":"Smith","sequence":"first","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohaib","family":"Virk","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu\u2010Hui (Hubert)","family":"Low","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Gao","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Clark","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute (SHNCI) Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,7]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Cancer Research UK. 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