{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T14:14:00Z","timestamp":1771942440446,"version":"3.50.1"},"reference-count":24,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Introduction: Cutaneous squamous cell carcinoma (cSCC) is a common non-melanoma skin cancer primarily affecting the head and neck area, with possibility of local recurrence and metastasis. Surgical excision is the standard treatment. The objective of this study was to investigate the treatment outcomes of cSCC including local recurrence, late-onset metastasis and mortality as well as to identify the associated risk factors.\nMaterial and methods: A retrospective single-center analysis was conducted involving patients with cSCC of the head and neck treated by surgical excision at Turku University Hospital between 2000 and 2021 with a minimum 2-year follow-up from primary surgery.\nResults: A total of 195 patients, with a mean age of 79.1 years, were included. During follow-up, 17 (8.7%) recurrences were diagnosed, nine (4.6%) patients developed late-onset metastasis, and 100 (51.3%) patients died. The significant risk factors for recurrences included age \u2265 80 years (p = 0.006), poor tumor differentiation (p = 0.02) and tumor invasion depth (p = 0.02). Tumor depth also increased metastasis risk (p &lt; 0.0001). Poor tumor differentiation (p = 0.004) and metastasis (p = 0.04) were associated with higher mortality. Greater histological deep margins decreased the risk of recurrence (p = 0.01) and metastasis (p = 0.02) and improved survival (p = 0.006). All-cause 3-year and 5-year mortality rates were 27.7 and 36.4%, respectively.\nConclusion: Deeper growing, poorly differentiated cSCC tumors of the head and neck carry a higher risk of recurrence and metastasis. Pursuing greater deep excision margins could reduce these risks.\u00a0Given\u00a0the high age and all-cause mortality rates of cSCC patients, close surveillance should be individualized.<\/jats:p>","DOI":"10.2340\/jphs.v61.45372","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T13:45:27Z","timestamp":1771940727000},"page":"17-23","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes in cutaneous squamous cell carcinoma of the head and neck: a retrospective analysis of risk factors, recurrence and metastasis"],"prefix":"10.2340","volume":"61","author":[{"given":"Veera","family":"Korhonen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esko","family":"Ver\u00e4j\u00e4nkorva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari","family":"Koivisto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Pajula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"142722","doi-asserted-by":"crossref","unstructured":"Stratigos A, Garbe C, Lebbe C, et al. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer. 2015;51(14):1989\u20132007. https:\/\/doi.org\/10.1016\/j.ejca.2015.06.110","DOI":"10.1016\/j.ejca.2015.06.110"},{"key":"142723","doi-asserted-by":"crossref","unstructured":"Silberstein E, Sofrin E, Bogdanov-Berezovsky A, et al. Lymph node metastasis in cutaneous head and neck squamous cell carcinoma. Dermatol Surg. 2015;41(10):1126\u20131129. https:\/\/doi.org\/10.1097\/DSS.0000000000000488","DOI":"10.1097\/DSS.0000000000000488"},{"key":"142724","doi-asserted-by":"crossref","unstructured":"Yan F, Tillman BN, Nijhawan RI, et al. High-risk cutaneous squamous cell carcinoma of the head and neck: a clinical review. Ann Surg Oncol. 2021;28(13):9009\u20139030. https:\/\/doi.org\/10.1245\/s10434-021-10108-9","DOI":"10.1245\/s10434-021-10108-9"},{"key":"142725","doi-asserted-by":"crossref","unstructured":"Lubov J, Labb\u00e9 M, Sioufi K, et al. Prognostic factors of head and neck cutaneous squamous cell carcinoma: a systematic review. J Otolaryngol Head Neck Surg. 2021;50(1):54. https:\/\/doi.org\/10.1186\/s40463-021-00529-7","DOI":"10.1186\/s40463-021-00529-7"},{"key":"142726","doi-asserted-by":"crossref","unstructured":"Harris BN, Bayoumi A, Rao S, et al. Factors associated with recurrence and regional adenopathy for head and neck cutaneous squamous cell carcinoma. Otolaryngol Head Neck Surg. 2017;156(5):863\u2013869. https:\/\/doi.org\/10.1177\/0194599817697053","DOI":"10.1177\/0194599817697053"},{"key":"142727","doi-asserted-by":"crossref","unstructured":"Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol. 2018;78(2):237\u2013247. https:\/\/doi.org\/10.1016\/j.jaad.2017.08.059","DOI":"10.1016\/j.jaad.2017.08.059"},{"key":"142728","unstructured":"Simonacci F, Bertozzi N, Grieco MP, et al. Surgical therapy of cutaneous squamous cell carcinoma: our ex-perience. Acta Biomed. 2018;89(2):242\u2013248."},{"key":"142729","doi-asserted-by":"crossref","unstructured":"Krediet JT, Beyer M, Lenz K, et al. Sentinel lymph node biopsy and risk factors for predicting metastasis in cutaneous squamous cell carcinoma. Br J Dermatol. 2015;172(4):1029\u20131036. https:\/\/doi.org\/10.1111\/bjd.13508","DOI":"10.1111\/bjd.13508"},{"key":"142730","doi-asserted-by":"crossref","unstructured":"Ilmonen S, Sollamo E, Juteau S, et al. Sentinel lymph node biopsy in high-risk cutaneous squamous cell car-cinoma of the head and neck. J Plast Reconstr Aesthet Surg. 2022;75(1):210\u2013216. https:\/\/doi.org\/10.1016\/j.bjps.2021.08.041","DOI":"10.1016\/j.bjps.2021.08.041"},{"key":"142731","doi-asserted-by":"crossref","unstructured":"Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. 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