Effect of immunocompromise on metastatic cutaneous squamous cell carcinoma in the parotid and neck

BACKGROUND: Our aim was to examine the effect of a compromised immune state on the outcomes in patients treated for metastatic cutaneous squamous cell carcinoma (SCC). METHODS: A retrospective analysis of patients with metastatic cutaneous SCC to the parotid and neck treated at Greenlane Hospital between 1992 and 2002 was conducted. Outcomes were compared between immune-competent and immunocompromised patients. A logistic regression analysis of likely risk factors for poor outcome was done. RESULTS: Forty-nine patients were identified, nine of whom were immunocompromised. All patients were treated by parotidectomy and/or neck dissection. The facial nerve was sacrificed in 42% of the patients. Thirty-seven patients underwent postoperative radiotherapy (76%). Recurrence was significantly more common in the immunocompromised group (56% vs 28%), with higher rates of local and distant recurrence. Survival at 1 and 2 years was reduced. CONCLUSION: Immunocompromise has a significant impact on the outcome of metastatic cutaneous SCC to the parotid and neck, affecting recurrence and survival.