1.Introduction

Rising incidence of cutaneus squamous cell carcinoma (cSCC) in high-risk areas of the head and neck region present significant challenges in preserving their complex anatomical and functional structures and ensuring total removal to prevent locoregional recurrence.

This study aims to identify risk factors of locoregional recurrence to improve clinical outcomes in cSCC.

Material and methods

This retrospective study included 176 patients diagnosed with cSCC in the head and neck region. Initial tumor locations, tumor thickness and -depth, and primary sonography status was obtained. Local as well as locoregional recurrence rate, recurrence-free survival and individual risk factor analysis were calculated using Kaplan Meier analysis and cox regression.

Results

Of the 176 patients, 125 (71%) had tumors in high-risk regions (lip, ear, or nose), all of whom underwent primary sonography. All 14 locoregional recurrences occurred in these high-risk areas, with none in low-risk regions. The median local recurrence-free survival was 65 months, and locoregional recurrence-free survival was 66 months. Tumor depth significantly affected local recurrence-free survival (p=0.035, hazard ratio 1.6), while tumor diameter did not (p=0.68). Additionally, 4.5% developed metachronous lymph node metastases, requiring radical surgery, including facial nerve sacrifice in two patients.

Discussion

This study highlights that cSCC in high-risk head and neck areas have a higher recurrence rate and often requires complex surgery. Tumor depth, not diameter, is a critical factor in recurrence, emphasizing the need for assessment. These results stress the importance of rigorous monitoring and personalized treatment for cSCC in high risk region.

Nein