Prognostic Significance of Skin Involvement from Mucosal Tumors of the Head and Neck

Objective: To examine the hypothesis that skin involvement from mucosal squamous cell carcinoma of the head and neck is a prognostic indicator of a poor outcome.

Design: Retrospective review of cases and statistical assessment of median survival times.

Patients: Patients with mucosal squamous cell carcinoma of the head and neck. Fifteen patients had direct skin extension and 11 patients had intradermal lymphatic spread.

Setting: University medical center.

Results: Direct skin involvement was a prognostic sign of poor outcome but was less ominous than skin involvement by intradermal lymphatic spread. The patients with direct involvement had a 7-month median survival; those with lymphatic spread had a 3-month median survival. At 3 years, all but one patient had died. Involvement of facial skin was better prognostically for duration of survival than was involvement of neck skin. Surgical resection of the involved skin in half of the patients extended palliation 20 months beyond the median survival of the other patients.

Conclusions: Skin involvement from mucosal squamous cell carcinoma of the head and neck indicates a poor prognosis, but resection offers short-term palliation.