Skin metastases from head and neck squamous cell carcinoma: Incidence and impact

Background. Squamous cell carcinoma (SCC) of the upper aerodigestive tract rarely metastasizes to the skin. This study was designed to review the inci dence of skin metastases, to identify associated risk factors, and to inves tigate the prognostic significance of skin metastases. Methods. A cohort of 2491 patients treated for SCC originating in the upper aerodigestive tract were evaluated retrospectively, Patients who developed skin metastases were evaluated with respect to tumor stage, treatment, and outcome. Patients with skin metastases were compared with patients who dev eloped distant metastases at other sites and with those who did not develop distant metastases. Results. Skin metastases developed in 19 (0.763%) patients. The median time to occurrence was 6 months. Ninety percent of patients died of disease wit hin a median of 3 months (1 to 16 months) following diagnosis. The developm ent of skin metastasis is most closely related to the presence of two or mo re cervical metastases and/or extracapsular spread of tumor in the cervical metastases. Similar risk factors were identified for the development of di stant metastases to other sites. Conclusion. Metastasis to skin is a rare occurrence which has prognostic si gnificance similar to distant metastasis to other areas. (C) 1999 John Wile y & Sons, Inc.