Toppi Jason, Tham Yik Seng, Webb Angela, Henderson Michael A, Rischin Danny, Magarey Matthew J R
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.
ANZ J Surg. 2020 Jul;90(7-8):1391-1395. doi: 10.1111/ans.16095. Epub 2020 Jul 5.
Surgery is the primary treatment for patients with recurrent head and neck cutaneous squamous cell carcinoma (cSCC) who have previously been treated by definitive surgery and radiotherapy. There are limited published data to direct management and the role of immunotherapy is currently under evaluation.
This was a retrospective study of patients with at least stage III recurrent head and neck cSCC previously managed by definitive surgery and radiotherapy.
A total of 30 patients met the inclusion criteria. Eighty-seven percent were male and the median age at the time of surgery was 79 years. After salvage surgery, 7% developed local recurrence and 43% regional or distant failure. The 2-year overall survival and disease-free survival were 45% (95% confidence interval 24-64) and 11% (95% confidence interval 1-34), respectively. Advanced age was associated with a higher risk of overall mortality (P < 0.05).
Patients with recurrent head and neck cSCC in the setting of previous radiotherapy have high recurrence rates with poor survival justifying consideration for treatment with anti-PD-1 immunotherapy strategies.
手术是既往接受过根治性手术和放疗的复发性头颈部皮肤鳞状细胞癌（cSCC）患者的主要治疗方法。关于指导治疗的已发表数据有限，免疫疗法的作用目前正在评估中。
这是一项对至少为III期复发性头颈部cSCC患者的回顾性研究，这些患者既往接受过根治性手术和放疗。
共有30例患者符合纳入标准。87%为男性，手术时的中位年龄为79岁。挽救性手术后，7%出现局部复发，43%出现区域或远处失败。2年总生存率和无病生存率分别为45%（95%置信区间24 - 64）和11%（95%置信区间1 - 34）。高龄与较高的总死亡率风险相关（P < 0.05）。
既往接受过放疗的复发性头颈部cSCC患者复发率高，生存率低，因此有理由考虑采用抗PD - 1免疫治疗策略进行治疗。
