Invasions and Metastases of Facial and Neck Skin by Head and Neck Cancer

Choi, Eun Chang; Koh, Yoon Woo; Kim, Moon Suk; Kim, Hyun Joon; Chung, Tae Young; Choi, Jae Jin; Kim, Chul Ho; Kim, Young Ho

Abstract

BACKGROUND AND OBJECTIVES
This study was designed to review the incidence of skin involvement in the head and neck cancer. We also reviewed its pattern, treatment results, and prognostic significance of skin invasion and metastases.
MATERIALS AND METHODS
We carried out an retrospective evaluation of 41 patients who required resection of the facial or neck skin during surgery for their head and neck cancer in the last ten years. Patients with head and neck skin cancer were excluded from this study. Patients who developed skin involvement were evaluated with regard to the primary origin of tumor, the tumor stage, and the pattern of skin involvement, treatment and outcome. The cases were classified into four groups: firstly, a group with the presence of skin scar made by previous biopsy; secondly, a group with tumor fixed to skin; thirdly, a group with skin resected with a sufficient resection marginal, and lastly a group with gross involvement of skin by tumor.
RESULTS
Among 41 patients who required resection of the skin, patients with skin invasion were noted in 24 cases. Only one out of four cases of the biopsy group had skin involvement whereas a half of the fixed group had skin invasion. For the marginal group, only two cases had invasion of skin. The treatment result of patients with skin involvement had poor prognosis compared to patients without skin involvement. In particular, patients with skin metastasis had extremely poor survival.
CONCLUSIONS
Skin involvement in the head and neck cancer indicates a poor prognosis, and should not be considered for surgery.