Abstract: Background. Our aim was to examine the effect of a compromised immune state on the outcomes in patients treated for metastatic cutaneous squamous cell carcinoma (SCC). Methods. A retrospective analysis of patients with metastatic cutaneous SCC to the parotid and neck treated at Greenlane Hospital between 1992 and 2002 was conducted. Outcomes were compared between immune-competent and immunocom-promised patients. A logistic regression analysis of likely risk factors for poor outcome was done. Results. Forty-nine patients were identified, nine of whom were immunocompromised. All patients were treated by paroti-dectomy and/or neck dissection. The facial nerve was sacrificed in 42 % of the patients. Thirty-seven patients underwent post-operative radiotherapy (76%). Recurrence was significantly more common in the immunocompromised group (56 % vs 28%), with higher rates of local and distant recurrence. Survival at 1 and 2 years was reduced. Conclusion. Immunocompromise has a significant impact on the outcome of metastatic cutaneous SCC to the parotid and neck, affecting recurrence and survival. A 2006 Wiley Period
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