Head/neck cSCC: immunosuppression tied to poor survival in Canadian meta-analysis

  • Sahovaler A & al.
  • JAMA Otolaryngol Head Neck Surg
  • 07/03/2019

  • Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A systematic review and meta-analysis suggests that immunosuppression, lymph node ratio (LNR), and extracapsular spread are associated with reduced survival of patients with head and neck cutaneous squamous cell carcinoma (cSCC) with regional lymph node metastasis (LNM).
  • Adjuvant radiotherapy (RT) is associated with improved survival.

Why this matters

  • Identification of risk factors can help guide patient management.

Key results

  • Immunosuppression (HR, 2.66; P<.0001 lnr and extracapsular spread were associated with reduced os.>
  • Immunosuppression (HR, 3.82; P<.0001 was associated with reduced disease-specific survival>
  • Adjuvant RT was associated with improved OS (HR, 0.45; P=.005) and DSS (HR, 0.52; P=.0008).

Study design

  • 20 observational studies and 1 randomized clinical trial (3534 patients) were included.
  • Funding: None disclosed.

Limitations

  • Most included studies were retrospective.
  • Heterogeneity between included studies.