Management of cutaneous head and neck squamous cell carcinoma with trigeminal nerve involvement: a systematic review

Authors

  • Justin Maldonado Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Samir Lohana Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Emily Barrow Department of Otorhinolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
  • Jackson Vuncannon Department of Otorhinolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
  • Ivan Pradilla Neuroscience Research Group (NeURos), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
  • Youssef Zohdy Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Juan Manuel Revuelta Barbero Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Edoardo Porto Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
  • Alejandra Rodas Department of Otorhinolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
  • Travis Atchley Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
  • Biren Patel Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Leonardo Tariciotti Department of Neurosurgery, Emory University, Atlanta, Georgia, USA; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
  • Silvia Vergara Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Nikki Nikki Schmitt Department of Otorhinolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
  • C. Arturo Solares Department of Otorhinolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
  • Tomas Garzon-Muvdi Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  • Gustavo Pradilla Department of Neurosurgery, Emory University, Atlanta, Georgia, USA

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20243508

Keywords:

Skull base surgery, Skull base oncology, Perineural invasion, Perineural spread, CNV, Skin cancer

Abstract

Cutaneous head and neck squamous cell carcinoma (cHNSCC) is the second most common cancer worldwide, carrying a favorable prognosis. Perineural invasion/spread dramatically reduces survival outcomes. The trigeminal nerve (CNV) is most commonly affected, providing abundant opportunities for skull base and intracranial cavity invasion. Standard treatment includes surgery and radiotherapy (SRT). We intended to systematically review the literature on cHNSCC with CNV involvement and evaluate the effects of treatment modalities and pattern of CNV invasion/spread on outcomes. We performed a systematic review according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Kaplan-Meier curves were utilized to determine the impact of treatment and pattern of invasion/spread on disease-free survival (DFS) and overall survival (OS). Fifty-one studies were identified, generating a sample size of 172 patients with cHNSCC and CNV involvement. The most common treatment modality was SRT (n=90, 52.9%), and all three major CNV branches were affected with similar frequency (V1 33.7%, V2 33.7%, V3 32.6%). Cox proportional hazards regression models revealed significant differences in OS for V1 vs V2 involvement (HR 2.84 95% CI 1.02-7.89), skull base invasion (HR 3.90 95%CI 1.30-11.65), SRT vs RT alone (HR 5.77 95% CI 2.13-15.6), SRT vs other treatment (HR 6.21 95 CI 2.24-17.20). Only SRT and RT had a significant difference in DFS (HR of 3.90, 95%CI 1.30-11.65). In cHNSCC with CNV involvement, treatment modality and the pattern of CNV are crucial for locoregional control and mortality. V1 involvement and definitive RT are associated with significantly lower survival curves.

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Published

2024-11-26

Issue

Vol. 10 No. 6 (2024): November-December 2024

Section

Systematic Reviews