Does Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck Warrant Adjuvant Treatment After Surgical Resection

The head and neck is the most common region of invasive cutaneous squamous cell carcinoma (SCC); however evidence is limited in defining the best treatment for advanced and recurrent disease. While there is good evidence that surgical resection of disease can offer improved outcomes, the role of adjuvant radiation and chemotherapy is less clear. We discuss recurrent cutaneous SCC of the head and neck within the context of current treatment guidelines, evidence behind defining risk for recurrent disease or disease related mortality, and evidence underlying adjuvant radiation and chemotherapy for these patients. Based on current evidence, we recommend adjuvant radiotherapy for high-risk cutaneous SCC of the head and neck in the setting of extensive perineural invasion or nodal metastases (evidence quality low; weak recommendation). In addition, based on recent data from a randomized study, we generally do not recommend adjuvant chemotherapy for high-risk cutaneous SCC (evidence quality moderate; weak recommendation).