Approach to the advanced stage cutaneous, tumors of the head and neck: A retrospective analysis of 50 cases

Skin cancer is the most common form of malignancy in the world, the incidence of cutaneous malignancies has increased dramatically over the past several decades. More than 80% of cases involve the head and neck region, resection and latter reconstruction of advanced cutaneous malignancies constitute significant problems due to aesthetic and functional concerns. Aim of this study is to discuss the therapeutic options and challenges usually seen in the treatment course. From 2006 to 2016, 50 patients with advanced stage (TNM stage of 3 or greater) cutaneous head and neck cancers were included in the study. Patients were evaluated according to demographic data and treatment options. The mean age of patients was 61.4 (26-87), 32 were male and 18 were female. Most common tumor type was squamous cell carcinoma (36 patients), most common localizations were mandible (7 patients) and orbita (6 patients). After tumor ablation, most commonly performed reconstruction was free tissue transfer (31 patients). 38 patients received adjuvant therapy (chemotherapy, radiotherapy or interferon) at the postoperative period. Six patients were lost at following one year period. Head and neck region are more exposed to direct sunlight  than any other body part. Especially advanced stage cutaneous malignancies can be seen in these region due to patient negligence and previous failed treatment attempts. Surgical therapy is long standing option, usually necessitates 3D reconstruction with free flaps and multidisciplinary approach is crucial in the treatment course. Postoperative rehabilitation is complex and demanding process which requires extra patient and family motivation, also must be individualized for each patient.