Conclusion
Our study demonstrated, in laCSCC and reCSCC, 50% of patients with parotid metastasis with 32.4% extracapsular parotid metastasis spread; 13.5% overall rate of neck occult metastasis, 51.3% clinical neck metastasis with 37.8% neck extracapsular spread. The risk of positive parotid metastasis evolving into positive neck metastasis was 37.6. The clinical skin T4 tumor and presence of parotid metastasis negatively impacted patient survival; P1 stage resulted in 30% and 5% survival at 5 years and 10 years, respectively. Our outcomes support the surgically aggressive approach for laCSCC and reCSCC, with partial parotidectomy for P0 and total parotidectomy for P1-3 stages and selective neck dissection I-III in all patients.