Hasmat S, Ebrahimi A, Luk PP, et al. - In this multicenter analysis, researchers evaluated how survival in head and neck cutaneous squamous cell carcinoma (HNcSCC) with lymph node metastases has changed over time. The study sample consisted of 1,301 patients with metastatic HNcSCC treated between 1980 and 2017. Using multivariate Cox regression, differences in disease-specific survival (DSS) and overall survival (OS) by decade were evaluated. The authors observed a rise in the proportion of patients over 80 years of age and of those who were immunosuppressed over the research period. There was a decline in risk of cancer-related mortality from 0.47 in 1990-1999 to 0.30 in 2000-2009 vs 1980-1989, after adjusting for number and size of metastatic nodes, extranodal extension, perineural invasion, immunosuppression, treatment, and institution. In 2010-2017, this stayed stable at 0.30, and after 1990, OS stayed stable. Fewer patients die from metastatic HNcSCC even with an aging and more often immunosuppressed population.