Distant metastases in head and neck cancer patients who achieved loco-regional control

TLDR

Distant metastases are a key cause of treatment failure in head and neck carcinoma patients who achieve locoregional control. This study aimed to determine the frequency of distant metastases and assess prognostic factors influencing their development in this patient cohort. A retrospective analysis of 1,244 head and neck cancer patients with oral cavity, pharyngeal, or laryngeal tumors who achieved locoregional control was performed using prospectively collected database information. Five percent of these patients developed distant metastases, with N stage, T stage, and tumor location in the hypopharynx or supraglottis identified as independent risk factors, and advanced local and regional extension further increasing the risk.

Abstract

One of the reasons for failure in patients with head and neck carcinoma who achieve locoregional control with treatment is the appearance of distant metastases. The objective of this study was to evaluate the frequency of distant metastases in this group of patients and to determine the relative role of several prognostic factors in the subsequent development of distant metastases.Retrospective study from a database that collects the information prospectively in a cohort of patients with head and neck carcinoma. Patients and Methods The study was carried out in 1244 patients with oral cavity, pharyngeal, or laryngeal carcinoma who achieved locoregional control. We evaluated the frequency of distant metastases and the influence of different variables in their appearance.Five percent of patients with locoregional control had distant metastases. In the univariate study, the variables that influenced the appearance of distant metastases were tumor site, T stage, N stage, and histologic differentiation. On multivariate analysis, the variables that increased the risk of distant metastases were N stage, T stage, and the location of the tumor at the hypopharynx and the supraglottis.Five percent of patients with oral cavity, pharyngeal, or laryngeal carcinomas who achieved locoregional control died as a consequence of the development of distant metastases. The factors that significantly increased the risk of distant metastases in this group of patients were the advanced local and regional extension of the tumor and the location at the hypopharynx or supraglottis.