Survival After Distant Metastasis in Head and Neck Cancer

In addition to locoregional recurrence distant metastases can limit the survival of patients with head and neck cancer. The aim of the study was to analyze survival after distant metastasis of head and neck cancer.

Patients with head and neck cancer and M0 status at initial diagnosis, who were treated with curative intent but developed distant metastases without synchronous locoregional recurrence were analyzed. Predictors for the duration of survival were evaluated using Cox regression analysis.

A total of 46 patients developed distant metastases which were detected after a mean time of 16 months, most were lung (59%) and bone metastases (24%). The most common therapy for distant metastasis was palliative chemotherapy; due to poor general condition, 21% of patients were treated with best supportive care. The mean survival was 7.5 months, the overall survival at 1 and 2 years after diagnosis of distant metastasis were 40.4% and 26.2%, respectively. Regression analysis showed no significant predictors for prolonged survival, however, the three patients surviving at the time of data collection were treated by surgical resection of solitary metastases.

In cases of distant metastases, due to poor prognosis of the patients, palliation is important and the treatment approach should be chosen taking into account the general condition of the patient. In individual cases, resection of solitary metastases may be useful.