Incidence and Risk Factors of Distant Metastases of Head and Neck Carcinoma

Head and neck carcinomas are characterized by frequent metastases to cervical lymph nodes and locoregional recurrence. By contrast, distant metastases (M1) are seldom detected.

This study retrospectively analyzed patients with head and neck cancer who were treated at the Department of Otorhinolaryngology of F. D. Roosevelt Faculty Hospital in Banska Bystrica in 2011-2017. M1 incidence, localization, and risk factors were determined, as well as time to development of M1, methods of M1 diagnosis, and patient survival.

M1 was diagnosed in 50 (10.5%) of 474 patients and was significantly more frequent in patients with oropharyngeal cancer, more extensive primary tumors (T3 and T4 status), nodal disease (N2 and N3 status), and poorly differentiated carcinomas. M1 was most often detected in the lungs (59%) and skeleton (47%). M1 was detected by computed tomography (CT) scans in 84% of patients and by, positron emission tomography/CT (PET/CT) in 12%. Mean patient survival was 10.4 ± 3.5 months, with two patients being in remission.

M1 is detected most frequently by CT scans. PET/CT screening is indicated in patients with risk factors, including metastases to 3 lymph nodes or bilateral lymph nodes, lymph nodes >6 cm, low jugular lymph node metastases, or regional recurrence. Curative treatment is possible for patients with good performance status, solitary M1, and locoregional remission. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 22. 2. 2019 Accepted: 30. 5. 2019.