Factors influencing survival in head and neck patients with giant cervical lymph node metastasis

Giant cervical lymph node metastasis originating from head and neck epidermoid carcinoma has traditionally indicated a poor prognosis. However, some patients with stage IV disease may live many years. In order to identify factors which might contribute to long-term survival, a retrospective analysis of 94 patients with head and neck squamous cell carcinoma and metastatic cervical lymph nodes greater than 4 cm was performed. At the time of study, 15 patients were alive; 62 of the remaining 79 patients had died due to related causes. Of the 15 survivors, mean survival time was 10.3 years, and the determinate five-year or greater survival rate was 20%. In contrast, mean survival of the 62 determinate nonsurvivors was 1.4 years. Recommended treatment for stage IV head and neck cancer patients with giant cervical lymph nodes consists of preoperative radiation therapy followed by wide-field en bloc resection.