title: Distant metastases from head and neck squamous cell carcinomas.
abstract: Distant metastases (DMs) occurred in 83 (11.4%) of 727 retrospectively studied head and neck cancer patients. Primary tumor location and initial treatment did not influence DM development; larger primaries (P < .04) or more extensive neck disease (P < .007) more often caused DMs. Initial diagnosis to DMs averaged 11.7 months (range, 0 to 60 months), with 84% diagnosed within 24 months. With the exception of laryngeal primaries, no facet of tumor, host, or initial treatment influenced where or how rapidly DMs developed. Lung was the most common DM site (83.4%), then bone (31.1%) and liver (6.0%). Survival with DMs averaged 4.3 months (range, 1 day to 2.7 years); 86.7% died within 1 year. This report yields the following conclusions: 1. Initial tumor size and neck disease are the only predictors of DMs. 2. DMs usually occur within 2 years of the initial diagnosis. 3. Lung is the most common DM site, making chest x-ray the most effective DM screen. 4. Survival with DMs is usually less than a year.
authors.affiliation: Department of Otolaryngology, University of Texas Medical Branch, Galveston 77555-0521.
authors.forename: K H
authors.initials: KH
authors.lastname: Calhoun
authors.forename: P
authors.initials: P
authors.lastname: Fulmer
authors.forename: R
authors.initials: R
authors.lastname: Weiss
authors.forename: J A
authors.initials: JA
authors.lastname: Hokanson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies