Distant metastases after definitive radiotherapy for squamous cell carcinoma of the head and neck.
OBJECTIVE
To analyze parameters that influence the risk of distant metastases after definitive radiotherapy.


METHODS
Between 1983 and 1997, 873 patients were treated with definitive radiotherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate risk factors that might influence the risk of distant metastases.


RESULTS
The 5-year distant metastasis-free survival rate was 86%. Univariate analyses revealed that the risk of distant metastases was significantly influenced by gender (p =.0092), primary site (p =.0023), T stage (p <.0001), N stage (p <.0001), overall stage (p <.0001), level of nodal metastases in the neck (p <.0001), histologic differentiation (p =.0096), control above the clavicles (p <.0001), and time to locoregional recurrence (p <.0001). Multivariate analysis of freedom from distant metastases revealed that gender (p =.0390), T stage (p <.0001), N stage (p =.0060), nodal level (p <.0001), and locoregional control (p <.0001) significantly influenced this end point. Multivariate analysis revealed that gender (p =.0049), T stage (p <.0001), N stage (p <.0001), and locoregional control (p <.0001) significantly influenced cause-specific survival.


CONCLUSIONS
The risk of distant metastases after definitive radiotherapy is 14% at 5 years and is significantly influenced by gender, T stage, N stage, nodal level, and locoregional control.
Al-Othman
Majid O F
MO
Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, Gainesville, Florida 32608, USA.
Morris
Christopher G
CG
Hinerman
Russell W
RW
Amdur
Robert J
RJ
Mendenhall
William M
WM
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis