title: [Distant metastases in head and neck cancer].
abstract: BACKGROUND
  The presence of distant metastasis (DM) after the initial treatment of head and neck squamous cell carcinoma (HNSCC) is not considered a common event and it is associated to a poor outcome.
  
  
  OBJECTIVE
  To investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in SCC.
  
  
  METHODS
  A retrospective study of 633 patients with HNSCC to describe the clinical characteristics of the DM.
  
  
  RESULTS
  During the follow-up period after the initial treatment, 6.2% of the patients were diagnosed of having distant metastasis. The site of primary tumor was hypopharynx in 14.4%, unknown origin in 11.8% and oropharynx in 8.5%. The most common sites of DM were the lungs (58%) and the bone (22%). Three year overall survival in patients with DM was 2.5% (versus 49,5% in the control group).
  
  
  CONCLUSIONS
  This study confirms that DM have an adverse impact in survival. There is a need of guidelines for screening of distant metastases in patients with HNSCC in order to get an early diagnosis and a more effective treatment. Because of the poor prognosis of DM, protocols including adjuvant chemotherapy should be investigated.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Valle del Nalón, Riañ-Langreo. alvarezmarcos@telefonica.net
authors.forename: C A
authors.initials: CA
authors.lastname: Alvarez Marcos
authors.forename: J L
authors.initials: JL
authors.lastname: Llorente Pendás
authors.forename: V
authors.initials: V
authors.lastname: Franco Gutiérrez
authors.forename: M
authors.initials: M
authors.lastname: Hermsen
authors.forename: M P
authors.initials: MP
authors.lastname: Cuesta Albalad
authors.forename: H
authors.initials: H
authors.lastname: Fernández Espina
authors.forename: C
authors.initials: C
authors.lastname: Suárez Nieto
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary*; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D012189:Retrospective Studies; D015996:Survival Rate