title: [Survival with distant metastatic disease in head and neck cancer. A retrospective analysis].
abstract: OBJECTIVE
  The objective of this retrospective analysis was to investigate parameters with a potential impact on survival in a collective of 114 patients with distant metastatic disease after head and neck cancer.
  
  
  METHODS
  The primary endpoint was the survival with distant metastatic disease, the secondary endpoint was overall survival. Primary therapy, local recurrence, second neoplasms, palliative chemotherapy (CHT) and radiotherapy (RT), as well as Karnofsky performance status (KPS) at the time of diagnosis of the metastases were analyzed as potential impact parameters using the log-rank test with subsequent Cox regression analysis.
  
  
  RESULTS
  Palliative CHT (P=0.0020) and KPS (P=0.0011) had a significant positive impact on the median survival probability with metastases (8.2 months) using the log-rank test, KPS at the time of diagnosis of metastases remained as an independent prognostic parameter in the Cox regression (P=0.0013). Primary therapy, local tumor control and KPS had a significant positive influence on the median overall survival probability (18.5 months) univariately (P=0.0139, P=0.0106, P= 0.0096) and multivariately (P=0.0123, and P=0.0063, P=0.0197, respectively).
  
  
  CONCLUSIONS
  KPS at the time of diagnosis of metastases is an independent prognostic parameter for both endpoints. Lacking evidence for life prolongation, palliative therapies should therefore first and foremost focus on the stabilization of the KPS.
authors.affiliation: Klinik für Strahlentherapie, Universität Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg. barbara.dietl@klinik.uni-regensburg.de
authors.forename: B
authors.initials: B
authors.lastname: Dietl
authors.forename: J
authors.initials: J
authors.lastname: Marienhagen
authors.forename: C
authors.initials: C
authors.lastname: Schaefer
authors.forename: F
authors.initials: F
authors.lastname: Pohl
authors.forename: T
authors.initials: T
authors.lastname: Murthum
authors.forename: O
authors.initials: O
authors.lastname: Kölbl
mesh_terms: D005260:Female; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate