title: Squamous cell cancer of the head and neck with distant metastasis at presentation.
abstract: BACKGROUND
  Current literature reports widely different rates of distant metastasis at presentation for squamous cell carcinoma of the head and neck (SCCHN). We used the Surveillance Epidemiology and End Results (SEER) database to determine the rate of and risk factors for distant metastasis.
  
  
  METHODS
  We identified patients with SCCHN diagnosed between 1988 and 2003. The rate of distant metastasis was determined and then stratified by tumor site, size, and nodal status. To evaluate the contribution of each individual factor, both univariate and multivariate analyses were performed.
  
  
  RESULTS
  Among 73,247 patients identified, 2066 patients (2.82%, 95% confidence interval [CI] 2.70-2.94%) had distant metastasis. Independent risk factors for distant metastasis included primary site, nodal status, tumor size, age, and race.
  
  
  CONCLUSIONS
  In SCCHN, there is a relationship between the risk of distant metastasis and tumor site, size, and nodal status. This information can be used to guide the evaluation and treatment of SCCHN.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, John Cochran Veterans Administration Medical Center, St. Louis, Missouri, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Kuperman
authors.forename: Vorachart
authors.initials: V
authors.lastname: Auethavekiat
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Adkins
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
authors.forename: Sharon
authors.initials: S
authors.lastname: Collins
authors.forename: Chaiyaporn
authors.initials: C
authors.lastname: Boonchalermvichian
authors.forename: Kathryn
authors.initials: K
authors.lastname: Trinkaus
authors.forename: Ling
authors.initials: L
authors.lastname: Chen
authors.forename: Daniel
authors.initials: D
authors.lastname: Morgensztern
mesh_terms: D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D044469:Racial Groups; D012042:Registries; D012307:Risk Factors; D018426:SEER Program; D014481:United States / Q000453:epidemiology