title: Clinicopathologic analysis and predictive factors for distant metastases in patients with head and neck squamous cell carcinomas.
abstract: BACKGROUND
  The recognition of patients at high risk for the development of distant metastasis (DM) is required to recognize a subset of patients who may benefit from systemic therapy.
  
  
  METHODS
  In a retrospective analysis of patients treated between 1995 and 2006, 443 patients with surgically treated primary head and neck squamous cell carcinoma were included. The frequency and clinicopathologic risk factors for DM were evaluated.
  
  
  RESULTS
  A total of 60 patients (13.5%) developed DM. In a univariate analysis, tumor site (pharynx), pN classification (pN2-N3), differentiation grade (poorly differentiated), disease stage (stage IV), number (3 or more nodes), and site (bilateral nodes) of nodal metastasis were found to be significantly associated with the risk of DM. In a multivariate analysis, the only significant risk factors were the differentiation grade and the number and site of nodal metastasis.
  
  
  CONCLUSIONS
  Patients with pharyngeal poorly differentiated tumors, with multiple or bilateral nodal metastases, are at greater risk of DM and should be considered for systemic therapy.
authors: Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain. acocapelaz@yahoo.es
authors: Andrés
authors: A
authors: Coca-Pelaz
authors: Juan P
authors: JP
authors: Rodrigo
authors: Carlos
authors: C
authors: Suárez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors