title: Curative treatment can be an option for patients with metastatic squamous cell cancer of the head and neck.
abstract: BACKGROUND
  No specific study has focused on patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) at diagnosis. Due to high response rates of induction chemotherapy in chemo-naïve patients with localized disease, their prognosis should be better than patients with recurrent disease.
  
  
  METHODS
  From January 1, 2008 to July 1, 2012, we retrospectively collected all patients' records with SCCHN diagnosed as metastatic. Patients, disease, treatment and its results were analyzed. Survival was calculated using the Kaplan-Meier method.
  
  
  RESULTS
  Of the 749 new patients treated for SCCHN in our institution, 16 (2.1%) were metastatic at diagnosis, of whom five had cytological results to prove it. Six patients died before treatment or had palliative care and ten received initial chemotherapy and then surgery and/or radiotherapy according to the primary response. Four patients treated with first-line chemotherapy with docetaxel-5FU-cisplatin (TPF) showed a complete response of metastatic lesions allowing locoregional treatment. The overall survival at 1 year and 3 years was 50% and 24%, respectively. The median survival was 7 months (1-72 months). Seven patients (43.7%) had a higher survival at 12 months, including five (31.5%) who are still alive without recurrence with a mean follow-up of 30 months. There was a significant difference in overall survival (P<0.01) between patients who had chemotherapy with TPF versus other therapeutic protocols. The median survival of patients with lung metastases only was 15 months (1-72 months), significantly higher than that of patients with liver and/or bone localizations, which was 2 months (1-9 months).
  
  
  CONCLUSIONS
  Patients with metastatic SCCHN treated by TPF followed by multimodal treatment could achieve long survival.
authors.affiliation: Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Guenne
authors.affiliation: Medicine Department, Lyon-I University, Centre Léon Bérard, Lyon, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Fayette
authors.affiliation: Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cosmidis
authors.affiliation: Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Fuchsmann
authors.affiliation: Medical Oncology Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Tartas
authors.affiliation: Radiotherapy Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Favrel
authors.affiliation: Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Céruse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: TPF; cetuximab; head and neck; metastases; squamous cell carcinoma