title: Utility of Surgery/Radiotherapy in Distant Metastatic Head and Neck Squamous Cell Carcinoma: A Population-Based Approach.
abstract: The aim of this study is to analyze the survival benefits of surgery and/or radiation therapy over no therapy in patients with metastatic (M1) squamous cell carcinoma of the head and neck region (HN-SCC).
  
  
  
  Retrospective administrative database analysis.
  
  
  
  The Surveillance, Epidemiology, and End Results (SEER) database was queried for M1 HN-SCC cases from 1988 to 2012 (6663 patients). Patient demographics, initial treatment, and survival outcomes were analyzed. Survival was analyzed with the Kaplan-Meier model.
  
  
  
  Of the 6663 patients identified with M1 HN-SCC in the SEER database, 1669 patients received no therapy; 2459 patients, radiotherapy; 570 patients, surgery; and 1100 patients, surgery with adjuvant radiotherapy. The mean survival was 8.44 months for patients who did not undergo any therapy. In comparison, patients who underwent radiotherapy alone, surgery alone, or surgery with radiotherapy had mean survivals of 18.03 (P < .0001), 31.07 (P < .0001), and 39.93 (P < .0001) months, respectively. The 5-year disease-specific survival rates were 6.35% for no therapy, 17.51% for radiotherapy alone, 30.50% for surgery alone, and 33.75% for surgery with radiotherapy (P < .0001). Site-specific analysis revealed that surgery and/or radiation provides disease-specific survival benefit as compared with no therapy at all subsites within the head and neck region.
  
  
  
  Surgery and/or radiation-which has been shown to improve quality of life in patients with advanced cancer-is associated with an increased survival when utilized in patients with distant metastatic disease.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Tapan D
authors.initials: TD
authors.lastname: Patel
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Marchiano
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Oliver Y
authors.initials: OY
authors.lastname: Chin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Suat
authors.initials: S
authors.lastname: Kilic
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA cwp39@njms.rutgers.edu.
authors.forename: Richard Chan Woo
authors.initials: RC
authors.lastname: Park
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011788:Quality of Life; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Epidemiology; M1; Surveillance; and End Result (SEER) database; epidemiology; head and neck; metastasis; squamous cell carcinoma; survival; treatment