A Clinical Study of Distant Metastases in Head and Neck Cancer

Kim, Byung Kook; Jeong, Jin Uk; Park, Chan Il; Rha, Ki Sang; Nam, Boo Hyun

Abstract

BACKGROUND AND OBJECTIVES: There are many failed cases with distant metastases (DMs) of head and neck cancer. In such cases, patients usually have poor prognosis, with a median duration of survival between 4 and 6 months. To find out the correlation between the general clinical aspects and distant metastases in patients with head and neck cancer, we analyzed our previous experiences. MATERIALS AND METHOD: We reviewed records retrospectively in 41 of 460 patients with head and neck cancers from 1986 to 1995. DMs were confirmed with X-ray, CT, MRI, liver scan, FNAC, PCNA, and biopsy. We used the staging system of American Joint Committee on Cancer.
RESULTS
1) Clinically manifested DMs were found in 8.9% (41/460) of patients. 2) DMs were frequently observed in the oropharynx (13.8%), oral cavity (11.4%), and larynx (10.3%) cancer. 3) The lung is the most common site of DMs for head and neck cancer. Liver and bone are the only other sites of DMs that are commonly clinically diagnosed. 4) DMs usually occur within 2 years of the initial diagnosis. 5) The incidence of DMs was significantly higher in the advanced T, N stages and clinical stage than in the early T, N stages and clinical stage (p<0.05).
CONCLUSION
The results of this study suggest that the advanced T, N stages and clinical stage may be some of the most critical factors influencing the eventual development of DMs.