Distant metastases and survival prediction in head and neck squamous cell carcinoma

Abstract

Objective: This study was designed to identify the risk factors associated with distant metastases (DM) and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC).

Study design: Database analysis plus chart review.

Setting: Tertiary care academic medical center.

Subjects and methods: Four hundred four eligible patients were involved who were treated with a minimum 2-year follow-up from January 2005 through August 2009. Confirmation of DM was performed by histopathology or follow-up imaging. Univariate and multivariate analyses were used for factors predictive of DM. The survival of patients was calculated by the Kaplan-Meier method.

Results: Thirty-six of the 404 eligible patients (8.9%) developed DM, most frequently in the lungs (80.6%). Univariate analyses revealed that T and N classifications, lymphovascular invasion and perineural invasion of the primary tumor, and locoregional recurrences were each significantly associated with the development of DM (P < .05). Multivariate analyses showed that T and N classifications and locoregional recurrences were independent predictors of DM (P < .05). The overall 1- and 2-year survival rates of the 36 patients with DMs were 40.6% and 13.5%, respectively. Metastases to more than 1 organ negatively affected patient survival (P < .001).

Conclusion: Patients with advanced tumors, nodal involvement, or locoregional recurrences may require more frequent surveillance for the development of DMs.