Distant Metastases from Oropharyngeal Cancer

Goodwin, W. Jarrard

doi:10.1159/000055745

Cited by 18 publications

(11 citation statements)

References 7 publications

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“…Locoregional control is a well-established predictor for the development of DM in SCC of the oropharynx and other head and neck sites 16–18 but we also found it to be a significant factor for survival with already established DM. The loco-regional control rate was significantly better in the p16-positive group with DM.…”

Section: Discussionmentioning

confidence: 48%

Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: A critical analysis of patterns and outcomes

et al. 2014

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Objective With good loco-regional control, disease failure in p16-positive oropharyngeal squamous cell carcinoma (OPSCC) mainly results from distant metastasis (DM). Our objective was to characterize the patterns and clinical outcomes of DM in p16-positive OPSCC and compare these to patients with p16-negative disease. Methods Primary OPSCC patients who developed DM after completing surgical or non-surgical treatment were identified and p16 status was evaluated. Patterns of DM and post-DM progression-free (PFS) and disease-specific survival (DSS) were assessed. Results Forty-one of the 66 (62%) patients with DM were p16-positive. DM patterns were not statistically different by p16 status. However, p16-positive patients developed DM later in their course and had longer survival. All p16-negative patients either had progression or died within 24 months of DM detection whereas the 2-year post-DM PFS in the p16-positive group was 20% (95% CI:8–32.5%,p=0.003). The 3-year post-DM disease-specific survival (DSS) estimate in the p16-positive patients was 16% (95%CI: 7–18%) while all p16-negative patients died within 34 months (p<0.001). p16-negativity, loco-regional disease, and no/palliative versus curative intent treatment were all associated with reduced post-DM DSS in multivariate analysis. Conclusions The DM pattern did not differ remarkably between p16-positive and negative OPSCC patients in our practice. In p16-positive OPSCC with pulmonary oligometastatic disease, curative intent treatment and optimized locoregional control for the index primary prolonged survival.

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Section: Discussionmentioning

confidence: 48%

Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: A critical analysis of patterns and outcomes

et al. 2014

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“…Head and neck cancer (HNC) is one of the 10 most common malignancies worldwide 1. Previous studies have shown that approximately 20% of patients with HNC have distant metastases and second primary cancers, with lung, bone, and liver being the most frequent distant sites 2–4. HNC is classified according to the TNM staging system, and treatment and prognosis are modified when distant malignancies are present.…”

Section: Introductionmentioning

confidence: 99%

Comparison of whole body positron emission tomography (PET)/PET‐computed tomography and conventional anatomic imaging for detecting distant malignancies in patients with head and neck cancer: A meta‐analysis

Zuo

et al. 2012

The Laryngoscope

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“…It is an aggressive disease with metastasis having been reported in up to 15–20% of cases, with lungs, bone and liver being common sites 2. Although cutaneous metastasis occurs in <1% of patients,3 several large studies (the largest having 100 453 patients) on cutaneous metastasis have shown that up to 9% of all cutaneous metastasis occur from head and neck malignancies, the majority of which were squamous cell carcinoma4—implying that, in cutaneous metastasis from an unknown primary, head and neck malignancies are important primaries to be considered.…”

Section: Discussionmentioning

confidence: 99%

Leukemoid reaction as a paraneoplastic syndrome in hypopharyngeal squamous cell carcinoma with cutaneous metastasis: an exceedingly rare occurrence

Subramaniam

Hiremath

2015

BMJ Case Reports

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SUMMARYHead and neck squamous cell carcinoma is considered a locoregional disease, with a distinct chance of metastasis, however, skin is an unusual site. Haematological paraneoplastic syndromes are even rarer, and may be the only presenting feature in these malignancies, producing diagnostic confusion. Cutaneous metastasis, in addition to signifying poor response to treatment and prognosis, can cause diagnostic difficulty if the metastasis is located with an occult primary, and is associated with a higher incidence of multiple synchronous primaries. This article describes a 52-yearold patient with multiple swellings on the left side of the neck and hoarseness of voice. On evaluation, the multiple swellings were found to be cutaneous metastasis from a hypopharyngeal squamous cell carcinoma, with a leukemoid reaction. He opted for palliative radiotherapy and succumbed to his illness within 3 months of presentation. This article discusses the importance of this unusual presentation and diagnostic difficulties associated with it.

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Distant Metastases from Oropharyngeal Cancer

Cited by 18 publications

References 7 publications

Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: A critical analysis of patterns and outcomes

Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: A critical analysis of patterns and outcomes

Comparison of whole body positron emission tomography (PET)/PET‐computed tomography and conventional anatomic imaging for detecting distant malignancies in patients with head and neck cancer: A meta‐analysis

Leukemoid reaction as a paraneoplastic syndrome in hypopharyngeal squamous cell carcinoma with cutaneous metastasis: an exceedingly rare occurrence

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