Risk Factors for Distant Metastases in Head and Neck Squamous Cell Carcinoma

Abstract

To evaluate the frequency of distant metastases (DM) and to determine the ability of certain clinical and pathologic factors to predict the development of distant metastases. Design: Retrospective analysis. Setting: University hospital. Patients: A total of 1972 patients with oral, oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinomas who were treated from 1981 to 1998 and who were not diagnosed as having DM at the time of initial treatment. Main Outcome Measures: We evaluated the frequency of DM and the influence of different variables in their appearance. Results: A total of 181 patients (9.2%) (95% confidence interval, 7.9%-10.5%) developed DM. Younger age (Ͻ45 years), hypopharyngeal localization, an advanced T stage and/or N stage tumor according to the TNM staging system, high histologic grade, and locoregional control were found to be significantly associated with the risk of DM at both univariate and multivariate analyses. Conclusions: The incidence of DM in subjects with head and neck squamous cell carcinoma is relatively low. The risk of DM is influenced by age, site of primary cancer, local and/or regional extension, grading, and achievement of locoregional control.

Connective Tissue Growth Factor Activates Pluripotency Genes and Mesenchymal–Epithelial Transition in Head and Neck Cancer Cells

“…Both of them will have a worse prognosis than those with high CTGF and low pluripotency factor expression. This finding provides a reasonable explanation for the clinical observation that head and neck cancers severely destruct local tissues but rarely metastasize to distal organs (21). According to our results, we suggest that combining the CTGF and pluripotency gene expression profiles in HNSCC will be a better prognostic indicator than an individual marker.…”

“…Head and neck squamous cell carcinoma (HNSCC), including cancers originating in the oral cavity, oropharynx, hypopharynx, and larynx, is one of the leading causes of cancer-related death worldwide. Local progression and lymph node involvement are the major causes of HNSCC-related mortality and the incidence of distal organ metastasis is relatively rare compared with other cancers (21). However, the mechanism responsible for the local progression of HNSCC is unclear.…”

Comparison between computed tomography and clinical evaluation in tumour/node stage and follow-up of oral cavity and oropharyngeal cancer

“…[1][2][3] Although significant improvements in head and neck cancer therapy have been observed over the last decades, some authors have stated that the final survival rates were not significantly influenced by the advent of new approaches. 4,5 On the other hand, in some documented cases, the estimated survival rates have shown remarkably good results with pre-operative chemoradiotherapy (CRT) and radical surgery. 6 However, these findings are based on data from a large proportion of studies using consecutive patient series.…”

Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer

“…Where possible, the risk of occult lymph node metastases or residual disease following treatment should be controlled by neck dissection. Meanwhile, patients with advanced N stage are at high-risk for distant metastases [17][18][19], and this had an impact on our results. We observed a significant difference in overall survival between patients with N0-1 stage and those with N2b-3 stage (Figure 2).…”