The future of head and neck surgery

General Considerations on Distant Metastases from Head and Neck Cancer

“…It also has the merit of objectivity. The quality of that survival is the other important factor but is not easy to assess [11]. It is also interesting that survival is at the top of the list when patients are asked to rank the issues that are most important after treatment of head and neck cancer [12].…”

“…Survival is related both to control of primary tumor and prevention of the development of distant metastases. The proportion of deaths from locoregional disease may have fallen but is offset by the 'long-term' occurrence of distant metastases particularly in supraglottic and pharyngeal cancer [11]. In addition, a high proportion of patients with distant metastases also have persistent or recurrent locoregional disease.…”

Metastasis of Head and Neck Squamous Cell Carcinoma

“…Distant metastases are particularly important in supraglottic laryngeal and pharyngeal cancers (Buckley, 2000). Factors which favor the development of metastases include the primary tumor's ability to activate oncogenes, downregulate tumor suppressor genes, express cell-surface adhesion molecules, synthesize and respond to autocrine and paracrine growth and motility factors, secrete proteases, and produce angiogenic and immunosuppressive cytokines.…”

Surgical Management of Head and Neck Cancer: The Next Decade

“…There are scienti c and clinical reasons for this paradigm (11). Pathologic studies have demonstrated that the pattern of metastasis to different levels in the neck is predictable (5,12) and, for most sites of the head and neck, level V metastases are extremely infrequent, in particular in the absence of metastases in other levels.…”