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KMID : 0356820110270020177
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Korean Journal of Head & Neck Oncology
2011 Volume.27 No. 2 p.177 ~ p.182
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Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy
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Lee Hye-Won
Baek Dong-Hoon
Lee Kyung-Nam
Jo Eun-Jung
Kim Hyo-Jeong
Seol Young-Mi
Song Moo-Kon
Choi Young-Jin
Shin Ho-Jin
Chung Joo-Seop
Cho Goon-Jae
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Abstract
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Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy.
Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis.
Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis.
Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.
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KEYWORD
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Distant metastasis, Head and neck, Neutropenia, Nodal stage
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