In spite of aggressive treatment with combined modalities, regional and distant metastases are one of the major causes of failure in management of the advanced head and neck cancers.
Even though the incidence of distant metastasis is low, the prognosis is very grave in most of the cases because treatment modalities are restricted.
Most of distant metastases are detected within two years after curative treatment and are related to the characteristics of primary cancers: 1) clinical stages 2) histologic types and grades 3) status of lymph node metastases 4) locoregional
recurrences.
Authors analyzed the 15 cases of distant metastases in the head and neck squamous cell carcinoma that were followed up after initial treatment for the last six years.
@ES The results were as follows:
@EN 1) Distant metastasis was significantly more frequent, with the primary sites of supraglottic larynx, tongue, and nasopharynx(p<0.05).
2) The incidence of distant metastasis was increased with poorer differentiation of pathology, extracapsular invasion of the involved lymph node, and advanced clinical stage. But it was not statistically significant(p>0.05).
3) Locoregional recurrence was frequently related to distant metastasis. But it was not statistically significant(p>0.05).
4) Initial treatment modality did not affect the incidence of distant metastasis.
5) The curative management of distant metastasis failed in 93.3% of cases, and the duration of mean survival was 11.6±6.9 months,
These results suggest that prevention by comprehensive management of primary cancers, and early detection of distant metastasis by lose follow-up are important in management of advanced head and neck cancers.
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