Abstract
Purpose
While metastases directed therapy for oligometastatic disease is recommended in different cancer entities, the treatment of solitary metastases in head and neck squamous cell carcinoma (HNSCC) patients is not clearly defined.
Methods
A retrospective analysis was performed on data from 143 HNSCC patients treated between 2001 and 2016 in a tertiary university hospital. Clinical factors and outcome were measured using the median survival of patients receiving metastases specific therapy in comparison with matched control patients.
Results
In 37 patients, distant metastases were treated specifically with either surgery and/or stereotactic ablative radiotherapy and had with 23.97 months a more than three times higher median survival than 10 untreated matched controls with potentially treatable distant metastases (7.07 months).
Conclusions
Our retrospective analysis demonstrates a significant survival benefit for HNSCC patients who received a specific therapy regarding distant metastasis irrespective of localization as compared to a matched control cohort.
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References
Parkin DM et al (2005) Global cancer statistics, 2002. CA Cancer J Clin 55(2):74–108
Bernier J et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350(19):1945–1952
Argiris A et al (2008) Head and neck cancer. Lancet 371(9625):1695–1709
Vermorken JB, Specenier P (2010) Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol 21(Suppl 7):vii252-61
National Comprehensive Cancer Network (2016) NCCN clinical practice guidelines in oncology head and neck cancers (Version 1.2016). https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed 23 Sept 2016
Reyes DK, Pienta KJ (2015) The biology and treatment of oligometastatic cancer. Oncotarget 6(11):8491–8524
Hellman S, Weichselbaum RR (1995) Oligometastases. J Clin Oncol 13(1):8–10
Weichselbaum RR, Hellman S (2011) Oligometastases revisited. Nat Rev Clin Oncol 8(6):378–382
Simmonds P et al (2006) Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer 94(7):982–999
Mahmoud N, Bullard K, Dunn (2010) Metastasectomy for stage IV colorectal cancer. Dis Colon Rectum 53(7):1080–1092
Fiorentino F et al (2010) Pulmonary metastasectomy in colorectal cancer: a systematic review and quantitative synthesis. J R Soc Med 103(2):60–66
Young ER et al (2015) Resection of subsequent pulmonary metastases from treated head and neck squamous cell carcinoma: systematic review and meta-analysis. Clin Otolaryngol 40(3):208–218
Florescu C, Thariat J (2014) Local ablative treatments of oligometastases from head and neck carcinomas. Crit Rev Oncol Hematol 91(1):47–63
Mehanna H et al (2010) Head and neck cancer—Part 2: treatment and prognostic factors. BMJ 341(c4690):721–725
Baatenburg de Jong RJ et al (2001) Prediction of survival in patients with head and neck cancer. Head Neck 23(9):718–724
Khanfir A et al (2007) Prognostic factors in metastatic nasopharyngeal carcinoma. Cancer/Radiothérapie 11(8):461–464
Tian YH et al (2016) Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: a subset with better overall survival. Head Neck 38(8):1152–1157
Yucel B et al (2015) The negative prognostic impact of bone metastasis with a tumor mass. Clinics (Sao Paulo) 70(8):535–540
Han K-R et al (2003) Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma. Urology 61(2):314–319
Nakajima Y et al (2017) Surgical treatment for pulmonary metastasis of head and neck cancer: study of 58 cases. Ann Thorac Cardiovasc Surg 23(4):169–174
Yotsukura M et al (2015) Survival predictors after resection of lung metastases of head or neck cancers. Thorac Cancer 6(5):579–583
Onishi H et al (2011) Stereotactic body radiotherapy (SBRT) for operable stage I non-small-cell lung cancer: can SBRT be comparable to surgery? Int J Radiat Oncol Biol Phys 81(5):1352–1358
Comito T et al (2015) Liver metastases and SBRT: a new paradigm? Rep Pract Oncol Radiother 20(6):464–471
Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84(1):324–338
Khatri VP, Petrelli NJ, Belghiti J (2005) Extending the frontiers of surgical therapy for hepatic colorectal metastases: is there a limit? J Clin Oncol 23(33):8490–8499
Shinohara T et al (2015) Survival benefit of surgical treatment for liver metastases from gastric cancer. J Gastrointest Surg 19(6):1043–1051
Acknowledgements
The authors gratefully acknowledge Armin Ott from the Institute for Medical Statistics and Epidemiology at Technical University of Munich for his advice on the statistical analysis.
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All authors have no conflicts of interest.
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Only routine clinical data were retrospectively collected from patients’ charts and pseudonymously analyzed, and therefore, no formal ethical approval was obtained. We declare that all authors have contributed to read and approved the final manuscript for submission.
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Dominik Schulz and Markus Wirth contributed equally to this manuscript.
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Schulz, D., Wirth, M., Piontek, G. et al. Improved overall survival in head and neck cancer patients after specific therapy of distant metastases. Eur Arch Otorhinolaryngol 275, 1239–1247 (2018). https://doi.org/10.1007/s00405-018-4920-9
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DOI: https://doi.org/10.1007/s00405-018-4920-9