Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T08:08:01.987Z Has data issue: false hasContentIssue false
  • English
  • Français

Distant metastases in terminal head and neck cancer patients

Published online by Cambridge University Press:  29 June 2007

Yoav P. Talmi ,
Daniel Cotlear ,
Alexander Waller ,
Zeev Horowitz ,
Abraham Adunski ,
Yehuda Roth  and
Jona Kronenberg
Yoav P. Talmi*
Affiliation:
Departments of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Daniel Cotlear
Affiliation:
Departments of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Alexander Waller
Affiliation:
Department of Tel-Hashomer Hospice, The Chaim Sheba Departments Medical Center, Tel Hashomer, Israel.
Zeev Horowitz
Affiliation:
Departments of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Abraham Adunski
Affiliation:
Department of Geriatrics, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Yehuda Roth
Affiliation:
Departments of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Jona Kronenberg
Affiliation:
Departments of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
*
Address for correspondence: Yoav P. Talmi, M.D., The Chaim Sheba Medical Center, Tel Hashomer, Israel52621. Fax: 972-3-5346515
Get access Rights & Permissions [Opens in a new window]

Abstract

With improved control of cancer above the clavicles, distant metastases (DM) are frequently more seen and are becoming a more common cause of morbidity and mortality. The present study defined the incidence of distant metastases in a cohort of terminal head and neck cancer patients (HNCP) and compared it to current reported data. The incidence of distant metastases in relation to the primary tumour was evaluated and their impact on survival was assessed. A retrospective survey of patient charts was made, based on the hospice database and original referring hospital charts. Data of 59 patients admitted to the hospice were evaluated. The incidence and location of locoregional and distant disease were studied and effects on survival analyzed.

The overall survival from diagnosis to demise was 42.7 months. Thyroid cancer was seen in 20.3 per cent of cases and squamous cell cancer was seen in 59.3 per cent. Distant metastases were found in 83 per cent and 48.6 per cent of patients respectively. Laryngeal cancer patients had a 54.5 per cent incidence of distant metastases. Locoregional disease was seen in 47 per cent of cases and 35.7 per cent of them had distant metastases while a 64.3 per cent incidence of distant metastases was found in cases without locoregional disease. Mean survival was 47.3 months with distant metastases vs 36.5 months without metastases. The difference was not statistically significant.

The incidence of distant metastases in squamous cell cancer in terminalHNCP was 48.6 per cent. This is the highest reported incidence of metastases in a clinical series. Patients without locoregional disease had almost a two-fold incidence of metastases. Survival was not affected by metastases in this series.

Keywords

Head and neck neoplasmsNeoplasm metastasis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 5 , May 1997 , pp. 454 - 458
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramson, A. L., Parisier, S. C., Zamansky, M. J., Sulka, M. (1971) Distant metastases from carcinoma of the larynx. Laryngoscope 81: 1503–1511.CrossRefGoogle ScholarPubMed
Beahrs, O. H., Henson, D. E., Hutter, R. V. P., Kennedy, B. J. (1992) AJCC (American Joint Committee on Cancer) Manual for stagingof cancer. 4th Edition, J. P. Lippincott. Chicago.Google Scholar
Bhatia, R., Bahadur, S. (1987) Distant metastases in malignancies of the head and neck. Journal of Laryngology and Otology 101: 925–928.CrossRefGoogle ScholarPubMed
Braund, R.R., Martin, H. E. (1941) Distant metastasis in cancer of the upper respiratory and alimentary tracts. Surgery Gynecology and Obstetrics 73: 63–71.Google Scholar
Calhoun, K. H., Fulmer, P., Weiss, R., Hokanson, J. A. (1994) Distant metastases from head and neck squamous cell carcinomas. Laryngoscope 104: 1199–1205.CrossRefGoogle ScholarPubMed
Crile, G. W. (1906) Excision of cancer of the head and neck. Journal of the American Medical Association 47: 1780–1786.CrossRefGoogle Scholar
Crile, G. W. (1923) Carcinoma of the jaws, tongue, cheek and lips. Surgery Gynecology and Obstetrics 36: 159–162.Google Scholar
Dennington, M. L., Carter, D. R., Meyers, A. D. (1980)Distant metastases in head and neck epidermoid carcinoma. Laryngoscope 90: 196–201.CrossRefGoogle ScholarPubMed
Dorrance, G. M., McShane, J. K. (1928) Cancer of the tongue and floor of mouth. Annals of Surgery 88: 1007–1021.CrossRefGoogle Scholar
Farr, H. W., Arthur, K. (1972) Epidermoid carcinoma of the mouth and pharynx 1960–1964. Journal of Laryngology and Otology 86:243–253.CrossRefGoogle ScholarPubMed
Gowen, G. F., deSuto-Nagy, G. (1963) The incidence and sites of distant metastases in head and neck carcinoma. Surgery Gynecology and Obstetrics 116: 603–607.Google ScholarPubMed
Kotwall, C., Sako, K., Razack, M. S., Rao, U., Bakamjian, V., Shedd, D. P. (1987) Metastatic patterns in squamous cell cancer of the head and neck. American Journal of Surgery 154: 439–442.CrossRefGoogle ScholarPubMed
Leibel, S. A., Scott, C. B., Mohiuddin, M., Marcial, V. A., Coia, L. R., Davis, L. W., Fuks, Z. (1991) The effect of local-regional control on distant metastatic dissemination in carcinoma of the headand neck: results of an analysis from the RTOG head and neck database. Intern ational Journal of Radiation Oncology, Biology and Physics 21: 549–556.CrossRefGoogle Scholar
Merino, O. R., Lindberg, R. D., Fletcher, G. H. (1977)An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 40: 145–151.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Nishijima, W., Takooda, S., Tokita, N., Takayama, S.,Sakura, M. (1993) Analyses of distant metastases in squamous cell carcinoma of the head and neck and lesions above the clavicle at autopsy. Archives of Otolaryngology, Head and Neck Surgery 119: 65–68.CrossRefGoogle ScholarPubMed
O'Brien, P. H., Carlson, R., Steubner, E. A. Jr., Staley, C. T. (1971) Distant metastases in epidermoid cell carcinoma of the head and neck. Cancer 27: 304–307.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Papac, R. J. (1984) Distant metastases from head and neck cancer. Cancer 53: 342–345.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Peltier, L. F., Thomas, L. B., Barclay, T. H. S., Kremen, A. J. (1951) The incidence of distant metastases among patients dying with head and neck cancers. Surgery 30: 827–833.Google ScholarPubMed
Probert, J. C., Thompson, R. W., Bagshaw, M. A. (1974)Patterns of spread of distant metastases in head and neck cancer. Cancer 33: 127–133.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Rubenfeld, S., Kaplan, G., Holder, A. (1962) Distant metastases from head and neck cancer. American Journal of Roentgenology 87: 441–448.Google Scholar
Slotman, G. J., Mohit, T., Raina, S., Swaminathan, A. P., Ohanian, M., Rush, B. F. (1984) The incidence of metastases after multimodal therapy for cancer of the head and neck. Cancer 54: 2009–2014.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Talmi, Y. P., Roth, Y., Waller, A., Chesnin, V., Adunski, A., Lander, M. I., Kronenberg, J. (1995) Care of the terminal head and neck cancer patient in the hospice setting. Laryngoscope 105: 315–318.CrossRefGoogle ScholarPubMed
Troell, R. J., Terris, D. J. (1995) Detection of metastases from head and neck cancers. Laryngoscope 105: 247–250.CrossRefGoogle ScholarPubMed
Vikram, B. (1984) Changing patterns of failure in advanced head and neck cancer. Archives of Otolaryngology 110: 564–565.CrossRefGoogle ScholarPubMed
Vikram, B., Strong, E. W., Shah, J. P., Spiro, R. (1984) Failure at distant sites following multimodality treatment for advanced head and neck cancer. Head and Neck Surgery 6: 730–733.CrossRefGoogle ScholarPubMed
Weber, P. C., Johnson, J. T., Myers, E. N. (1994) The impact of bilateral neck dissection on pattern of recurrence and survival in supraglottic carcinoma. Archives of Otolaryngology, Head and Neck Surgery 120: 703–706.CrossRefGoogle ScholarPubMed
Zbaren, P., Lehmann, W. (1987) Frequency and sites of distant metastases in head and neck squamous cell carcinoma. An analysis of 101 cases at autopsy. Archives of Otolaryngology, Head and Neck Surgery 113: 762–764.CrossRefGoogle ScholarPubMed