Journal article
Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer
The Laryngoscope, Vol.131(6), pp.E1838-E1846
06/2021
DOI: 10.1002/lary.29208
PMCID: PMC8896291
PMID: 33098338
Abstract
Investigate the relationship between site and pattern of distant metastasis (DM) and overall survival (OS) in a multi-institutional cohort of patients with DM head and neck cancer (HNC).
Retrospective review.
283 patients treated at 4 academic centers in the Midwest HNC Consortium between 2000 and 2015 were retrospectively reviewed. Disease patterns were divided between solitary metastatic versus polymetastatic (≥2 sites) disease. Survival functions for clinically relevant variables were estimated using Kaplan-Meier and Cox proportional hazards models.
Median OS for all patients was 9.0 months (95% confidence interval [CI]: 7.4-10.6). Lung (n = 220, 77.7%) was the most common site of DM, followed by bone (n = 90, 31.8%), mediastinal lymph nodes (n = 55, 19.4%), liver (n = 41, 14.5%), and brain (n = 17, 6.0%). Bone metastases were independently associated with the worst prognosis (hazard ratio [HR] = 1.6, 95% CI: 1.3-2.1). On univariate analysis, brain metastases were associated with improved prognosis (HR = 0.5, 95% CI: 0.3-0.9), although this was not statistically significant on the multivariate analysis. Polymetastatic disease was present in the majority of patients (n = 230, 81.3%) and was associated with a worse prognosis compared to solitary metastatic disease (HR = 1.4, 95% CI: 1.0-2.0).
Our large, multi-institutional review indicates that both the metastatic pattern and site of DM impact OS. Polymetastatic disease and bone metastasis are associated with worse prognosis, independent of treatment received.
4 Laryngoscope, 131:E1838-E1846, 2021.
Details
- Title: Subtitle
- Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer
- Creators
- Craig A Bollig - Rutgers, The State University of New JerseyChristopher I Newberry - University of UtahTabitha L I Galloway - University of MissouriRobert P Zitsch - University of MissouriElyse K Hanly - University of IowaVivian L Zhu - University of IowaNitin Pagedar - University of IowaRohit Nallani - Department of Otolaryngology–Head and Neck Surgery University of Kansas School of Medicine Kansas City Kansas U.S.A.Andres M Bur - Department of Otolaryngology–Head and Neck Surgery University of Kansas School of Medicine Kansas City Kansas U.S.A.William C Spanos - Sanford HealthJeffrey B Jorgensen - University of Louisville
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.131(6), pp.E1838-E1846
- DOI
- 10.1002/lary.29208
- PMID
- 33098338
- PMCID
- PMC8896291
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Grant note
- R01 DE029524 / NIDCR NIH HHS
- Language
- English
- Date published
- 06/2021
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984312247702771
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