Survival impact of pulmonary metastasectomy for patients with head and neck cancer

Head Neck. 2013 Dec;35(12):1745-51. doi: 10.1002/hed.23232. Epub 2013 Mar 6.

Abstract

Background: The purpose of this study was to evaluate the survival impact and prognostic factors of pulmonary metastasectomy in patients with pulmonary metastasis from head and neck cancer.

Methods: A retrospective study of 69 patients was analyzed. Twenty-four patients (35%) underwent pulmonary metastasectomy, and the remaining 45 patients (65%) were treated with chemotherapy or best supportive care.

Results: The 1-year overall survival (OS) of 69 patients was 28%. Pulmonary metastasectomy (p = .01) and histology (p < .001) had a significant impact on the prognosis. One-year OS of patients who underwent metastasectomy and those who did not was 90% and 35%, respectively. In the metastasectomy group, recurrence of primary ahead of lung metastasis (p = .006) and disease-free interval (DFI; ≤21.4 months; p = .046) were significant negative prognostic factors.

Conclusion: Pulmonary metastasectomy has an impact on survival in carefully selected patients, especially for those with a long DFI and with no recurrence of primary cancer ahead of lung metastasis.

Keywords: head and neck cancer; pulmonary metastasis; surgical treatment prognostic factors.

MeSH terms

  • Adenoma / mortality
  • Adenoma / pathology
  • Adenoma / therapy
  • Antineoplastic Agents / therapeutic use
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / secondary
  • Carcinoma / therapy
  • Cisplatin / therapeutic use
  • Docetaxel
  • Female
  • Fluorouracil / therapeutic use
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Histiocytoma, Malignant Fibrous / mortality
  • Histiocytoma, Malignant Fibrous / pathology
  • Histiocytoma, Malignant Fibrous / secondary
  • Histiocytoma, Malignant Fibrous / therapy
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Male
  • Metastasectomy*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local
  • Pneumonectomy
  • Prognosis
  • Retrospective Studies
  • Taxoids / therapeutic use
  • Thoracotomy

Substances

  • Antineoplastic Agents
  • Taxoids
  • Docetaxel
  • Cisplatin
  • Fluorouracil