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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
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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

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