Long-term survival in patients with metastatic head and neck squamous cell carcinoma treated with metastasis-directed therapy.

Abstract

BACKGROUND:

Our objective was to evaluate the outcomes of metastatic head and neck squamous cell carcinoma (HNSCC) by disease burden with an emphasis on metastasis-directed therapy (MDT) in patients with limited metastatic disease burden.

METHODS:

In total, 186 patients who developed metastatic disease after definitive therapy for HNSCC were included. Clinically and radiographically apparent metastases were enumerated. Kaplan-Meier methods were used to estimate survival. Cox regression was used to assess the association between clinical variables.

RESULTS:

Patients with a single metastasis had a 5-year overall survival (OS) of 35% (95% CI 16-54%) in contrast to patients with multiple metastases with a 5-year OS of 4% (95% CI 2-9%). Thirty patients (16.1%) underwent MDT. On multivariable analysis, oral cavity or sinonasal primary (HR 2.22 95% CI 1.16-4.25, p = 0.015; HR 4.88, 95% CI 1.10-21.70, p = 0.037, respectively) were associated with higher risk of death, whereas receipt of MDT (HR 0.36, 95% CI 0.17-0.74, p = 0.006) was associated with lower hazard of death. Median subsequent metastasis-free survival and 5-year survival after MDT (n = 30) were estimated at 26.4 months (95% CI: 9.8-54.0) and 31%, (95% CI: 15-48%).

CONCLUSIONS:

HNSCC patients with limited metastatic disease may derive significant benefit from MDT. Prospective trials evaluating MDT in HNSCC are warranted.

• Authors: Thomas H Beckham, Jonathan E Leeman, Peng Xie, Xiaolin Li, Debra A Goldman, Zhigang Zhang, Eric Sherman, Sean McBride, Nadeem Riaz, Nancy Lee, C Jillian Tsai
• Journal: British journal of cancer (Br J Cancer) Vol. 121 Issue 11 Pg. 897-903 (11 2019) ISSN: 1532-1827 [Electronic] England
• PMID: 31649318 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Topics

• Adult
• Aged
• Aged, 80 and over
• Disease-Free Survival
• Female
• Follow-Up Studies
• Head and Neck Neoplasms (mortality, radiotherapy, secondary, surgery)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Squamous Cell Carcinoma of Head and Neck (mortality, radiotherapy, secondary, surgery)
• Survival Rate