Delivered as an oral presentation at the Triological Society Combined Sections Meeting, Miami, Florida, U.S.A., January 26–28, 2012.
Head and Neck
Article first published online: 27 MAR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 7, pages 1507–1511, July 2012
How to Cite
Spector, M. E., Chinn, S. B., Rosko, A. J., Worden, F. P., Ward, P. D., Divi, V., McLean, S. A., Moyer, J. S., Prince, M. E. P., Wolf, G. T., Chepeha, D. B. and Bradford, C. R. (2012), Diagnostic modalities for distant metastasis in head and neck squamous cell carcinoma: Are we changing life expectancy?. The Laryngoscope, 122: 1507–1511. doi: 10.1002/lary.23264
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 21 JUN 2012
- Article first published online: 27 MAR 2012
- Manuscript Accepted: 2 FEB 2012
- Manuscript Received: 22 JAN 2012
- National Institutes of Health. Grant Number: P50 CA97248
- NIH NCI NIDCR SPORE: SPORE in Head and Neck Cancer—The Molecular Basis of Head and Neck Cancer Therapy
- NIH Training. Grant Number: T32 DC005356
- Distant metastasis;
- head and neck cancer;
- positron emission tomography scan;
- Level of Evidence: 2b
To determine if the various imaging modalities for distant metastasis (DM) diagnosis alters life expectancy in head and neck squamous cell carcinoma (HNSCC).
One hundred seventy patients (mean age, 59.1 years; male:female, 135:35) with HNSCC who developed DM were reviewed. The main outcome measures were the method of DM diagnosis and time from DM diagnosis to death while controlling for clinical parameters (age, gender, tobacco status, primary tumor site, initial TNM classification, number and site of DM, administration of palliative chemotherapy).
Tumor subsites were: 40 oral cavity, 75 oropharynx, 36 larynx, 10 hypopharynx, one nasopharynx, and eight unknown primary. Of the patients, 16.5% (28/170) had distant metastasis at presentation; the remaining 142 patients were diagnosed with DM at a median of 324 days from diagnosis. Although patients diagnosed with DM by positron-emission tomography (PET) scan were more likely to have multiple DM sites (P = .0001), there were no differences in life expectancy in patients who were diagnosed with or without PET scan (median, 185 vs. 165 days, P = .833). There were no differences in life expectancy based on age, gender, site of primary tumor, or number/site of DM. The use of palliative chemotherapy resulted in a significantly longer life expectancy (median, 285 vs. 70 days; P = .001).
Although a PET scan is more likely to diagnose multiple DM sites, there was no difference in life expectancy based on imaging modality. Patients who are symptomatic from their distant metastasis have a worse life expectancy, and palliative chemotherapy was able to increase life expectancy, even in patients who were symptomatic from the distant metastasis.