Skip to main content

Advertisement

Log in

Pulmonary Metastasectomy for Head and Neck Cancers

  • Original Article
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background: Distant metastases from carcinomas that arise from the head and neck region are infrequent. The most common site is the lung. To evaluate the results of resection of pulmonary metastases for head and neck cancers, we reviewed our own cases of these metastases.

Methods: Between November 1966 and March 1995, 83 patients with pulmonary metastases from head and neck cancers underwent 94 thoracic operations. All patients had obtained or had obtainable locoregional control of their primary head and neck cancers. Kaplan-Meier and Cox regression models were used to analyze the prognostic factors for survival after metastasectomy.

Results: Median age was 53 years (range, 17–77). Fifty-nine were male and 24 were female. Forty-one patients had squamous cell cancers, and 36 had glandular tumors that consisted mostly of thyroid and adenoid cystic carcinomas. The median disease-free interval from the time of treatment of the head and neck primary cancers to the development of pulmonary metastases was 27 months. Sixty-eight (82%) patients had complete resection. Overall operative mortality rate was 2%. Overall actuarial survival rate after metastasectomy was 50% at 5 years. Patients with glandular tumors had a 5-year survival rate of 64% compared with 34% for patients with squamous cell cancers. When the patients with glandular tumors were analyzed according to their histology, patients with adenoid cystic carcinomas had an 84% 5-year survival, but none remained disease-free. Patients with thyroid cancers fared similarly whether they were treated medically or surgically. On multivariate analysis, the adverse prognostic factors for patients with squamous cell cancers were incomplete resection, age greater than 50 years, and disease-free interval less than or equal to 2 years.

Conclusions: Approximately 30% of patients with pulmonary metastases from squamous cell cancers of the head and neck who underwent complete resection of all their metastases can expect to achieve long-term survival. The role of pulmonary resection for patients with glandular tumors is unclear.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics. CA Cancer J Clin 1998;48:6–29.

    CAS  PubMed  Google Scholar 

  2. Martini N, Melamed MR. Multiple primary lung cancers. J Thorac Cardiovasc Surg 1975;70:606–612.

    Google Scholar 

  3. Vikram BV, Strong EW, Shah JP, Spiro R. Failure at distant sites following multimodality treatment for advanced head and neck cancer. Head Neck Surg 1984;6:730–733.

    Google Scholar 

  4. Dennington ML, Carter DR, Meyers AD. Distant metastases in head and neck epidermoid carcinoma. Laryngoscope 1980;90:196–201.

    Google Scholar 

  5. Merino OR, Lindberg RD, Fletcher GH. An analysis of distant metastases from squamous cell cancers of the upper respiratory and digestive tracts. Cancer 1977;40:145–151.

    Google Scholar 

  6. Calhoun KH, Fulmer P, Weiss R, Hokanson JA. Distant metastases from head and neck squamous cell carcinomas. Laryngoscope 1994;104:1199–1205.

    Google Scholar 

  7. Papac RJ. Distant metastases from head and neck cancer. Cancer 1984;53:342–345

    Google Scholar 

  8. Lefor AT, Bredenberg CE, Kellman RM, Aust JC. Multiple malignancies of the lung and head and neck. Arch Surg 1986;121:265–270.

    Google Scholar 

  9. McCormack P. Surgical resection of pulmonary metastases. Semin Surg Oncol 1990;6:297–302.

    Google Scholar 

  10. Mazer TM, Robbins KT, McMurtrey MJ, Byers RM. Resection of pulmonary metastases from squamous carcinoma of the head and neck. Am J Surg 1988;156:238–242.

    Google Scholar 

  11. Finley RK, Verazin GT, Driscoll DL, et al. Results of surgical resection of pulmonary metastases of squamous cell carcinoma of the head and neck. Am J Surg 1992;164:594–598.

    Google Scholar 

  12. Wedman J, Balm AJM, Hart AAM, et al. Value of resection of pulmonary metastases in head and neck cancer patients. Head Neck 1996;18:311–316.

    Google Scholar 

  13. Schlumberger M, Challeton C, De Vathaire F, et al. Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med 1996;37:598–605.

    CAS  PubMed  Google Scholar 

  14. Kim KH, Sung MW, Chung PS, et al. Adenoid cystic carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 1994;120:721–726.

    Google Scholar 

  15. The International Registry of Lung Metastases. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997;113:37–49.

    Google Scholar 

  16. Shaha AR, Hoover EL, Mitrani M, et al. Synchronicity, multicentricity, and metachronicity of head and neck cancer. Head Neck Surg 1988;10:225–228.

    Google Scholar 

  17. Deleyiannis FW, Thomas DB. Risk of lung cancer among patients with head and neck cancer. Otolaryngol Head Neck Surg 1997;116:630–636.

    Google Scholar 

  18. Vikram B, Strong EW, Shah JP, Spiro R. Second malignant neoplasms in patients successfully treated with multimodality treatment for advanced head and neck cancer. Head Neck Surg 1984;6:734–737.

    Google Scholar 

  19. Sercarz J, Ellison D, Holmes EC, Calcaterra TC. Isolated pulmonary nodules in head and neck cancer patients. Ann Otol Rhinol Laryngol 1989;98:113–118.

    Google Scholar 

  20. Chung KY, Mukhopadhyay T, Kim J, et al. Discordant p53 gene mutations in primary head and neck cancers and corresponding second primary cancers of the upper aerodigestive tract. Cancer Res 1993;53:1676–1683.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert J. Ginsberg MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, D., Labow, D.M., Dang, N. et al. Pulmonary Metastasectomy for Head and Neck Cancers. Ann Surg Oncol 6, 572–578 (1999). https://doi.org/10.1007/s10434-999-0572-8

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10434-999-0572-8

Key Words

Navigation