Metachronous mediastinal and lung metastases from head and neck cancer: A case series, literature review and considerations for treatment

Federico Ampil; Carlos Previgliano; Carrie Porter; Troy Richards; Amol Takalkar

doi:10.1016/j.oraloncology.2019.104518

Metachronous mediastinal and lung metastases from head and neck cancer: A case series, literature review and considerations for treatment

Oral Oncol. 2020 Mar:102:104518. doi: 10.1016/j.oraloncology.2019.104518. Epub 2019 Dec 18.

Authors

Federico Ampil¹, Carlos Previgliano², Carrie Porter³, Troy Richards², Amol Takalkar²

Affiliations

¹ Department of Radiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, USA. Electronic address: fampil@lsuhsc.edu.
² Department of Radiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, USA.
³ Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, USA.

PMID: 31862239
DOI: 10.1016/j.oraloncology.2019.104518

Abstract

Metachronous mediastinal and lung metastases (MMLM), important sources of morbidity and mortality, in people with head and neck cancer (HNC) have received little attention. Between 1980 and 2004, 37 patients with treated HNC and MMLM diagnosed on follow-up imaging (with histological confirmation in 14 cases) were identified. The median interval from diagnosis of HNC to the appearance of MMLM was 14.5 months. The overall median survival was 4 months, and the 1-year crude survival rate (CSR) was 16%. A meaningful difference in the 1-year CSRs between the palliative radiation treated and untreated subjects (39% and 4%, respectively, p < 0.01) was observed. Because associated costs of health care utilization are considerable, and yet survival is limited, optimum management of MMLM-HNC with improvement of prognosis remains a challenge.

Keywords: Distant metastases; Head and neck cancer; Lung metastases; Mediastinal metastases; Metachronous metastases; Palliative radiotherapy.

Publication types

Letter
Review

MeSH terms

Aged
Combined Modality Therapy
Female
Follow-Up Studies
Head and Neck Neoplasms / pathology*
Head and Neck Neoplasms / therapy
Humans
Lung Neoplasms / secondary*
Lung Neoplasms / therapy
Male
Mediastinal Neoplasms / secondary*
Mediastinal Neoplasms / therapy
Middle Aged
Neoplasms, Second Primary / secondary*
Neoplasms, Second Primary / therapy
Prognosis
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / pathology*
Squamous Cell Carcinoma of Head and Neck / therapy