Factors predicting the development of distant metastases in patients with head and neck squamous cell carcinoma: A retrospective study from a single centre.

PURPOSE The presence of distant metastases (DMs) after the initial treatment of head and neck squamous cell carcinoma is associated with a poor outcome. The incidence of DMs in head and neck cancer is about 4-26%. The purpose of this study was to evaluate the prevalence of distant metastases and the factors predicting the development of DMs. METHODS Between January 2000 and December 2010, 292 patients with head and neck squamous cell carcinoma were included in this study. RESULTS Thirty three patients (11.3%) developed local recurrences, 27 patients (9.2%) developed DMs. The median post DMs survival was 23.4 months (range 1.8-229.1). The factors that significantly increased the risk of DMs were the presence of local recurrence (p=0.0001, OR:17.32, 95% CI:4.86-19.90), pathologically positive neck (p=0.008, OR:5.97, 95% CI: 3.25-10.45), and primary tumor localized in oral cavity or lip (p=0.035, OR:2.6, 95% CI:1.43-4.65). CONCLUSION Patients with these factors should be considered candidates for adjuvant systemic treatment and evaluated for early detection of DMs during follow-up.