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Published in: Annals of Surgical Oncology 10/2008

01-10-2008 | Thoracic Oncology

Does Surgical Resection of Pulmonary Metastases of Head and Neck Cancer Improve Survival?

Authors: Hauke Winter, MD, Georgios Meimarakis, MD, Gabriele Hoffmann, MD, Manuela Hummel, MD, Dominik Rüttinger, MD, Astrid Zilbauer, MD, Klaus Stelter, MD, Fritz Spelsberg, MD, Karl-Walter Jauch, MD, PhD, Rudolph Hatz, MD, PhD, Florian Löhe, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2008

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Abstract

Background

The prognosis of patients with metastasized head and neck cancer is poor. Limited experience exists with the benefit of resection of lung metastases and systematic mediastinal and hilar lymph node dissection on survival of patients with head and neck carcinoma.

Methods

Eighty patients undergoing metastasectomy for pulmonary metastases of primary head and neck cancer entered the study. Multivariate analysis was performed by Cox regression analysis. Survival differences between patients operated and those not operated on were analyzed by matched pair analysis.

Results

From 1984 until 2006, pulmonary metastases were diagnosed in 332 patients treated for head and neck cancer; 80 of these were admitted to our department for resection. Metastases of the primary head and neck tumor were confirmed histologically in 67 patients. The median overall survival after resection of lung metastases was 19.4 months and was statistically significantly better compared with patients who were not operated on (P < .001). The multivariate analysis after metastasectomy revealed that incomplete resection of pulmonary lesions, complications associated with surgery, and adjuvant therapy of the primary tumor are independent negative prognostic factors for survival. We observed a trend to improved survival in patients without hilar or mediastinal lymph node metastases.

Conclusion

The survival rate of patients operated on was statistically significantly higher than that of patients with conservative treatment. Even patients with multiple or bilateral pulmonary lesions after curative treatment of a primary tumor should be operated on if there is no contraindication against an extended surgical procedure and a complete resection of the metastases seems achievable.
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Metadata
Title
Does Surgical Resection of Pulmonary Metastases of Head and Neck Cancer Improve Survival?
Authors
Hauke Winter, MD
Georgios Meimarakis, MD
Gabriele Hoffmann, MD
Manuela Hummel, MD
Dominik Rüttinger, MD
Astrid Zilbauer, MD
Klaus Stelter, MD
Fritz Spelsberg, MD
Karl-Walter Jauch, MD, PhD
Rudolph Hatz, MD, PhD
Florian Löhe, MD, PhD
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-0001-4

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