Survival and Prognostic Analysis after Pulmonary Metastasectomy for Head and Neck Cancer

被引:7
作者
Dudek, Wojciech [1 ,2 ]
AlMoussa, Emad [2 ,3 ]
Schreiner, Waldemar [1 ,2 ]
Mantsopoulos, Konstantinos [2 ,4 ]
Sirbu, Horia [1 ,2 ]
机构
[1] Univ Hosp Erlangen, Dept Thorac Surg, Krankenhausstr 12, D-91054 Erlangen, Germany
[2] Friedrich Alexander Univ Erlangen Nuremberg, Erlangen, Germany
[3] Univ Hosp Erlangen, Dept Radiat Oncol, Erlangen, Germany
[4] Univ Hosp Erlangen, Dept Otorhinolaryngol Head & Neck Surg, Erlangen, Germany
关键词
head and neck cancer; lung metastases; survival; pulmonary metastasectomy; SQUAMOUS-CELL CARCINOMA; DISTANT METASTASES; SURGICAL RESECTION; LUNG METASTASES;
D O I
10.1055/s-0040-1713112
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background There is no consensus on the value of pulmonary metastasectomy (PM) for head and neck cancer (HNC). The aim of our single-institution study was to evaluate outcomes and to examine factors influencing 5-year survival of patients undergoing resections for HNC lung metastases. Methods All HNC patients undergoing curative-intent PM between January 2008 and December 2018 were retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on patient survival was evaluated using the univariable Cox proportional hazard model. Cutoff values of continuous variables were determined by a receiver operating characteristic analysis. Results In total, 44 patients (32 males and 12 females, with a median age of 65 years) underwent PM for metastatic HNC. There was one perioperative death, and major complications occurred in 2 (4.5%) patients. The median interval between the treatment of primary tumor and PM was 19.4 months (range: 0-151 months). Median size of the largest resected pulmonary lesion was 1.3cm (range: 0.3-6.9cm). Mean follow-up was 21 months (range: 0-123 months), and 5-year overall survival (OS) rate after the first PM was 41%. Resection was complete (R0) in all patients. Larger size of pulmonary metastasis (>= 1.4cm; hazard ratio: 4.49; 95% confidence interval: 1.79-11.27) was a significantly negative prognostic factor. Conclusion Despite the lack of randomized controlled trials, PM for HNC is a reasonable therapeutic option with favorable survival in a selected population. In patients with larger pulmonary lesions, shorter OS after PM is to be expected.
引用
收藏
页码:666 / 671
页数:6
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