SURGICAL-TREATMENT OF LUNG METASTASES OF HEAD AND NECK TUMORS

BACKGROUND: Head and neck tumors often spread to the lungs, with a var iety of presentations. The ideal treatment for those patients is still controversial, Resection of lung metastases was shown to significantl y influence overall survival of patients. OBJECTIVE: To evaluate resul ts of surgical resection of lung nodules in patients with head and nec k primary tumors. METHODS: A retrospective analysis was made of 53 pat ients with head and neck tumors and lung nodules (no other metastases detected in other organs) admitted to our department, They were separa ted into two groups: OPER (thoracotomy, n = 26), and NOTOPER (no thora cotomies, n = 27). Overall survival was compared (Kaplan-Meier, log-ra nk) between groups. RESULTS: Overall median survival of all patients w as 10 months, of OPER 20 months, and of NOTOPER 6 months (P <0.0001). Complete resection (n = 19) of lung metastases was associated with the greatest survival rate (median 23 months). Patients submitted to inco mplete resection (n = 7) had a median survival of 16 months, compared with 7 months for patients who received only chemotherapy (n = 7) and 4 months for patients (n = 20) with no treatment (P (0.0001). CONCLUSI ON: Resection of lung metastases offers a significant survival benefit for patients with head and neck primary tumors, when compared with th e current chemotherapeutic regimens. It should be considered for all p atients clinically fit and who present with no extrapulmonary disease, (C) 1997 by Excerpta Medica, Inc.