AUTOPSY FINDINGS IN PATIENTS WITH HEAD AND NECK SQUAMOUS-CELL CANCER AND THEIR THERAPEUTIC RELEVANCE

A series of 63 autopsied patients with a history of head and neck squa mous cell cancer (HNSCC) is reported with emphasis on the importance o f locoregional disease (LRD) versus distant metastasis (DM) in the ter minal course of the disease. There were 49 males and 14 females; mean age 64.9 years (range 35-94 years). Locoregional disease was present i n 39 patients (62%), in 25 (40%) without tumour at other body sites ou tside the head and neck region. Distant metastasis was observed in 15 patients (24%); in 12 (19%), it occurred with concomitant LRD. Second primary tumours (SPT) were observed in 20 patients (32%). They occurre d in the head and neck region (n = 7; 11%), the lung (n = 9; 14%) and at miscellaneous other sites (n = 4; 6%). Of the 13 patients with SPT outside the head and neck region, 2 had concomitant LRD. 11 patients ( 17%) died due to other causes, no tumour being found at autopsy. These figures indicate that still a major part of HNSCC patients die with L RD as the single tumour manifestation, which means that improvement of local tumour control will result in a significant therapeutic gain. C opyright (C) 1996 Elsevier Science Ltd