Clinical investigation on pulmonary metastasis of head and neck carcinomas

Objective: To establish a treatment strategy for pulmonary metastases, we c linically investigated the characteristics of distant metastases from head and neck carcinomas. Methods: In 636 head and neck carcinomas, the pathophy siology of distant metastases was investigated by charts, roentgenographies , computed tomographies and scintigraphies. Results: Of the squamous cell c arcinomas, oropharyngeal tumors were most highly metastatic, followed by lo wer gingiva, floor of the mouth, maxillary sinus, and tongue. In distant me tastases, 30 (4.7%), 5 (0.8%), and 7 (1.1%) metastasized to the lungs only, lungs and other organs, and organs excluding the lungs, respectively. In p ulmonary metastases, the right, left and both lungs were involved in 18, 5, and 8 patients, respectively, although details were not obtained for 4 pat ients. Pulmonary metastases consisted of 1, 2, and 3 or more tumors in 18, 4, and 6 patients, respectively. Diffuse cancer cell infiltration was obser ved in 3 patients. Of the 42 patients with distant metastases, 12 patients died of progressive pulmonary metastases, and 5 of these patients manifeste d only 1 pulmonary lesion throughout life. However, the metastatic pulmonar y tumors were controlled surgically or conservatively in 3 patients. Conclu sion: These results indicate that distant metastases from head and neck car cinomas involve the lungs most frequently and that chemoimmunotherapy and s urgical removal of the metastatic tumors are recommended when indicated. Co pyright (C) 2000 S. Karger AG. Basel.