General considerations on distant metastases from head and neck cancer

Mortality in head and neck cancer is due to locoregional disease, distant m etastases or intercurrent disease. As treatment of the primary tumor and ce rvical metastases has improved, the proportion of deaths from co-morbidity and from distant metastases has increased. Distant metastases almost invari ably herald a poor prognosis in head and neck cancer with an average surviv al of 4.3-7.3 months and treatment is usually palliative. Reliable detectio n is important to prevent inappropriate treatment. The risk is related to t he site, stage and histology of the primary tumor and the presence of cervi cal metastases. Early detection and treatment of cervical metastases may pr event distant metastases. Accurate staging of tumors helps to identify high -risk tumors that should be specifically investigated for distant metastase s. Copyright (C) 2001 S.Karger AG, Basel.