European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 5, pp 1239–1247 | Cite as

Improved overall survival in head and neck cancer patients after specific therapy of distant metastases

  • Dominik Schulz
  • Markus Wirth
  • Guido Piontek
  • Andreas Knopf
  • Christoph Straube
  • Steffi Pigorsch
  • Stephanie E. Combs
  • Anja Pickhard
Head and Neck



While metastases directed therapy for oligometastatic disease is recommended in different cancer entities, the treatment of solitary metastases in head and neck squamous cell carcinoma (HNSCC) patients is not clearly defined.


A retrospective analysis was performed on data from 143 HNSCC patients treated between 2001 and 2016 in a tertiary university hospital. Clinical factors and outcome were measured using the median survival of patients receiving metastases specific therapy in comparison with matched control patients.


In 37 patients, distant metastases were treated specifically with either surgery and/or stereotactic ablative radiotherapy and had with 23.97 months a more than three times higher median survival than 10 untreated matched controls with potentially treatable distant metastases (7.07 months).


Our retrospective analysis demonstrates a significant survival benefit for HNSCC patients who received a specific therapy regarding distant metastasis irrespective of localization as compared to a matched control cohort.


HNSCC Distant metastases Specific treatment Overall survival Radiotherapy 



The authors gratefully acknowledge Armin Ott from the Institute for Medical Statistics and Epidemiology at Technical University of Munich for his advice on the statistical analysis.



Compliance with ethical standards

Conflict of interest

All authors have no conflicts of interest.

Ethics approval

Only routine clinical data were retrospectively collected from patients’ charts and pseudonymously analyzed, and therefore, no formal ethical approval was obtained. We declare that all authors have contributed to read and approved the final manuscript for submission.


  1. 1.
    Parkin DM et al (2005) Global cancer statistics, 2002. CA Cancer J Clin 55(2):74–108CrossRefPubMedGoogle Scholar
  2. 2.
    Bernier J et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350(19):1945–1952CrossRefPubMedGoogle Scholar
  3. 3.
    Argiris A et al (2008) Head and neck cancer. Lancet 371(9625):1695–1709CrossRefPubMedGoogle Scholar
  4. 4.
    Vermorken JB, Specenier P (2010) Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol 21(Suppl 7):vii252-61PubMedGoogle Scholar
  5. 5.
    National Comprehensive Cancer Network (2016) NCCN clinical practice guidelines in oncology head and neck cancers (Version 1.2016). Accessed 23 Sept 2016
  6. 6.
    Reyes DK, Pienta KJ (2015) The biology and treatment of oligometastatic cancer. Oncotarget 6(11):8491–8524CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hellman S, Weichselbaum RR (1995) Oligometastases. J Clin Oncol 13(1):8–10CrossRefPubMedGoogle Scholar
  8. 8.
    Weichselbaum RR, Hellman S (2011) Oligometastases revisited. Nat Rev Clin Oncol 8(6):378–382CrossRefPubMedGoogle Scholar
  9. 9.
    Simmonds P et al (2006) Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer 94(7):982–999CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Mahmoud N, Bullard K, Dunn (2010) Metastasectomy for stage IV colorectal cancer. Dis Colon Rectum 53(7):1080–1092CrossRefPubMedGoogle Scholar
  11. 11.
    Fiorentino F et al (2010) Pulmonary metastasectomy in colorectal cancer: a systematic review and quantitative synthesis. J R Soc Med 103(2):60–66CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Young ER et al (2015) Resection of subsequent pulmonary metastases from treated head and neck squamous cell carcinoma: systematic review and meta-analysis. Clin Otolaryngol 40(3):208–218CrossRefPubMedGoogle Scholar
  13. 13.
    Florescu C, Thariat J (2014) Local ablative treatments of oligometastases from head and neck carcinomas. Crit Rev Oncol Hematol 91(1):47–63CrossRefPubMedGoogle Scholar
  14. 14.
    Mehanna H et al (2010) Head and neck cancer—Part 2: treatment and prognostic factors. BMJ 341(c4690):721–725Google Scholar
  15. 15.
    Baatenburg de Jong RJ et al (2001) Prediction of survival in patients with head and neck cancer. Head Neck 23(9):718–724CrossRefPubMedGoogle Scholar
  16. 16.
    Khanfir A et al (2007) Prognostic factors in metastatic nasopharyngeal carcinoma. Cancer/Radiothérapie 11(8):461–464CrossRefGoogle Scholar
  17. 17.
    Tian YH et al (2016) Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: a subset with better overall survival. Head Neck 38(8):1152–1157CrossRefPubMedGoogle Scholar
  18. 18.
    Yucel B et al (2015) The negative prognostic impact of bone metastasis with a tumor mass. Clinics (Sao Paulo) 70(8):535–540CrossRefGoogle Scholar
  19. 19.
    Han K-R et al (2003) Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma. Urology 61(2):314–319CrossRefPubMedGoogle Scholar
  20. 20.
    Nakajima Y et al (2017) Surgical treatment for pulmonary metastasis of head and neck cancer: study of 58 cases. Ann Thorac Cardiovasc Surg 23(4):169–174CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Yotsukura M et al (2015) Survival predictors after resection of lung metastases of head or neck cancers. Thorac Cancer 6(5):579–583CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Onishi H et al (2011) Stereotactic body radiotherapy (SBRT) for operable stage I non-small-cell lung cancer: can SBRT be comparable to surgery? Int J Radiat Oncol Biol Phys 81(5):1352–1358CrossRefPubMedGoogle Scholar
  23. 23.
    Comito T et al (2015) Liver metastases and SBRT: a new paradigm? Rep Pract Oncol Radiother 20(6):464–471CrossRefPubMedGoogle Scholar
  24. 24.
    Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84(1):324–338CrossRefPubMedGoogle Scholar
  25. 25.
    Khatri VP, Petrelli NJ, Belghiti J (2005) Extending the frontiers of surgical therapy for hepatic colorectal metastases: is there a limit? J Clin Oncol 23(33):8490–8499CrossRefPubMedGoogle Scholar
  26. 26.
    Shinohara T et al (2015) Survival benefit of surgical treatment for liver metastases from gastric cancer. J Gastrointest Surg 19(6):1043–1051CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Dominik Schulz
    • 1
  • Markus Wirth
    • 2
  • Guido Piontek
    • 2
  • Andreas Knopf
    • 2
  • Christoph Straube
    • 3
    • 4
  • Steffi Pigorsch
    • 3
    • 4
  • Stephanie E. Combs
    • 3
    • 4
    • 5
  • Anja Pickhard
    • 2
  1. 1.Department of Internal Medicine II, Klinikum rechts der IsarTechnische Universität MünchenMunichGermany
  2. 2.Department of Otolaryngology Head and Neck Surgery, Klinikum rechts der IsarTechnische Universität MünchenMunichGermany
  3. 3.Department of Radiation Oncology and Radiotherapy, Klinikum rechts der IsarTechnische Universität MünchenMunichGermany
  4. 4.Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site MunichMunichGermany
  5. 5.Department of Radiation Sciences (DRS), Institute for Innovative Radiotherapy (iRT)Helmholtz Zentrum MünchenNeuherbergGermany

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