2023 Volume 36 Issue 2 Pages 130-136
Objective: Head and neck squamous cell carcinoma is often detected in a locally advanced state, and surgery, radiotherapy, and chemoradiotherapy are generally performed for local control. However, even when local control is achieved, some cases die due to distant metastasis （DM）. This study aimed to investigate the predictive factors for DM after total pharyngolaryngectomy （TPL） in head and neck cancer.
Material and Methods: Forty-three patients with head and neck squamous cell carcinomas underwent TPL in Nara Medical University Hospital from January 2010 to December 2019. The primary tumor sites were the oropharynx （n＝4）, hypopharynx （n＝34）, and larynx （n＝5）. The DM-free survival （DMFS） was evaluated according to factors including pathological T classification （T2 vs T3-4 and T3 vs T4）, pathological N classification （bilateral lymph node metastasis vs ipsilateral and no lymph node metastasis）, extra nodal extension （positive vs negative）, degree of differentiation （well differentiated vs moderately and poorly differentiated） and smoking （Brinkman Index （BI） ≥ 450 vs BI＜450）. Moreover, total treatment package time was evaluated in patients who underwent adjuvant chemoradiotherapy or radiotherapy after TPL.
Results: DM developed in 11 patients of the 43. Ten of 11 patients with DM underwent TPL as the initial treatment and one received salvage treatment. DMFS was statistically shorter in the group of bilateral lymph node metastasis and extra node extension positive. There was no significant difference in other factors.
Conclusions: Bilateral lymph node metastasis and extra node extension positive were predictive factors for shorter DMFS.
