Abstract
Background There is no consensus on the value of pulmonary metastasectomy (PM) for head and
neck cancer (HNC). The aim of our single-institution study was to evaluate outcomes
and to examine factors influencing 5-year survival of patients undergoing resections
for HNC lung metastases.
Methods All HNC patients undergoing curative-intent PM between January 2008 and December
2018 were retrospectively analyzed. The impact of factors related to primary tumor,
metastases, and associated therapy on patient survival was evaluated using the univariable
Cox proportional hazard model. Cutoff values of continuous variables were determined
by a receiver operating characteristic analysis.
Results In total, 44 patients (32 males and 12 females, with a median age of 65 years) underwent
PM for metastatic HNC. There was one perioperative death, and major complications
occurred in 2 (4.5%) patients. The median interval between the treatment of primary
tumor and PM was 19.4 months (range: 0–151 months). Median size of the largest resected
pulmonary lesion was 1.3 cm (range: 0.3–6.9 cm). Mean follow-up was 21 months (range:
0–123 months), and 5-year overall survival (OS) rate after the first PM was 41%. Resection
was complete (R0) in all patients. Larger size of pulmonary metastasis (≥1.4 cm; hazard
ratio: 4.49; 95% confidence interval: 1.79–11.27) was a significantly negative prognostic
factor.
Conclusion Despite the lack of randomized controlled trials, PM for HNC is a reasonable therapeutic
option with favorable survival in a selected population. In patients with larger pulmonary
lesions, shorter OS after PM is to be expected.
Keywords
head and neck cancer - lung metastases - survival - pulmonary metastasectomy
