The biology of distant metastases in head and neck cancer.

The detection and treatment of metastatic cancer continues to be a challenge for the head and neck oncologist. Unfortunately, head and neck cancer patients who develop distant metastases commonly present late in their course and rapidly succumb to their disease, despite advances in imaging technologies and increased sophistication of biochemical analyses. The development of a rational approach to detection and treatment of metastatic head and neck cancers should begin with an understanding of how these tumors occur and which patients are at greatest risk for developing them. This article presents an overview of the biological processes resulting in the speed of a malignancy from one site to another, with particular attention to head and neck carcinomas. The basic histopathologic, immunology and biochemical abnormalities associated with the development of these secondary tumors are also discussed. Copyright 2001 S. Karger AG, Basel