Takahiro Ochi1, Hironobu Wada2, Takahiro Nakajima1, Kazuhisa Tanaka1, Takayoshi Yamamoto1, Yuichi Sakairi1, Hidemi Suzuki1, Syuji Yonekura3, Toyoyuki Hanazawa3, Ichiro Yoshino1. 1. Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan. 2. Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan. Hironobu.Wada@chiba-u.jp. 3. Department of Otorhinolaryngology/Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Abstract
OBJECTIVE: The innovation of novel systemic chemo/immunotherapy for metastatic head and neck cancer might contribute to prognostic improvement. We aimed to clarify the recent characteristics and outcomes of pulmonary metastasectomy for head and neck cancer. METHODS: Twenty-five patients who underwent pulmonary metastasectomy from January 2011 to December 2016 were included. The clinicopathological factors and survival were assessed by retrospective chart reviews. RESULTS: The median follow-up period was 39 months (range, 7-94 months). The median age was 66 years (range, 20-89 years), and 23 males were included. The primary tumor locations were as follows: pharynx (n = 12), nasal/paranasal cavity (n = 5), larynx (n = 4), and others (n = 4). The 5-year overall survival rate was 49%. In the univariate analysis, a history of local recurrence before pulmonary metastasis was an independent predictor of a poor prognosis. In 90% of patients with recurrence after pulmonary metastasectomy, the site of recurrence was the lung. Eight patients achieved long-term survival without any evidence of recurrence (median: 45 months). Molecular targeting chemotherapy and immune-checkpoint inhibitors were used in five patients with systemic recurrence after pulmonary metastasectomy, leading to preferable survival. CONCLUSIONS: In the current era of advances in systemic chemotherapy and immunotherapy, surgical indication has not changed for resectable pulmonary metastases and selected patients can still benefit from pulmonary metastasectomy. Further investigation is needed to clarify the significance of systemic therapy in patients with pulmonary metastasis of head and neck cancer.
OBJECTIVE: The innovation of novel systemic chemo/immunotherapy for metastatic head and neck cancer might contribute to prognostic improvement. We aimed to clarify the recent characteristics and outcomes of pulmonary metastasectomy for head and neck cancer. METHODS: Twenty-five patients who underwent pulmonary metastasectomy from January 2011 to December 2016 were included. The clinicopathological factors and survival were assessed by retrospective chart reviews. RESULTS: The median follow-up period was 39 months (range, 7-94 months). The median age was 66 years (range, 20-89 years), and 23 males were included. The primary tumor locations were as follows: pharynx (n = 12), nasal/paranasal cavity (n = 5), larynx (n = 4), and others (n = 4). The 5-year overall survival rate was 49%. In the univariate analysis, a history of local recurrence before pulmonary metastasis was an independent predictor of a poor prognosis. In 90% of patients with recurrence after pulmonary metastasectomy, the site of recurrence was the lung. Eight patients achieved long-term survival without any evidence of recurrence (median: 45 months). Molecular targeting chemotherapy and immune-checkpoint inhibitors were used in five patients with systemic recurrence after pulmonary metastasectomy, leading to preferable survival. CONCLUSIONS: In the current era of advances in systemic chemotherapy and immunotherapy, surgical indication has not changed for resectable pulmonary metastases and selected patients can still benefit from pulmonary metastasectomy. Further investigation is needed to clarify the significance of systemic therapy in patients with pulmonary metastasis of head and neck cancer.
Authors: Hanibal Bohnenberger; Lars Kaderali; Philipp Ströbel; Diego Yepes; Uwe Plessmann; Neekesh V Dharia; Sha Yao; Carina Heydt; Sabine Merkelbach-Bruse; Alexander Emmert; Jonatan Hoffmann; Julius Bodemeyer; Kirsten Reuter-Jessen; Anna-Maria Lois; Leif Hendrik Dröge; Philipp Baumeister; Christoph Walz; Lorenz Biggemann; Roland Walter; Björn Häupl; Federico Comoglio; Kuan-Ting Pan; Sebastian Scheich; Christof Lenz; Stefan Küffer; Felix Bremmer; Julia Kitz; Maren Sitte; Tim Beißbarth; Marc Hinterthaner; Martin Sebastian; Joachim Lotz; Hans-Ulrich Schildhaus; Hendrik Wolff; Bernhard C Danner; Christian Brandts; Reinhard Büttner; Martin Canis; Kimberly Stegmaier; Hubert Serve; Henning Urlaub; Thomas Oellerich Journal: EMBO Mol Med Date: 2018-09 Impact factor: 12.137