Background

Distant metastasis is a poor prognostic factor in recurrent/metastatic squamous cell carcinoma of the head and neck. However, limited information on the prognostic impact of locoregional disease is available, despite its life-threatening features. We investigated the prognostic impact of incurable locoregional disease and distant metastasis in recurrent/metastatic squamous cell carcinoma of the head and neck.

Methods

We retrospectively analyzed 156 patients with recurrent/metastatic squamous cell carcinoma of the head and neck who received palliative chemotherapy between August 2006 and December 2019.

Results

The median follow-up time for all censored patients was 12.1 (range 1.9–63.5) months. The median overall survival was 12.4 (95% confidence interval 10.1–15.1) months. Incurable locoregional disease (hazard ratio: 2.31, P = 0.007), liver metastasis (hazard ratio: 2.84, P = 0.006), disease-free interval > 13 months (hazard ratio: 0.51, P = 0.041), cetuximab use (hazard ratio: 0.59, P = 0.007), and immune checkpoint inhibitor use (hazard ratio: 0.56, P = 0.006) were associated with prognosis. The number of distant metastatic sites was not associated with overall survival (1–2: hazard ratio: 0.60, P = 0.16; 3–4: hazard ratio: 1.34, P = 0.50). Patients with incurable locoregional disease had more life-threatening events than those with curable locoregional disease.

Conclusion

The presence of incurable locoregional disease had a significant prognostic impact, whereas the number of distant metastatic sites had no prognostic impact. Liver metastasis was a poor prognostic factor for recurrent/metastatic squamous cell carcinoma of the head and neck.

中文翻译：

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无法治愈的局部疾病是头颈部复发性或转移性鳞状细胞癌的强烈预后不良因素

背景

远处转移是头颈部复发性/转移性鳞状细胞癌的不良预后因素。然而，尽管局部疾病具有危及生命的特征，但关于其预后影响的信息有限。我们研究了无法治愈的局部疾病和远处转移对头颈部复发性/转移性鳞状细胞癌的预后影响。

方法

我们回顾性分析了 2006 年 8 月至 2019 年 12 月期间接受姑息性化疗的 156 例复发性/转移性头颈部鳞状细胞癌患者。

结果

所有接受审查的患者的中位随访时间为 12.1（范围 1.9-63.5）个月。中位总生存期为 12.4（95% 置信区间 10.1-15.1）个月。无法治愈的局部疾病（风险比：2.31，P  = 0.007），肝转移（风险比：2.84，P  = 0.006），无病间隔时间 > 13 个月（风险比：0.51，P  = 0.041），西妥昔单抗使用（风险比） ：0.59，P  = 0.007）和免疫检查点抑制剂的使用（风险比：0.56，P  = 0.006）与预后相关。远处转移部位的数量与总生存率无关（1-2：风险比：0.60，P  = 0.16；3-4：风险比：1.34，P = 0.50）。与可治愈的局部疾病患者相比，无法治愈的局部疾病患者有更多的危及生命的事件。

结论

无法治愈的局部疾病的存在对预后有显着影响，而远处转移部位的数量对预后没有影响。肝转移是头颈部复发性/转移性鳞状细胞癌的不良预后因素。