The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: Results of an analysis from the RTOG head and neck database Journal Article
| Authors: | Leibel, S. A.; Scott, C. B.; Mohiuddin, M.; Marcial, V. A.; Coia, L. R.; Davis, L. W.; Fuks, Z. |
| Article Title: | The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: Results of an analysis from the RTOG head and neck database |
| Abstract: | A retrospective analysis of the effect of local control on the development of distant metastases was performed in 2648 patients with carcinoma of the head and neck selected from the RTOG database. The 5-year time-adjusted incidence of distant metastases was 21% for patients who were in local-regional control at 6 months after the start of treatment, compared to 38% for local-regional failure patients (p < 0.001). The incidence of distant metastases detected between the interval of 6 months to 2.5 years after treatment was significantly increased in patients with tumors of the oral cavity, oropharynx, supraglottic larynx, and glottis who developed local-regional failure within this time period, compared to those who remained locally controlled (19% distant metastases for local-regional failure vs 7% for local-regional control (p < 0.001)). In contrast, there as no difference in the incidence of distant metastases in patients with carcinoma of the nasopharynx or hypopharynx regardless of the local-regional disease status. A Cox proportional hazards regression analysis demonstrated that local-regional control was the most significant variable affecting the development of distant metastases, followed by tumor site, N-stage, and T-stage. For all tumor sites, except for the hypopharynx and nasopharynx, improvements in local-regional control are likely to improve survival. Tumors of the hypopharynx and nasopharynx have a higher probability of micrometastatic dissemination at the time of initial diagnosis, and until effective methods to treat disseminated disease are developed, the effect of local control on survival will not be readily discerned. © 1991. |
| Keywords: | adult; aged; cancer surgery; retrospective studies; major clinical study; carcinoma, squamous cell; cancer radiotherapy; metastasis; neoplasm recurrence, local; proportional hazards models; distant metastasis; head and neck cancer; head and neck neoplasms; neoplasm metastasis; multivariate analysis; head and neck carcinoma; rtog; human; male; female; priority journal; article; local-regional control |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 21 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1991-08-01 |
| Start Page: | 549 |
| End Page: | 556 |
| Language: | English |
| DOI: | 10.1016/0360-3016(91)90669-u |
| PUBMED: | 1869453 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 September 2019 -- Source: Scopus |
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