[Significance of distant metastases and secondary cancers as a cause of death in patients with ENT cancers].

Hospital charts and autopsy reports of 148 patients with head and neck carcinoma were reviewed in order to assess the mortality from distant metastases and other primaries. 49% of the patients with uncontrolled local or regional disease died with distant metastases. Only 4% of these patients had a second primary. In patients with controlled local and regional disease the opposite was found. Distant metastases were uncommon (9%). Yet, 44% of the patients died of a second primary located in the upper aerodigestive tract or lungs. If life expectancy in patients with controlled head and neck carcinoma is to be improved, early detection of second primaries is important. As only 9% of patients with locally controlled disease die from distant metastases adjuvant chemotherapy is not indicated.