Calhoun K H, Fulmer P, Weiss R, Hokanson J A
Department of Otolaryngology, University of Texas Medical Branch, Galveston 77555-0521.
Laryngoscope. 1994 Oct;104(10):1199-205. doi: 10.1288/00005537-199410000-00003.
Distant metastases (DMs) occurred in 83 (11.4%) of 727 retrospectively studied head and neck cancer patients. Primary tumor location and initial treatment did not influence DM development; larger primaries (P < .04) or more extensive neck disease (P < .007) more often caused DMs. Initial diagnosis to DMs averaged 11.7 months (range, 0 to 60 months), with 84% diagnosed within 24 months. With the exception of laryngeal primaries, no facet of tumor, host, or initial treatment influenced where or how rapidly DMs developed. Lung was the most common DM site (83.4%), then bone (31.1%) and liver (6.0%). Survival with DMs averaged 4.3 months (range, 1 day to 2.7 years); 86.7% died within 1 year. This report yields the following conclusions: 1. Initial tumor size and neck disease are the only predictors of DMs. 2. DMs usually occur within 2 years of the initial diagnosis. 3. Lung is the most common DM site, making chest x-ray the most effective DM screen. 4. Survival with DMs is usually less than a year.
在727例接受回顾性研究的头颈癌患者中，83例（11.4%）出现远处转移（DMs）。原发肿瘤部位和初始治疗对DMs的发生没有影响；较大的原发肿瘤（P < 0.04）或更广泛的颈部疾病（P < 0.007）更常导致DMs。从初始诊断到发生DMs的平均时间为11.7个月（范围为0至60个月），84%在24个月内被诊断出来。除喉原发肿瘤外，肿瘤、宿主或初始治疗的任何方面均不影响DMs发生的部位或速度。肺是最常见的DMs转移部位（83.4%），其次是骨（31.1%）和肝（6.0%）。发生DMs后的平均生存期为4.3个月（范围为1天至2.7年）；86.7%在1年内死亡。本报告得出以下结论：1. 初始肿瘤大小和颈部疾病是DMs的唯一预测因素。2. DMs通常在初始诊断后2年内发生。3. 肺是最常见的DMs转移部位，因此胸部X线检查是最有效的DMs筛查方法。4. 发生DMs后的生存期通常不到一年。
