Squamous cell cancer of the head and neck with distant metastasis at presentation

Background. Current literature reports widely different rates of distant metastasis at presentation for squamous cell carcinoma of the head and neck (SCCHN). We used the Surveillance Epidemiology and End Results (SEER) database to determine the rate of and risk factors for distant metastasis. Methods. We identified patients with SCCHN diagnosed between 1988 and 2003. The rate of distant metastasis was determined and then stratified by tumor site, size, and nodal status. To evaluate the contribution of each individual factor, both univariate and multivariate analyses were performed. Results. Among 73,247 patients identified, 2066 patients (2.82%, 95% confidence interval [CI] 2.70–2.94%) had distant metastasis. Independent risk factors for distant metastasis included primary site, nodal status, tumor size, age, and race. Conclusions. In SCCHN, there is a relationship between the risk of distant metastasis and tumor site, size, and nodal status. This information can be used to guide the evaluation and treatment of SCCHN. © 2010 Wiley Periodicals, Inc. Head Neck, 2011