Survival Outcomes of Complete Pulmonary Metastasectomy for Head and Neck Squamous Cell Carcinomas

Figures & data

Figure 1 Patient flow (A) and our classification illustrated by head and neck anatomy (B).

Table 1 Characteristics of Patients

Variables	Group 1 (n = 40)	Group 2 (n = 69)	Group 3 (n = 122)	p
Age (years) (mean, range)	63 31–78	60 23–83	65 42–91	0.15
Male sex (number, %)	36, 90.0%	48, 69.6%	114, 93.4%	< 0.01*
Treatment for primary site				0.11
Surgery (number, %)	26, 65.0%	60, 87.0%	110, 83.8%
Chemotherapy	8, 20.0%	4, 5.8%	12, 9.8%
Radiotherapy or ablation	1, 2.5%	1, 1.4%	2, 1.6%
Unknown	5, 12.5%	4, 5.8%	7, 5.8%
Disease-free interval (month)	33.6 ± 28.8	20.5 ± 14.7	27.1 ± 20.2	0.02*
Pathological maximum diameter (mm)	24.2 ± 28.9	30.8 ± 37.3	27.8 ± 24.3	0.09
Procedures (number, percent)				0.21
Sublobar	28, 70.0%	41, 59.4%	64, 52.5%
Lobectomy or more	12, 30.0%	28, 40.6%	58, 47.5%

Note: *p < 0.05 indicates significant values.

Table 2 Univariate Analysis for Overall Survival and 5-Year Overall Survival

	Overall Survival
	N = 231	5 Years (%)	P value
Age			0.08
> 60	123	50.3
≤ 60	108	36.4
Sex			0.56
Male	198	42.5
Female	33	40.9
Primary site			< 0.01*
Group 1	40
Nasopharynx	3	NA
Oropharynx	30	51.9
Salivary gland	7	55.6
Group 2	69
Oral Cavity	12	36.7
Tongue	45	24.9
Paranasal sinus	12	14.3
Group 3	122
Hypopharynx	55	34.6
Larynx	67	57.2
DFI (months)			0.09
≤ 24	131	37.1
> 24	100	50.0
Pathological maximum diameter (mm)			< 0.01*
≤ 20	121	52.6
> 20	110	31.6
Procedures			0.17
Sublobar	134	44.8
Lobectomy or more	95	40.3
Unknown	2
Side			0.63
Either	212	42.1
Bilateral	19	44.9
Number			0.58
Solitary	181	42.4
Multiple	50	42.6

Note: *p < 0.05: indicates significant values.

Abbreviations: DFI, disease-free interval; NA, not available.

Figure 2 Kaplan-Meier survival curve with 95% confidence interval. (A) Overall survival of patients with head and neck squamous cell carcinomas patients after pulmonary metastasectomy. Red line: nasopharynx, oropharynx, and salivary gland (G1, n = 40); green line: Oral cavity, tongue, and paranasal sinus (G2, n = 69); and blue line: hypopharynx and larynx (G3, n =122). (B) Overall survival of patients with head and neck squamous cell carcinomas patients after the date of treatment of primary cancers. Red line: nasopharynx, oropharynx, and salivary gland (G1, n = 40); green line: Oral cavity, tongue, and paranasal sinus (G2, n = 69); and blue line: hypopharynx and larynx (G3, n =122).

Table 3 Multivariate Analysis for Overall Survival

Variables	HR	95% CI	P
Age (≤ 60)	1.38	0.93–2.05	0.10
Maximum tumour diameter (> 20 mm)	1.97	1.32–2.94	< 0.01*
Group 2	2.03	1.35–3.03	< 0.01*
Disease free survival (≤ 24 months)	1.43	0.95–2.14	0.61

Note: *p < 0.05 indicates significant values.

Abbreviations: HR, hazard ratio; CI, confidence intervals.

Figure 3 Kaplan–Meier survival curve with 95% confidence interval. (A) Overall survival of patients with head and neck squamous cell carcinomas patients after pulmonary metastasectomy. Red line: oral cavity, tongue, and paranasal sinus with pathological maximum diameter (> 20 mm) (n = 36); green line; others (n = 195). (B) Overall survival of patients with head and neck squamous cell carcinomas patients after pulmonary metastasectomy. Red line: any head and neck sites excluding oral cavity, tongue, and paranasal sinus with a pathological maximum diameter (≤ 20 mm) (n = 88); green line: any head and neck sites excluding oral cavity, tongue, and paranasal sinus with a pathological maximum diameter (> 20 mm) (n = 74); blue line: oral cavity, tongue, and paranasal sinus (n = 69).