Background/Objectives: Distant metastasis (DM), though uncommon at initial presentation, significantly worsens the prognosis of head and neck squamous cell carcinomas (HNSCCs). This review aimed to investigate the occurrence rates, patterns, and implications of HNSCC DM. Methods: A systematic search was performed in Scopus, PubMed and Web of Science. Results: Out of 7576 identified titles, 35 studies were included, encompassing 28,193 patients. The pooled rate of DM was 10.01%, with significant heterogeneity existing among the studies (I2: 94.13%). The most common metastatic sites were the lungs, bones, and brain (58%, 15%, 4%, respectively). Treatment modalities varied: overall, 20.4% of patients received radiotherapy alone, 7% underwent chemotherapy, and 4.5% received surgical metastasectomies. Combined treatments accounted for 18.3% of patients. However, 41.3% of patients received no treatment for DM. The median overall survival (OS) after DM diagnosis was 10.1 months. Studies highlighted a 36.3% two-year survival rate for patients with oligo-metastases, compared to the 7.4% rate for those with multiple metastases. At the time of DM diagnosis, half of the studied population presented with locoregional failure. Conclusions: Advanced imaging techniques and emerging systemic therapies offer hope for improved DM detection and treatment. However, continuous research is essential to develop therapeutic strategies that can enhance survival and improve the quality of life for patients with DM.
背景/目的：远处转移（DM）虽然在初诊时并不常见，但会显著恶化头颈部鳞状细胞癌（HNSCC）的预后。本综述旨在探讨HNSCC远处转移的发生率、模式及其临床意义。方法：在Scopus、PubMed和Web of Science数据库中进行系统性检索。结果：在7576篇已识别文献中，共纳入35项研究，涵盖28,193名患者。远处转移的汇总发生率为10.01%，各研究间存在显著异质性（I²：94.13%）。最常见的转移部位为肺、骨和脑（分别为58%、15%和4%）。治疗方式多样：总体而言，20.4%的患者仅接受放疗，7%接受化疗，4.5%接受转移灶切除术。联合治疗占18.3%的患者。然而，41.3%的患者未接受针对远处转移的治疗。远处转移诊断后的中位总生存期（OS）为10.1个月。研究强调，寡转移患者的两年生存率为36.3%，而多发转移患者仅为7.4%。在远处转移诊断时，半数研究对象出现局部区域复发。结论：先进的影像学技术和新兴的全身疗法为改善远处转移的检测和治疗带来了希望。然而，持续的研究对于制定能够提高患者生存率和生活质量的远处转移治疗策略至关重要。
Head and Neck Squamous Cell Carcinoma with Distant Metastasis: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家