Table 3.
Metastasis features of the included studies.
| Author | Year | Primary SCC Site |
Metastasis Sites (No. Cases (%)) |
Locoregional Recurrence (No. Cases (%)) | Time to Metastasis Diagnosis (months) |
Treatment (No. Cases (%)) |
Survival |
|---|---|---|---|---|---|---|---|
| Abbas et al. [19] | 2018 | O |
a Brain 3 (50%); Lg 2 (33%); brain + Lg 1 (17%) |
23 (26.1%) b | NA | S 11 (13%); ND 78 (88.6%); S + RT 73 (83%); S + CTRT 4 (5%) | OS 77.3% |
| Aires et al. [20] | 2017 | O | c Lg (89%); B (15%); axillary LN (8%); Lv (8%); pleura (7%) | 13 (50%) | 12 * (2–40) | S 95 (35%); S + RT 108 (39%); S + CTRT 71 (26%) | NA |
| Al-Othman et al. [21] | 2003 | OP |
a Lg 56 (46%); B 42 (34%); other 24 (20%) |
NA | 12§ | RT 551 (63%) RT + ND 322 (37%) |
5y DSS 70% 5y DFS 86% |
| Albergotti et al. [22] | 2018 | OP HPV+ |
a PolyM+: Lg 18 (69%); other sites 8 (31%) OligoM+: Lg 11 (92%) |
PolyM+: 8 (30.8%) OligoM+: 5 (41.7%) |
PolyM+:17 * OligoM+:23 * |
e PolyM+: CT 13; SRS or BCT 2; SRS or CTRT 3; MSC + adj CT 1 OligoM+: MSC 6; NeoadjCT + MSC1; CT 3; MSC + CRT1; MSC + adj CT 1 |
PolyM+: * OS * 2y 15%; OligoM+: OS * 2.6y 58%; * DFS 20.7mos |
| Barros-Silva et al. [23] | 2020 | O; OP |
a Lg 9 (41%); brain 6 (27%); B 5 (23%); larynx 1 (4%); Lv 1 (4%) |
NA | NA | None 55 (14%); S 48 (12%); S + RT 97 (24%); S + RT + CT 21 (5%); RT 100 (25%); RT + CT 83 (21%) |
15y OS 47% |
| Berzenji et al. [24] | 2021 | O; OP; HP; L; NP; sinus; CUP |
c Lg 187 (58%); mediastinal LN 164 (51%); skin 66 (20%); B 62 (19%); Lv 45 (14%); brain 7 (2%); adrenal glands 7 (2%); parotid glands 5 (1%); spleen 5 (1%); kidneys 5 (1%); pancreas 1 (0.3%); other 52 (16.0%) |
Local: 27 (8.3%) Regional: 48 (14.8%) LR: 22 (6.8%) |
13.8 * ± 12.3 | e None 240 (74%); S or RT 65 (20%); CT 13 (4%); CTRT or CT + S 6 (2%) | § DSS 3.2 mos; * DSS 6.3 mos |
| Caballero et al. [25] | 2008 | HP; L |
a Lg 10 (70.8%); pleura 2 (11.7%); B 4 (23.5%); Lv 1 (5.8%); multiple DM 7 (29.1%) |
Local: 9 (9.5%) Regional: 4 (11.8%) |
19.1 * (1–41) | TLM | OS 2.8 mos |
| Calhoun et al. [26] | 1994 | O; OP; HP; L |
c Lg 69 (83%); B 26 (31%); Lv 5 (6%); brain 2 (2%) |
24 (28.9%) | 11.7* |
e S 15 (18%); RT 37 (44%); S + RT 28 (33.7%); none 3 (4%) |
* time from diagnosis of DM to death 4.3 mos |
| Chiesa-Estomba et al. [27] | 2021 | O; OP; HP; L; NP | a Lg 25 (86.2%); Lv 3 (10.3%); skin 1 (3.4%) | NA | NA | NA | NA |
| Coca-Pelaz et al. [28] | 2012 | O; OP; HP; L |
a Lg 33 (55%); B 2 (3%); Lv 1 (2%); multiple DM 24 (40%) |
16 (26.6%) | NA | S 443 (100%); ND 392 (88%); Adj RT 216 (49%) |
NA |
| Dragovic et al. [29] | 2013 | O; OP; HP; L |
a Lg 28 (50%); multiple DM 10 (18%); B 6 (11%); skin 4 (7%); mediastinum 2 (3%); Lv 2 (3%); brain 2 (3%); gastrostomy site 1 (2%); pancreas 1 (2%) |
27 (48.2%) | 16 * | Neoadj CT 62 (11%); RT 205 (37%); CTRT 355 (63%) | 3y OS 59%; 3y DMFS 87%; § OS after DM 5 mos |
| Duprez et al. [30] | 2017 | O; OP; HP; L; CUP |
c Lg 110 (78%); B 42 (29.7%); Lv 24 (17%); LN outside neck 28 (19.8%); skin 16 (11.3%); pleura 13 (9.2%); adrenal gland 2 (1.4%); soft tissues 2 (1.4%); pancreas 2 (1.4%); brain 1 (0.7%); omentum 1 (0.7%); spleen 1 (0.7%) |
64 (45%) | 70% ≤ 1 y; 89% ≤ 2 y |
S 227 (22%); ND 361 (35%); CT 318 (31%); RT (100%) | 1y DMFS 67% 2y DMFS 55% 5y DMFS 41% 10y DMFS 29% |
| Fleming et al. [31] | 2021 | OP HPV+ |
c Lg 61 (74%); B 23 (28%); Lv 10 (12%); axillary LN 5 (6%); brain 3 (4%) |
26 (35.1%) | NA | NA | § OS after DM 14.6 mos |
| Gaffney et al. [32] | 2023 | OP HPV+ |
c Lg 33 (64%); thoracic nodes 18 (37%); B 14 (27%); visceral 12 (23%); brain 2 (4%); skin 1 (2%) |
NA | 15.1 § (2.6–63) |
e Ind CT 10 (19%); RT 17 (33%); CTRT 35 (67%) |
NA |
| Garavello et al. [33] | 2006 | O; OP; HP; L | c Lg 101 (56%); B 18 (10%); Lv 7 (4%) | 72 (5.4%) | NA | NA | NA |
| Gumusay et al. [34] | 2015 | O; OP; HP; L; NP |
a Lg 13 (48.2%); multiple DM 8 (29.6%); B 5 (14.8%); Brain 2 (7.4%) |
33 (11.3%) b | NA | NA | 5y DMFS 87% |
| Hasegawa et al. [35] | 2015 | O |
a Lg 17 (38%); multiple DM 16 (36%); B 5 (11%); Lv 4 (9%); brain 2 (4%); skin 1 (2%) |
17 (58.7%) | NA | S 174 (39%); ND 277; Adj RT 76 (17%); Adj CT 38 (8%) | 5y OS DM with LRF 0% 5y OS DM with LRC 26.9% |
| Hauswald et al. [36] | 2011 | OP; HP |
a Lg (38%); multiple DM (36%); B (11%); Lv (9%); brain (4%); skin (2%) |
28 (62%) | 8 § | CTRT 127 (100%) | 1y OS DM 72% |
| Huang et al. [37] | 2013 | OP |
a HPV+: Lg 42 (78%); skin 12 (22%); brain 8 (15%); abdominal LN 8 (15%); muscle 3 (6%); pancreas 2 (3.7%); axilla 2 (4%); spleen 1 (2%); kidney 1 (2%); pericardial LN 1 (2%) HPV−: Lg 22 (88%); Lv 4 (16%); B 3 (12%) |
HPV+: Local 3 (5.5%) Regional 6 (11.1%) LR 6 (11.1%) HPV−: Local 4 (16%) Regional 5 (20%) | NA | e HPV +: Palliative CT 3/54 S 6/54 Palliative RT 2/54 HPV−: Palliative CT 1/25 on lung M+ | 2y DSS DM HPV+ 1% 2y DSS DM HPV− 4% |
| Kang et al. [38] | 2016 | O; OP; HP; L; NP; Sinuses |
a Lg 74 (76%); B 23 (24%); mediastinum 3 (3%); skin 3 (3%); Lv 2 (2%); brain 2 (2%); pleura 2 (2%); heart 1 (1%) |
Local 8 (8%) Regional 27 (28%) LR 14 (14%) |
15 § (1–87) | S 272 (35%); S + RT ± CT 268 (34%); RT 93 (12%); CTRT 141 (18%) |
2y OS DM 36.7% 2y OS DM and LRF 2.8% 2y OS single M+ 26.2% 2y OS polyM+ 7.1% |
| Kowalski et al. [39] | 2005 | O; OP |
a Lg 45 (2%); B 28 (1%); Lv 2 (0.1%); brain 2 (0.1%); soft tissues 2 (0.1%); peritoneum 1 (0.04%); mediastinum 1 (0.04%); axillary LN 1 (0.04%); multiple DM 7 |
Local 16 (17.9%) Regional 19 (27.9%) |
31.5% in 6 | S 637 (27%); RT 1147 (49%); S + RT 543 (23%) |
5y DMFS 93.3% |
| Krstevska et al. [40] | 2010 | O; OP; HP; L |
a Lg 18 (69%); Lv 3 (11%); B 1 (4%); multiple DM 4 (15%) |
18 (69.2%) | 16.5 * ± 7.5 (5–35) |
S + RT 117 (58%); RT 84 (50%) |
5y DMFS 84.8% |
| Lee et al. [41] | 2012 | O; OP; HP; L | c Lg (81%); B (39%); Lv (11%) | 16 (20.5%) | 12 * (2–38) | S 308; RT 42; Neoadj CT 28; CTRT 26 |
2y OS singleM+ 25.7% 2y OS multipleM+ 0% |
| León et al. [42] | 2000 | O; OP; HP; L; NP | d Lg 33 (52%); B 8 (12%); Lv 3 (5%); multiple DM 20 (31%) | 115 (64.2%) | 12 * | Ind CT 408 | 5y DMFS 94% |
| Lim J-Y et al. [43] | 2010 | O; OP; HP; L | d Lg (64%); B (9%); Lv (3%); skin (1%); axilla (1%); cavernous sinus (1%) | 31 (41.3%) | 13 * (2–70) | S 296 (47%); S + RT 335 (53%) U-ND 391 (62%); B-ND 152 (24%) |
5y DMFS 87.5% |
| Lim Y-C et al. [44] | 2007 | O; OP | a Lg 5 (36%); Lv 3 (21%); B 2 (14%) | 3 (21.4%) | 10 § | ND 212 (92%); Adj RT 130 (57%) |
§ OS after DM 5 mos |
| Mattioli et al. [45] | 2022 | OP | a Lg 37 (65%); other 20 (35%) | 25 (43.8%) | NA | S 33 (8%); RT 78 (19%); CTRT 215 (53%); S + RT 33 (8%); S + CTRT 44 (11%); None 5 (1%) | 5y OS DM 37%; 5y OS no-DM 76%; § OS after DM 34 mos |
| McBride et al. [46] | 2013 | OP |
a Lg 22 (64%); Lv 4 (12%); B 4 (12%); LN outside neck 4 (12%) |
4 (16%) |
§ 7.9 (1.6–25.4) |
e CTRT 23; Ind CT + RT 4; S + RT 1 |
§ OS after DM 18.3 mos; 1y OS after DM 72%; 2y OS after DM 41% |
| Merino et al. [9] | 1977 | O; OP; HP; L; Sinus |
a OligoM+: Lg 284 (52%); B 111 (20%); Lv 33 (6%); other 52 (9.5%) mediastinum (3%) PolyM+: Lg + B 18 (3.3%); other 32 (5.9%) |
b 570 (11.3%) | 4% in 9 80% in 24 |
RT 2819; S 1686; Neo-adj RT 161; Adj RT 353 |
NA |
| Osaki et al. [47] | 2000 | O; OP; Sinus | a Lg 30 (71.4%); Lg + other 5 (11.9%); other (Lg excluded) 7 (16.6%) | 25 (59.5%) | NA | S 179; CRT + IMT 327; CTRT 133 | NA |
| Shingaki et al. [48] | 1996 | O; OP; Sinus | c Lg 18 (85.7%); B 5 (23.8%); skin 5 (23.8%); brain 3 (14.2%); Lv 1 (4.7%) | NA | 14 * (5–35) | Elective ND 44 Therapeutic ND 59 |
NA |
| Shintani et al. [49] | 1995 | O (Tongue) |
c Lg 13 (50%); B 5 (19%); skin 3 (11%); mediastinum 2 (8%); Lv 1 (4%); brain 1 (4%); pleura 1 (4%) |
NA | (6–36) | ND 93 (42%) | NA |
| Tomioka et al. [50] | 2021 | O |
c Lg 31 (86.1%); B 14 (38.9%); Lv 3 (8.3%); mediastinum 2 (5.5%); adrenal gland 1 (2.7%); cerebellum 1 (2.7%); spleen 1 (2.7%) |
31 (89.1%) | 21.3 * (2–94) |
S 775; BCT 112 |
NA |
| Trosman et al. [51] | 2015 | OP HPV+: 28 (11.1%) HPV−: 9 (23.1%) |
c HPV+: Lg 23 (83%); B 12 (21.1%); Lv 7 (12.3%); intra-abdominal lymph nodes 3 (5.3%); axillary lymph nodes 2 (3.5%); brain 2 (3.5%); kidney 2 (3.5%); muscle 2 (3.5%); skin 2 (3.5%); pericardium 1 (1.8%); peritoneum 1 (1.8%); HPV−: 9; Lg 7 (78%); B 2 (16.7%); brain 2 (16.7%) Lv 1 (8.3%) |
b HPV+: Local 14 (5.5%) Regional 12 (4.7%) HPV−: Local 8 (20.5%) Regional 4 (10.2%) |
NA | CT: 252 HPV+; 39 HPV− RT: 252 HPV+; 39 HPV- Salvage ND: 2 HPV+; 1 HPV |
HPV+: 3y OS 90%; § OS 25.6 mos; HPV−: 3y OS 62%; § OS 11.1 mos |
| Yao et al. [52] | 2011 | O; OP; HP; L; CUP |
c Lg 37 (82.2%); Lv 7 (4.4%); B 5 (6.6%); axilla/mediastinum 3 (6.6%); Lg + B 2 (4.4%); Lg + Lv 5 (11.1%) |
6 (13.3%) | 6.6 * (1.0–39.97) | CTRT 136; RT 50; S + RT 85; S + CTRT 13 |
3y OS 68.9%; 3y DMFS 84.1% |
Index: a percentage of all patients with DM; b value and percentage including all patients; c percentage of all DM sites; d percentage of patients with DM and locoregional control; e treatment of DM. Abbreviations *: mean; § median; Adj: adjuvant; B: bone; BCT: brachytherapy; B-ND: bilateral nodal dissection; CTRT: chemo-radiotherapy; DFS: disease-free survival; PolyM: poly-metastasis; DM: distant metastasis; DMFS: distant metastasis-free survival; DSS: disease-specific survival; IMT: immunotherapy; Ind CT: induction chemotherapy; HP: hypopharyngeal; HPV: human papilloma virus; L: laryngeal; NA: not available; NP: nasopharyngeal; Lg: lung; LN: lymph node; LR: locoregional; Lv: liver; Mos: months; MSC: metastatectomy; ND: nodal dissection; Neoadj: neo-adjuvant; OS: overall survival; RT: radiotherapy; S: surgery; SRS: stereotactic radio-surgery; TLM: transoral laser microsurgery; U-ND: unilateral nodal dissection; y: year.