Objective：To analyze the status of distant metastases in head and neck carcinoma, the relationship between distant metastasis and survival time, and the difference of survival time according to treatment after distant metastasis.


Materials and Method
s : The medical records of ninty-three confirmed patients with distant metastases among 1,004 admitted patients between 1991 and 1994, were reviewed. Diagnosis of distant metastases were confirmed with X-ray, CT, MRI, bone scan, FNAC, PCNA, and biopsy.


Results
: Histopathologically, fifty-six cases of distant metastases were squamous cellcarcinoma and thirty-seven cases were non-squamous cell carcinoma, among those 14 cases of undifferenciated carcinoma and twelve cases of adenoid cystic carcinoma were included. The overall incidence of distant metastases was 9.3%(93/1,004), varying from 3.0%(5/169) for glottic cancers to 23.6%(25/106) for cancer of the nasopharynx. The most common sites of distant metastases were lungs(50.5%), bones(33.3%), livers(14.0%), and subcutaneous tissues(14.0%). In nineteen cases, distant metastases were detected at the initial diagnosis. Seventy nine cases were died with disease and the mean survival time was 18.1±2.1 months and the mean survival time after distant metastases was 7.6±1.1 months. The mean suvival time of the treated group after distant metastases was 10.7±1.6 months and that of the untreated group was 3.1±0.6 months. The difference was statistically significant(p<0.005).


Conclusion
: In head and neck carcinoma, most of the distant metastases had developed early in the first year with some symtoms and signs. So, close follow-up, detailed history taking, and screening tests such as chest PA, bone scan are needed. The adequate treatment after distant metastases is benefit for the survival time of the patients.