Pretreatment screening on distant metastases and head and neck cancer patients: Validation of risk factors and influence on survival

The validity of three or more lymph node metastases, bilateral lymph node metastases, lymph nodes larger than 6 cm, low jugular lymph node metastases and regional recurrence as high risk factors for the development of distant metastases was confirmed. If more high risk factors are present the cumulative incidence of distant metastases increases significantly. The detection of distant metastases by pretreatment screening worsens the overall survival as compared to distant metastases detected during follow-up.