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78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2007, Munich

Which role does hematogenous formation of metastases play as a tumour progress parameter in ENT oncology?

Meeting Abstract

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German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno075

The electronic version of this article is the complete one and can be found online at:

Published: August 8, 2007

© 2007 Motsch.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



100 years ago, people were of the firm conviction that carcinomas of the oral cavity, pharynx and larynx only led to remote metastases in exceptional cases (<1%) as a result of their topic. This assumption has been unambiguously refuted. At the time of the first diagnosis, remote metastases are a rare occurrence even now with 1-2%.

318 ENT carcinoma patients given radiosurgery therapy since 1994 were examined in a long-term sequence with regard to the occurrence of tumour progress parameters. 42% of the carcinomas were localised in the 42% oro-pharynx, 34% in the hypopharynx, 15% in the oral cavity and 9% in the supraglottis. The staging showed the following distribution: T2 16.4%, T3 26.4%, T4 57.2%, N0 27%, N1 13%, N2 54%, N3 6%.

By 31.08.2006, 148 patients had died; tumour-dependent 20, local relapse 62, remote formation of metastases 60, secondary carcinoma 5. The probability of developing a clinically relevant remote metastasis in local tumour control was statistically equally as high as the risk of a loco-regional tumour relapse (Z test 0.85). A 5-year survival of 48% was established.

Both kinds of tumour progression were dependent on the initial tumour size (T/N category). The occurrence of remote metastases was not bound to a loco-regional relapse. The significantly more favourable prognosis of the oro-pharynx carcinoma was due to the lower occurrence of remote metastases. Local relapses, on the other hand, occurred with the same frequency in every tumour localisation.

Multi-modal therapy concepts improve the chances of a local tumour control. Remote metastases to be put down to a peri-operative, occult tumour cell dissemination (primarily G0 cells) increasingly determine the survival prognosis.