Abstract

The median overall survival (OS) of some head and neck malignancies, such as head and neck squamous cell carcinoma (HNSCC), with metastatic lesions was only 12 months. Whether aggressive pulmonary metastasectomy (PM) improves survival is controversial. Patients with primary head and neck malignancy undergoing PM were enrolled. Clinical outcomes were compared among different histological types. Whole-exome sequencing was used for matched pulmonary metastatic samples. The genes where genetic variants have been identified were sent for analysis by DAVID, IPA, and STRING. Forty-nine patients with primary head and neck malignancies were enrolled. Two-year postmetastasectomy survival (PMS) rates of adenoid cystic carcinoma, thyroid carcinoma, nasopharyngeal carcinoma, and HNSCC were 100%, 88.2%, 71.4%, and 59.2%, respectively (P = 0.024). In HNSCC, the time to distant metastasis was an independent predictive factor of the efficacy of PM. Several pathways, such as branched-chain amino acid (BCAA) consumption, were significantly associated with the progression of HNSCC [P < 0.001, fold enrichment (FE) = 5.45]. Moreover, metabolism-associated signaling pathways also seemed to be involved in cancer metastasis. Histological types and time to distant metastasis were important factors influencing the clinical outcomes of PM. For HNSCC, metabolic-associated signaling pathways were significantly associated with tumor progression and distant metastasis. Future validations are warranted.

Details

Title
Clinical, pathophysiologic, and genomic analysis of the outcomes of primary head and neck malignancy after pulmonary metastasectomy
Author
Hsueh-Ju, Lu 1 ; Chih-Cheng Hsieh 2 ; Chi-Chun Yeh 3 ; Yi-Chen, Yeh 4   VIAFID ORCID Logo  ; Chun-Chi, Wu 5 ; Feng-Sheng, Wang 6 ; Jin-Mei, Lai 7 ; Yang, Muh-Hwa 8   VIAFID ORCID Logo  ; Cheng-Hsu, Wang 9 ; Huang, Chi-Ying F 10 ; Peter Mu-Hsin Chang 11 

1  Division of Medical Oncology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Program in Molecular Medicine, School of Life Sciences, National Yang Ming University, Taipei, Taiwan 
2  Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming University, Taipei, Taiwan 
3  Jin An Clinic, New Taipei City, Taiwan 
4  Faculty of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 
5  Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan 
6  Department of Chemical Engineering, National Chung Cheng University, Chiayi, Taiwan 
7  Department of Life Science, Fu Jen Catholic University, New Taipei City, Taiwan 
8  Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan 
9  Cancer Center, Keelung Chang Gang Memorial Hospital, Keelung, Taiwan 
10  Program in Molecular Medicine, School of Life Sciences, National Yang Ming University, Taipei, Taiwan; Institute of Biopharmaceutical Sciences, National Yang Ming University, Taipei, Taiwan 
11  Faculty of Medicine, National Yang Ming University, Taipei, Taiwan; Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan 
Pages
1-13
Publication year
2019
Publication date
Sep 2019
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-019-49212-y
ProQuest document ID
2303202575
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.