{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:12Z","timestamp":1787014032727,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,13]],"date-time":"2015-05-13T00:00:00Z","timestamp":1431475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary metastasectomy involves the surgical removal of pulmonary nodules. It is a recognised therapeutic modality for the treatment of metastatic disease. There is no consensus as to the role of pulmonary metastasectomy in squamous cell carcinoma of the head and neck. The objective of this study was to determine whether, in selected patients, resection of subsequent pulmonary metastases prolongs survival in patients already treated for head and neck squamous cell carcinoma and to identify independent risk factors that influence 5\u2010year survival of patients undergoing pulmonary metastasectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review of English and non\u2010English articles using\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      (1950\u2010present),\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      (1980\u2010present),\n                      <jats:styled-content style=\"fixed-case\">NHS<\/jats:styled-content>\n                      evidence and Cochrane databases. Search terms included but were not limited to: squamous cell carcinoma, pulmonary metastasectomy or resection, head and neck cancer, malignancy or tumour. Studies examining outcomes for patients with head and neck squamous cell carcinoma who underwent pulmonary metastasectomy for metachronous pulmonary metastases were included. Independent data extraction of articles by two trained researchers using predefined data fields was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen of 47 studies (all retrospective) fulfilled eligibility criteria, with a total of 403 patients. In total, 11 papers reported 5\u2010year survival rates (Kaplan\u2013Meier) in 387 patients with head and neck squamous cell carcinoma following pulmonary metastasectomy. Meta\u2010analysis of survival data showed an overall absolute 5\u2010year survival rate of 29.1% for patients undergoing pulmonary metastasectomy for metachronous metastases from head and neck squamous cell carcinoma. Two papers reported significantly worse 5\u2010year survival rates in patients with oral head and neck squamous cell carcinoma compared with other sites (9.2%\n                      <jats:italic>versus<\/jats:italic>\n                      32.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001 and 15.4%\n                      <jats:italic>versus<\/jats:italic>\n                      45.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01). Two papers reported that the presence of cervical lymph node metastases at diagnosis of the primary tumour significantly worsened 5\u2010year survival rates following pulmonary metastasectomy (13.8% (N+)\n                      <jats:italic>versus<\/jats:italic>\n                      32% (N0)\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01 and 24% (N+)\n                      <jats:italic>versus<\/jats:italic>\n                      60% (N0)\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.025). Other significant poor prognostic factors included incomplete pulmonary resection and the presence of multiple pulmonary nodules.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review provides level 2a evidence of the effectiveness of pulmonary metastasectomy for metachronous pulmonary metastases from head and neck squamous carcinoma, which may offer prolonged survival for selected patients. Poor prognostic factors for pulmonary metastasectomy in this cohort of patients include the presence of lymph node metastasis at the diagnosis of the original tumour, squamous cell carcinoma of the oral cavity, incomplete pulmonary resection and the presence of multiple pulmonary nodules.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.12348","type":"journal-article","created":{"date-parts":[[2014,10,30]],"date-time":"2014-10-30T09:48:28Z","timestamp":1414662508000},"page":"208-218","source":"Crossref","is-referenced-by-count":80,"title":["Resection of subsequent pulmonary metastases from treated head and neck squamous cell carcinoma: systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"40","author":[{"given":"E.R.","family":"Young","sequence":"first","affiliation":[{"name":"Institute of Head and Neck Studies and Education School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Diakos","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Khalid\u2010Raja","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20952"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(97)90059-4"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000055740"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)00164-5"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.08.033"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70397-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2009.226399"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2009.219766"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9631-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyq023"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.04.040"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0001-4"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(88)80282-4"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0022-5223(19)35939-2","article-title":"Pulmonary resection for metastatic laryngeal carcinoma","volume":"92","author":"Rendina E.A.","year":"1986","journal-title":"J. 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