A study of the behavior of cancer of the head and neck during its late and terminal phases

Abstract In a period of twelve years, 2,700 autopsies were performed in the Francis Delafield Hospital in the City of New York on patients who died of malignant diseases. Three hundred forty cases can be classified as having primary sites in the head and neck area. A high incidence of second or third primary sites (nineteen per cent) was found in this group of patients, in comparison with an over-all incidence of 6 per cent of multiple primaries in the general group. Excluding the cases of secondary primary carcinoma in the prostate, the rate was 15.5 per cent. There was a 52 per cent incidence of distant metastases in the autopsy findings of carcinoma of the head and neck region, excluding the thyroid. No evidence was found to show that radical surgery in the head and neck area, if it failed, was associated with an increased incidence of distant metastases. Distant metastases developed in 54 per cent of the patients who underwent radical surgery in this series. This was comparable to the over-all incidence of the general group (55 per cent). Surgical failures of the esophageal lesions were seemingly associated with a higher incidence of distant metastases in this series.