ArticleTranslational cancer research2026
Distant lymph node metastasis in head and neck cancer: incidence, predictors, and survival outcomes in a population-based cohort.
Article in Translational cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Distant lymph node metastasis (DLM) is rare in head and neck cancer (HNC), occurring in only 0.76% of cases, underscoring the importance of understanding its clinical behavior. However, population-based data on the incidence, predictors, and prognostic implications of DLM relative to other metastatic patterns remain limited. This study aimed to determine the incidence of DLM at diagnosis, identify its independent predictors, and evaluate the impact of DLM and its treatment on survival in a population-based cohort of patients with HNC. Methods: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database [2016-2022] and identified 42,908 patients with HNC. Multivariable logistic regression was used to determine factors associated with DLM at diagnosis. Overall survival (OS) was estimated using the Kaplan-Meier method. Cancer-specific mortality was assessed using a competing-risks analysis, while treatment effects within the DLM-positive cohort were studied using a 3-month landmark analysis to reduce immortal-time bias. Results: DLM was present at diagnosis in 325 patients (0.76%). Independent prognostic factors were age 60 years or older, hypopharyngeal tumor primary site, advanced tumor (T) and node (N) stage, neuroendocrine carcinoma, and melanoma (all P<0.05). Model discrimination was good [area under the receiver operating characteristic curve (AUC) =0.835]. Patients with DLM had significantly shorter median OS than those without distant metastasis (8.0 Conclusions: These findings suggest that subclassifying metastatic disease could enhance risk stratification and guide more personalized treatment strategies.
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