Cause of death in squamous cell carcinoma of the head and neck. An autopsy study on 31 patients.

A series of 31 autopsied patients, with a history of head and neck squamous cell carcinoma is reported, with the emphasis on the cause of death. There were 26 males and 5 females; mean age being 64 years (range 44-88 years). Locoregional disease (LRD) was the cause of death in 19 patients (61%) and was present in 2 patients dying of an unrelated cause. Distant metastasis (DM) was found in 8 patients (26%) but had caused death in only 1 of them. A shorter survival time for patients with DM than for those without (8 months versus 13 months) indicates that DM is established early in the course of the disease. Therefore, a longer survival time will not result in an increase in DM and we infer that a better locoregional control will also not result in a real increase in DM but only in an apparent one, due to a shift of cause of death from LRD to DM in a group of patients that formerly would have died of LRD before the already present DM had become manifest.