PURPOSE OF REVIEW The rate of distant metastases in patients with head and neck squamous cell carcinoma (HNSCC) ranges between 4 and 26%. Their appearance marks a critical stage in disease progression, significantly reducing survival rates. Treatment options require a multidisciplinary approach and differ based on the number and extension of distant metastases. The aim of this narrative review is to provide a comprehensive and updated overview of the current state of the art in management of such a clinical scenario. RECENT FINDINGS Accurate detection and staging of distant metastases are essential to determine prognosis and guide therapeutic strategies. Oligometastatic condition refers to patients with only a few distant metastases (up to 5). Surgery or stereotactic body radiotherapy are the best curative treatment options for oligometastatic. However, the majority of HNSCC has a polymetastatic disease, not amenable to curative approach. Therefore, systemic therapies, including chemotherapy (CHT) or target molecular therapy and/or best supportive care, are usually reserved to these patients. Rarely, head and neck region, in particular supraclavicular cervical lymph nodes, may be a site of distant metastases from non-head and neck cancer, particularly from the genitourinary and gastrointestinal tracts. SUMMARY The occurrence of distant metastases in HNSCC represents a pivotal point in the disease progression, lowering survival rates. Pattern of distant metastases has been related to survival outcomes. Patients with distant metastases from an HNSCC always require a multidisciplinary approach and an accurate selection is necessary to individualize the best treatment strategy.

中文翻译：

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头颈部鳞状细胞癌远处转移的现代管理。


综述目的 头颈部鳞状细胞癌 （HNSCC） 患者的远处转移率在 4% 至 26% 之间。它们的出现标志着疾病进展的关键阶段，显著降低了存活率。治疗方案需要多学科方法，并根据远处转移的数量和扩展而有所不同。本叙述性综述的目的是对此类临床场景管理的当前技术水平提供全面和更新的概述。最近的发现 准确检测和分期远处转移对于确定预后和指导治疗策略至关重要。寡转移性疾病是指只有少数远处转移的患者 （最多 5 个）。手术或立体定向放疗是寡转移性的最佳治愈性治疗选择。然而，大多数 HNSCC 患有多转移性疾病，不适合根治性方法。因此，全身治疗，包括化疗 （CHT） 或靶向分子治疗和/或最佳支持治疗，通常保留给这些患者。极少数情况下，头颈部区域，尤其是锁骨上颈部淋巴结，可能是非头颈癌的远处转移部位，尤其是泌尿生殖道和胃肠道转移。摘要 HNSCC 中远处转移的发生代表了疾病进展的关键点，降低了生存率。远处转移的模式与生存结局有关。HNSCC 远处转移的患者始终需要多学科方法，并且需要准确选择以个体化最佳治疗策略。