Multi-institutional study of clinical outcomes of patients with head and neck cancer presenting with cN3 disease.

Background: To evaluate disease control, toxicities, and variables associated with clinical outcomes for patients with head and neck squamous cell carcinoma and clinical N3 disease (HNSCC N3) treated with definitive chemoradiation therapy.

Methods: We performed a retrospective review of patients with HNSCC N3 treated at two high-volume academic centers between 1996 and 2019.

Results: We identified 85 patients with a median follow-up of 2.8 years. Five-year overall survival, regional control, and freedom from distant metastases rates were 38%, 80%, and 80%, respectively. Severe complications were identified in 19% of patients.

Conclusions: Favorable regional control is achievable with definitive chemoradiation therapy for patients with HNSCC N3 disease. Distant metastases are a common pattern of failure and should be a focus of prospective study.