Health AI Central
Peer-Reviewed Publication
Radiother Oncol2026;111769.September 4, 2026Journal Article

Metastatic patterns, outcomes, and prognostic factors in de novo metastatic head and neck cancer by tumor HPV status.

Alexander Rühle1, Enrique Sanz-Garcia2, Jie Su3, Brian O'Sullivan4, John N Waldron5, Anna Spreafico6, Lillian Siu7, Lawson Eng8, Andrew McPartlin9, Andrew Bayley10, Scott V Bratman11, Ezra Hahn12, Andrew Hope13, Ali Hosni14, Nauman Malik15, Jillian Tsai16, John de Almeida17, Wei Xu18, John Kim19, Shao Hui Huang20
1Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Alexander.Ruhle@uhn.ca.
2Division of Medical Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Enrique.SanzGarcia@uhn.ca.
3Department of Biostatistics, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Susie.Su@uhn.ca.
4Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada; Department of Otolaryngology-Head & Neck Surgery, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Brian.Osullivan@uhn.ca.
5Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada; Department of Otolaryngology-Head & Neck Surgery, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: John.Waldron@uhn.ca.
6Division of Medical Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Anna.Spreafico@uhn.ca.
7Division of Medical Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Lillian.Siu@uhn.ca.
8Division of Medical Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Lawson.Eng@uhn.ca.
9Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Andrew.McPartlin@uhn.ca.
10Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Andrew.Bayley@uhn.ca.
11Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Scott.Bratman@uhn.ca.
12Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Ezra.Hahn@uhn.ca.
13Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Andrew.Hope@uhn.ca.
14Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Ali.Hosni@uhn.ca.
15Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Nauman.Malik@uhn.ca.
16Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Jillian.Tsai@uhn.ca.
17Department of Otolaryngology-Head & Neck Surgery, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: John.deAlmeida@uhn.ca.
18Department of Biostatistics, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Wei.Xu@uhn.ca.
19Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: John.Kim@uhn.ca.
20Department of Radiation Oncology, the Princess Margaret Cancer Centre/University of Toronto, Canada; Department of Otolaryngology-Head & Neck Surgery, the Princess Margaret Cancer Centre/University of Toronto, Canada. Electronic address: Shaohui.huang@uhn.ca.
PubMed DOI

Abstract

OBJECTIVES: To describe metastatic characteristics and outcomes in patients with de novo metastatic (cM1) head and neck squamous cell carcinoma (HNSCC). METHODS: cM1 HNSCC patients diagnosed between 2001 and 2024 were reviewed. Metastatic characteristics and management patterns were collected, including the timing of locoregional radiotherapy (LR-RT) relative to first-line systemic therapy. Overa…

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