Patterns of care in de-novo oligo-metastatic and oligo-recurrent head and neck cancers: A Head and Neck Cancer International Group (HNCIG) Survey

Background: The current survey was conducted among head and neck cancer physicians across the globe to understand the patterns of care and practice for de-novo oligo-metastatic (OM) and oligo-recurrent (OR) head and neck cancer (HNC). Material and methods: An 18-item survey questionnaire was designed and distributed through the member organizations of the Young Investigator Subcommittee of the HNCIG. The responses were presented as a proportion of the total response for a particular survey item. Results: A total of 204 responses were obtained with an overall response rate of 15.6 % (204/1307). The incidence of OM disease was reported to be < 10 % by 81.9 % of respondents with a higher incidence of oligo-recurrent disease (up to 20 %). Performance status and extent of disease are absolute essential factors for decision-making. In suitable patients, the majority of respondents (67.4 %) would like to treat with a combination of systemic and local therapy both to primary and metastatic site. For oligo-recurrent HNC, 63.7 % of respondents would treat with both systemic and metastatic directed therapy (MDT) with 27 % would consider MDT alone. Surgery and stereotactic body radiotherapy (SBRT) remain the choice of MDT for lung and liver metastasis. The majority of the respondents use SBRT in > 50 % of their patients. Conclusion: The current approach to de-novo OM and oligo-recurrent HNC varies in this global survey, but a significant proportion of respondents support radical intent treatment in select cases. Multicentre retrospective and prospective studies as well as international consensus statement are essential prerequisites for developing future clinical guidelines.