Resection of pulmonary metastases is often performed after surgical treatment of primary head and neck cancers, as the lungs are the most common site of their distant dissemination. 1 The indications and clinical contributions of surgery for metastatic colon and breast cancers have been widely studied. In contrast, only a few reports have described the clinical outcomes and benefits of the resection of pulmonary metastases of head or neck cancers. The number of patients undergoing resection of pulmonary metastases of head or neck cancers is relatively small compared with colon and breast cancers. At present, no consensus has been reached with respect to the adverse postoperative prognosis conferred, in particular, by clinical and pathological factors, after the resection of lung metastases of head or neck cancers. The purpose of this study was to evaluate the clinical outcomes after pulmonary metastasectomy of head and neck cancers,and to identify predictors of adverse clinical outcome among patients treated at our institution