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Carcinoma metastatic to cervical lymph nodes from an occult primary tumor: the outcome after combined-modality therapy.
Ann Surg Oncol. 2007 May; 14(5):1575-82.AS

Abstract

BACKGROUND

The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy.

METHODS

Ninety patients were treated with curative intent from 1990 to 2002.

RESULTS

The actuarial rate of neck disease control was 68.8% at 5 years (95% confidence interval [CI], 58.9%-78.7%). On multivariate analysis, the rate of neck disease control was significantly related to lymph nodal metastatic level (P = .006). The actuarial rate of developing head and neck primary tumors at 5 years was 8.9% (95% CI, 2.6%-15.2%). The 5-year actuarial rate of distant metastases was 19.1% (95% CI, 9.4%-28.9%). In multivariate analysis, a statistically significant difference in the rate of distant metastasis was obtained when patients were stratified according to the level of nodal involvement (P = .01) and the presence of extracapsular extension (P = .013). At the time of analysis, 50 of the 90 patients were alive. A total of 32 (35.6%) had died from causes related to their primary disease. Actuarial disease-specific survival at 2 and 5 years was 73.6% (95% CI, 64.3%-82.9%) and 62.8% (95% CI, 51.9%-73.7%), respectively. In multivariate analysis, a statistically significant difference in disease-specific survival was obtained when patients were stratified according to the level of nodal involvement and the presence of extracapsular extension.

CONCLUSIONS

Our study seems to support the use of combined-modality therapy in patients with neck metastases from carcinoma of occult primary. However, in the absence of randomized trials, comprehensive irradiation cannot be routinely advised.

Authors+Show Affiliations

ENT Department and Regional Center for Head and Neck Cancer, University of Padua, School of Medicine, Treviso Regional Hospital, Treviso, Italy. paolo.boscolorizzo@unipd.itNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17508250

Citation

Boscolo-Rizzo, Paolo, et al. "Carcinoma Metastatic to Cervical Lymph Nodes From an Occult Primary Tumor: the Outcome After Combined-modality Therapy." Annals of Surgical Oncology, vol. 14, no. 5, 2007, pp. 1575-82.
Boscolo-Rizzo P, Gava A, Da Mosto MC. Carcinoma metastatic to cervical lymph nodes from an occult primary tumor: the outcome after combined-modality therapy. Ann Surg Oncol. 2007;14(5):1575-82.
Boscolo-Rizzo, P., Gava, A., & Da Mosto, M. C. (2007). Carcinoma metastatic to cervical lymph nodes from an occult primary tumor: the outcome after combined-modality therapy. Annals of Surgical Oncology, 14(5), 1575-82.
Boscolo-Rizzo P, Gava A, Da Mosto MC. Carcinoma Metastatic to Cervical Lymph Nodes From an Occult Primary Tumor: the Outcome After Combined-modality Therapy. Ann Surg Oncol. 2007;14(5):1575-82. PubMed PMID: 17508250.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carcinoma metastatic to cervical lymph nodes from an occult primary tumor: the outcome after combined-modality therapy. AU - Boscolo-Rizzo,Paolo, AU - Gava,Alessandro, AU - Da Mosto,Maria Cristina, Y1 - 2007/02/16/ PY - 2006/10/05/received PY - 2006/12/07/accepted PY - 2006/11/30/revised PY - 2007/5/18/pubmed PY - 2007/10/5/medline PY - 2007/5/18/entrez SP - 1575 EP - 82 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 14 IS - 5 N2 - BACKGROUND: The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy. METHODS: Ninety patients were treated with curative intent from 1990 to 2002. RESULTS: The actuarial rate of neck disease control was 68.8% at 5 years (95% confidence interval [CI], 58.9%-78.7%). On multivariate analysis, the rate of neck disease control was significantly related to lymph nodal metastatic level (P = .006). The actuarial rate of developing head and neck primary tumors at 5 years was 8.9% (95% CI, 2.6%-15.2%). The 5-year actuarial rate of distant metastases was 19.1% (95% CI, 9.4%-28.9%). In multivariate analysis, a statistically significant difference in the rate of distant metastasis was obtained when patients were stratified according to the level of nodal involvement (P = .01) and the presence of extracapsular extension (P = .013). At the time of analysis, 50 of the 90 patients were alive. A total of 32 (35.6%) had died from causes related to their primary disease. Actuarial disease-specific survival at 2 and 5 years was 73.6% (95% CI, 64.3%-82.9%) and 62.8% (95% CI, 51.9%-73.7%), respectively. In multivariate analysis, a statistically significant difference in disease-specific survival was obtained when patients were stratified according to the level of nodal involvement and the presence of extracapsular extension. CONCLUSIONS: Our study seems to support the use of combined-modality therapy in patients with neck metastases from carcinoma of occult primary. However, in the absence of randomized trials, comprehensive irradiation cannot be routinely advised. SN - 1068-9265 UR - https://www.unboundmedicine.com/medline/citation/17508250/Carcinoma_metastatic_to_cervical_lymph_nodes_from_an_occult_primary_tumor:_the_outcome_after_combined_modality_therapy_ L2 - https://dx.doi.org/10.1245/s10434-006-9329-9 DB - PRIME DP - Unbound Medicine ER -