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Role of radiotherapy in the treatment of cervical lymph node metastases from an unknown primary site: retrospective analysis of 113 patients.
Int J Radiat Oncol Biol Phys. 2007 Nov 15; 69(4):1051-8.IJ

Abstract

PURPOSE

The management of patients with cervical lymph-node metastases from unknown primary site (UPS) remains a matter of discussion. This study aimed to analyze the results and prognostic factors in a series of patients treated with radiotherapy.

METHODS AND MATERIALS

Data from 113 patients who presented with cervical lymph nodes metastases from UPS treated from 1980 to 2004 were reviewed. Eighty-seven patients (77.0%) were squamous cell carcinoma (SCC). Ninety-one patients were treated with curative and 22 with palliative intent. Fifty-nine of 113 patients (52.2%) received surgery followed by radiotherapy and 54 of 113 (47.8%) received radiotherapy alone. Radiotherapy was delivered to the neck and pharyngeal mucosa in 67 patients and to the ipsilateral or bilateral neck in 45 patients. Twenty-one patients (18.5%) also received chemotherapy.

RESULTS

The 5-year overall survival rates were 40.7% for the entire group and 46.6% for the SCC subgroup. The occurrence of the occult primary was observed in 23 of 113 patients (20.3%), 19 (82.6%) within the head and neck region. At multivariate analysis, treatment with curative intent and extensive irradiation of bilateral neck and pharyngeal mucosa were favorable prognostic factors for the whole series, and treatment with curative intent, extensive irradiation of bilateral neck and pharyngeal mucosa, and absence of extracapsular spread were favorable prognostic factors for the SCC subgroup.

CONCLUSIONS

Patients with cervical lymph node metastases from UPS have a similar prognosis to those affected by other head and neck malignancies. Curative treatment strategies including neck dissection and extensive irradiation by three-dimensional conformal radiation therapy resulted in significantly better outcomes.

Authors+Show Affiliations

Radiotherapy Department, Hospital Maggiore della Carità, Novara, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

17716824

Citation

Beldì, Debora, et al. "Role of Radiotherapy in the Treatment of Cervical Lymph Node Metastases From an Unknown Primary Site: Retrospective Analysis of 113 Patients." International Journal of Radiation Oncology, Biology, Physics, vol. 69, no. 4, 2007, pp. 1051-8.
Beldì D, Jereczek-Fossa BA, D'Onofrio A, et al. Role of radiotherapy in the treatment of cervical lymph node metastases from an unknown primary site: retrospective analysis of 113 patients. Int J Radiat Oncol Biol Phys. 2007;69(4):1051-8.
Beldì, D., Jereczek-Fossa, B. A., D'Onofrio, A., Gambaro, G., Fiore, M. R., Pia, F., Chiesa, F., Orecchia, R., & Krengli, M. (2007). Role of radiotherapy in the treatment of cervical lymph node metastases from an unknown primary site: retrospective analysis of 113 patients. International Journal of Radiation Oncology, Biology, Physics, 69(4), 1051-8.
Beldì D, et al. Role of Radiotherapy in the Treatment of Cervical Lymph Node Metastases From an Unknown Primary Site: Retrospective Analysis of 113 Patients. Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1051-8. PubMed PMID: 17716824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of radiotherapy in the treatment of cervical lymph node metastases from an unknown primary site: retrospective analysis of 113 patients. AU - Beldì,Debora, AU - Jereczek-Fossa,Barbara A, AU - D'Onofrio,Alberto, AU - Gambaro,Giuseppina, AU - Fiore,Maria Rosaria, AU - Pia,Francesco, AU - Chiesa,Fausto, AU - Orecchia,Roberto, AU - Krengli,Marco, Y1 - 2007/08/22/ PY - 2007/01/24/received PY - 2007/04/20/revised PY - 2007/04/21/accepted PY - 2007/8/25/pubmed PY - 2007/12/14/medline PY - 2007/8/25/entrez SP - 1051 EP - 8 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 69 IS - 4 N2 - PURPOSE: The management of patients with cervical lymph-node metastases from unknown primary site (UPS) remains a matter of discussion. This study aimed to analyze the results and prognostic factors in a series of patients treated with radiotherapy. METHODS AND MATERIALS: Data from 113 patients who presented with cervical lymph nodes metastases from UPS treated from 1980 to 2004 were reviewed. Eighty-seven patients (77.0%) were squamous cell carcinoma (SCC). Ninety-one patients were treated with curative and 22 with palliative intent. Fifty-nine of 113 patients (52.2%) received surgery followed by radiotherapy and 54 of 113 (47.8%) received radiotherapy alone. Radiotherapy was delivered to the neck and pharyngeal mucosa in 67 patients and to the ipsilateral or bilateral neck in 45 patients. Twenty-one patients (18.5%) also received chemotherapy. RESULTS: The 5-year overall survival rates were 40.7% for the entire group and 46.6% for the SCC subgroup. The occurrence of the occult primary was observed in 23 of 113 patients (20.3%), 19 (82.6%) within the head and neck region. At multivariate analysis, treatment with curative intent and extensive irradiation of bilateral neck and pharyngeal mucosa were favorable prognostic factors for the whole series, and treatment with curative intent, extensive irradiation of bilateral neck and pharyngeal mucosa, and absence of extracapsular spread were favorable prognostic factors for the SCC subgroup. CONCLUSIONS: Patients with cervical lymph node metastases from UPS have a similar prognosis to those affected by other head and neck malignancies. Curative treatment strategies including neck dissection and extensive irradiation by three-dimensional conformal radiation therapy resulted in significantly better outcomes. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/17716824/Role_of_radiotherapy_in_the_treatment_of_cervical_lymph_node_metastases_from_an_unknown_primary_site:_retrospective_analysis_of_113_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(07)00760-2 DB - PRIME DP - Unbound Medicine ER -