Tags

Type your tag names separated by a space and hit enter

Surgery with complete resection improves survival in radiooncologically treated patients with cervical lymph node metastases from cancer of unknown primary.
Strahlenther Onkol. 2008 Mar; 184(3):150-6.SO

Abstract

PURPOSE

To assess long-term toxicity, outcome and prognostic factors after multimodal treatment of cervical lymph node metastases from cancer of unknown primary (CUP).

PATIENTS AND METHODS

In a retrospective study, the treatment results of 84 patients with CUP (median age 63 years, N1 n = 0, N2 n = 44, N3 n = 39, Nx n = 1), treated between 1971 and 2002 with radiotherapy (n = 84, median dose 60 Gy), platinum-based chemotherapy (n = 23) and surgery (n = 69, tonsillectomy [n = 40], neck dissection [n = 52], suprahyoid dissection [n = 18], lymph node excision [n = 14]), were analyzed.

RESULTS

After a mean follow-up time of 25 months (ranging from 0.1 to 260 months), the 3- and 5-year overall (disease-free) survival rates were 30% (39%) and 27% (34%), respectively. 75% of individuals achieved remission, whereas 23% showed no change or progression after treatment. The 3-, 5- and 10-year local control rates were 58%, 58% and 46%, respectively. 40% of patients suffered grade 3/4 late toxicity: severe skin contracture/induration (n = 2) and severe xerostomia (n = 32). Tonsillectomy (p = 0.003) and neck dissection (p = 0.037) performed before radiotherapy significantly improved outcome. Other prognostic factors were age (p = 0.0235), extracapsular spread (n = 63; p = 0.0045), incomplete resection (n = 24; p = 0.0026), nodal disease (p = 0.0034), and distant metastases (n = 17; p = 0.0002). After multivariate analysis only extracapsular spread (p = 0.004) and tonsillectomy (p = 0.01) showed impact on survival.

CONCLUSION

Irradiation of cervical lymph node metastases from CUP is an effective treatment option with acceptable late toxicity. Complete tonsillectomy and neck dissection significantly improved survival in N2/N3 disease. Extracapsular spread was the best predictor for survival and local control. Prospective studies defining a standard treatment are needed.

Authors+Show Affiliations

Department of Radiation Oncology, University of Heidelberg, Germany. Henrik.Hauswald@med.uni-heidelberg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

18330511

Citation

Hauswald, Henrik, et al. "Surgery With Complete Resection Improves Survival in Radiooncologically Treated Patients With Cervical Lymph Node Metastases From Cancer of Unknown Primary." Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [et Al], vol. 184, no. 3, 2008, pp. 150-6.
Hauswald H, Lindel K, Rochet N, et al. Surgery with complete resection improves survival in radiooncologically treated patients with cervical lymph node metastases from cancer of unknown primary. Strahlenther Onkol. 2008;184(3):150-6.
Hauswald, H., Lindel, K., Rochet, N., Debus, J., & Harms, W. (2008). Surgery with complete resection improves survival in radiooncologically treated patients with cervical lymph node metastases from cancer of unknown primary. Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [et Al], 184(3), 150-6. https://doi.org/10.1007/s00066-008-1765-y
Hauswald H, et al. Surgery With Complete Resection Improves Survival in Radiooncologically Treated Patients With Cervical Lymph Node Metastases From Cancer of Unknown Primary. Strahlenther Onkol. 2008;184(3):150-6. PubMed PMID: 18330511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgery with complete resection improves survival in radiooncologically treated patients with cervical lymph node metastases from cancer of unknown primary. AU - Hauswald,Henrik, AU - Lindel,Katja, AU - Rochet,Nathalie, AU - Debus,Juergen, AU - Harms,Wolfgang, PY - 2007/04/30/received PY - 2007/11/07/accepted PY - 2008/3/12/pubmed PY - 2008/7/4/medline PY - 2008/3/12/entrez SP - 150 EP - 6 JF - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] JO - Strahlenther Onkol VL - 184 IS - 3 N2 - PURPOSE: To assess long-term toxicity, outcome and prognostic factors after multimodal treatment of cervical lymph node metastases from cancer of unknown primary (CUP). PATIENTS AND METHODS: In a retrospective study, the treatment results of 84 patients with CUP (median age 63 years, N1 n = 0, N2 n = 44, N3 n = 39, Nx n = 1), treated between 1971 and 2002 with radiotherapy (n = 84, median dose 60 Gy), platinum-based chemotherapy (n = 23) and surgery (n = 69, tonsillectomy [n = 40], neck dissection [n = 52], suprahyoid dissection [n = 18], lymph node excision [n = 14]), were analyzed. RESULTS: After a mean follow-up time of 25 months (ranging from 0.1 to 260 months), the 3- and 5-year overall (disease-free) survival rates were 30% (39%) and 27% (34%), respectively. 75% of individuals achieved remission, whereas 23% showed no change or progression after treatment. The 3-, 5- and 10-year local control rates were 58%, 58% and 46%, respectively. 40% of patients suffered grade 3/4 late toxicity: severe skin contracture/induration (n = 2) and severe xerostomia (n = 32). Tonsillectomy (p = 0.003) and neck dissection (p = 0.037) performed before radiotherapy significantly improved outcome. Other prognostic factors were age (p = 0.0235), extracapsular spread (n = 63; p = 0.0045), incomplete resection (n = 24; p = 0.0026), nodal disease (p = 0.0034), and distant metastases (n = 17; p = 0.0002). After multivariate analysis only extracapsular spread (p = 0.004) and tonsillectomy (p = 0.01) showed impact on survival. CONCLUSION: Irradiation of cervical lymph node metastases from CUP is an effective treatment option with acceptable late toxicity. Complete tonsillectomy and neck dissection significantly improved survival in N2/N3 disease. Extracapsular spread was the best predictor for survival and local control. Prospective studies defining a standard treatment are needed. SN - 0179-7158 UR - https://www.unboundmedicine.com/medline/citation/18330511/Surgery_with_complete_resection_improves_survival_in_radiooncologically_treated_patients_with_cervical_lymph_node_metastases_from_cancer_of_unknown_primary_ L2 - https://dx.doi.org/10.1007/s00066-008-1765-y DB - PRIME DP - Unbound Medicine ER -