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Combined ipsilateral treatment of cervical lymph nodes metastases from an unknown primary.
B-ENT. 2008; 4(3):157-61.B

Abstract

INTRODUCTION

The management of squamous cell carcinoma in undetermined primary tumours in the head and neck region (approximately 5.5% of patients) is controversial.

MATERIAL AND METHODS

The present report examines the outcomes for 14 patients after an initial treatment strategy directed principally at the side of the neck that is clinically involved. The distribution of nodal status was as follows: 1 N1, 8 N2A, 4 N2B, and 1 N3.

RESULTS

Initial treatment included a modified neck dissection in 12 cases and radical neck dissection in 2 cases, plus postoperative radiation in 10 cases. Radiotherapy was directed at the ipsilateral side of the neck alone. Concomitant radiochemotherapy was given in 2 cases. The rate of disease control on the ipsilateral side was 12/14. Two patients were treated by chemotherapy but died of their disease. The failure rate on the contralateral side was 2/14. These two patients were successfully salvaged. During follow-up, a primary tumour was detected in one case. At the end of the follow-up, 10 patients were alive.

CONCLUSIONS

Modified radical neck dissection combined with postoperative radiation with or without chemotherapy could be considered in N1-N3 lymph node status. Despite generally advanced disease at presentation, patients presenting with cervical metastasis from an unknown primary carcinoma have a reasonable survival expectation and aggressive treatment is warranted. Careful follow-up is required for effective salvage treatment.

Authors+Show Affiliations

Department of Head and Neck and Thoracic Surgery, CHU Charleroi, Montigny Le Tilleul. didier.dequanter@chu-charleroi.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18949962

Citation

Dequanter, D, et al. "Combined Ipsilateral Treatment of Cervical Lymph Nodes Metastases From an Unknown Primary." B-ENT, vol. 4, no. 3, 2008, pp. 157-61.
Dequanter D, Lothaire P, Gastelblum P, et al. Combined ipsilateral treatment of cervical lymph nodes metastases from an unknown primary. B-ENT. 2008;4(3):157-61.
Dequanter, D., Lothaire, P., Gastelblum, P., Nguyen, T. H., Lalami, Y., Awada, A., & Andry, G. (2008). Combined ipsilateral treatment of cervical lymph nodes metastases from an unknown primary. B-ENT, 4(3), 157-61.
Dequanter D, et al. Combined Ipsilateral Treatment of Cervical Lymph Nodes Metastases From an Unknown Primary. B-ENT. 2008;4(3):157-61. PubMed PMID: 18949962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined ipsilateral treatment of cervical lymph nodes metastases from an unknown primary. AU - Dequanter,D, AU - Lothaire,P, AU - Gastelblum,P, AU - Nguyen,T Hien, AU - Lalami,Y, AU - Awada,A, AU - Andry,G, PY - 2008/10/28/pubmed PY - 2009/2/12/medline PY - 2008/10/28/entrez SP - 157 EP - 61 JF - B-ENT JO - B-ENT VL - 4 IS - 3 N2 - INTRODUCTION: The management of squamous cell carcinoma in undetermined primary tumours in the head and neck region (approximately 5.5% of patients) is controversial. MATERIAL AND METHODS: The present report examines the outcomes for 14 patients after an initial treatment strategy directed principally at the side of the neck that is clinically involved. The distribution of nodal status was as follows: 1 N1, 8 N2A, 4 N2B, and 1 N3. RESULTS: Initial treatment included a modified neck dissection in 12 cases and radical neck dissection in 2 cases, plus postoperative radiation in 10 cases. Radiotherapy was directed at the ipsilateral side of the neck alone. Concomitant radiochemotherapy was given in 2 cases. The rate of disease control on the ipsilateral side was 12/14. Two patients were treated by chemotherapy but died of their disease. The failure rate on the contralateral side was 2/14. These two patients were successfully salvaged. During follow-up, a primary tumour was detected in one case. At the end of the follow-up, 10 patients were alive. CONCLUSIONS: Modified radical neck dissection combined with postoperative radiation with or without chemotherapy could be considered in N1-N3 lymph node status. Despite generally advanced disease at presentation, patients presenting with cervical metastasis from an unknown primary carcinoma have a reasonable survival expectation and aggressive treatment is warranted. Careful follow-up is required for effective salvage treatment. SN - 1781-782X UR - https://www.unboundmedicine.com/medline/citation/18949962/Combined_ipsilateral_treatment_of_cervical_lymph_nodes_metastases_from_an_unknown_primary_ L2 - https://medlineplus.gov/headandneckcancer.html DB - PRIME DP - Unbound Medicine ER -