Cervical lymph node metastases from unknown primary tumours: results from a Danish national survey

Grau, C.; Johansen, Lars Vendelbo; Jakobsen, Johannes; Geertsen, Poul F.; Andersen, E.; Jensen, Brita B.

doi:10.1046/j.1365-2273.2000.00329-13.x

Cited by 110 publications

(257 citation statements)

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“…In another study it was 71% male and 29% female. 2 In this study, majority (40.625%) of patients were 6 th decade followed by 5 th decade (28.15%) patients that was consistent with the metastatic carcinoma to the cervical nodes from an unknown head & Neck region. 9 Unilateral neck node metastasis was 93.75% and bilateral 6.25%.…”

Section: Introductionsupporting

confidence: 70%

“…In another study, it was observed that enlarged lymphnode was commonest (94%) followed by pain (9%) and weight loss (7%). 2 In this study nodes were less than 3 cm in 31.25%, 3 to 6 cm in 56.25% and more than 6 cm in 12.5%. But study carried out by G.B Snow and his team showed enlarged lymph node <3 cm in 85% and > 3 cm in size in 15% only.…”

Section: Introductionmentioning

confidence: 40%

“…Metastasis most commonly developed at nodal levels II & III with less frequent involvement of levels I, IV, V & VI. 2 Diagnostic procedures of unknown primary carcinoma include a full Ear, Nose and Throat examination with nasoendoscopic examination of upper aero-digestive tract, computerized tomography scan and magnetic resonance. Examination under general anaesthesia should be performed which consists of laryngo-pharyngoscopyoesophagoscopy and careful palpation of the tongue base.…”

Section: Introductionmentioning

confidence: 99%

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Metastatic neck node with unknown primary

Karim

Siddiquee

Masud

et al. 2014

Bangladesh J of Otorhinolaryngology

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Objective: To find out the clinical presentation of metastatic neck node with unknown primary. Methods:A cross-sectional study done on the admitted patient from four tertiary level hospitals in Dhaka city from January 2010 to September 2010. Results: Most of the cases were squamous cell carcinoma (68.75%). the next common was adenocarcinoma (15.62%) and undifferentiated carcinoma (12.5%). Melanoma was a rare condition (3.13%). The commonest age group was 6 th decade (40.63%) which was followed by 5 th decade (28%). None of the case was found bellow the age of 30 years. The male to female ratio was 2:1. Commonest metastatic group of lymph node was Level II (50%), followed by Level-III (22%) Level-IV (19%), Level-V (6%) and Level-I (3%). Staging of lymph nodes were

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Section: Introductionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 40%

Section: Introductionmentioning

confidence: 99%

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Metastatic neck node with unknown primary

Karim

Siddiquee

Masud

et al. 2014

Bangladesh J of Otorhinolaryngology

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“…Cervical lymph node metastases of squamous cell carcinoma from unknown primary (CUP) represent about 5 % of all head and neck cancers [1][2][3]. Because of the lack of evidence from randomized studies and the early closing of the only randomized study proposed by the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group, the standard therapy has not been identified yet.…”

Section: Introductionmentioning

confidence: 99%

Induction Chemotherapy Followed by Radiotherapy in Patients with Cervical Lymph Node Metastases from Unknown Primary Carcinoma

Seol

Choi

Lee

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are available. This study was performed to assess the efficacy and safety profiles of induction chemotherapy followed radiotherapy in patients with cervical lymph node metastases from unknown primary cancer. Patients with histological diagnosis of cervical lymph-node metastasis from carcinoma with an unknown primary cancer underwent induction chemotherapy followed by radiotherapy. All patients had squamous cell carcinoma. Induction chemotherapy consisted of 3-4 cycles every 3 weeks of docetaxel (day 1.70 mg/m 2 ) and cisplatin (day 1.75 mg/m 2 ). Radiation therapy (RT) was started with in 10 weeks of the last cycle of chemotherapy, and it was administered 5 days per week. It was given in daily fractions of (1.8) Grays (Gy) of 2 Gy and the total dose to the primary tumor was 70-74 Gy. Neck dissection was reserved for residual disease after definitive radiotherapy. Overall survival, recurrent free survival, and locoregional control were calculated using the Kaplan-Meier method. Twenty one patients with an unknown primary cancer underwent induction chemotherapy and radiotherapy. After induction chemotherapy, 6 patients achieved CR and 8 patients achieved PR. The overall response rate after radiation, was 90.4 % (19 of 21 patients). Neutropenia and infection were the most common grade 3-4 adverse event during induction chemotherapy. Mucositis and dermatitis were the most common grade 3-4 toxicities during radiotherapy. With a median follow-up of 50.6 months, the estimated 2 years OS rates were 71 ± 6 %, respectively. The median OS was 42 months (95 % confidence interval CI 8-65 months). The recurrent-free survival rate at 2 years was 57 %, respectively. In the patients with responder to induction chemotherapy, superior relapse free survival and overall survival rate observed. No occurrence of primary cancer was observed during the follow-up period. Induction chemotherapy followed RT for unknown primarycancer has provided good overall and disease-free survival in all the patients with anacceptable rate of complications. The use of induction chemotherapy and radiationtherapy for more advanced disease led to good clinical results with reasonable toxicities.

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“…Studies comparing unilateral to bilateral neck irradiation have shown mixed results. Several single-institution reports have shown no difference in locoregional control rates [12][13][14][15] or overall survival rates 16 between patients with HNCUP treated with unilateral and bilateral neck treatment, whereas Beldi et al showed improved outcomes with more extensive treatment volumes. 17 Reddy et al demonstrated adequate control of the ipsilateral neck with unilateral irradiation, but contralateral failures were more common.…”

Section: Discussionmentioning

confidence: 99%