Cervical lymph node metastasis from an unknown primary: is a tonsillectomy necessary?

Lapeyre, M.; Malissard, L.; Peiffert, D.; Hoffstetter, S.; Toussaint, B.; Renier, Stéphane; Dolivet, Gilles; Geoffrois, L.; Fichet, V.; Simon, Caroline; Bey, P.

doi:10.1016/s0360-3016(97)00321-0

Cited by 85 publications

(66 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ipsilateral palatine tonsillectomy alone detects 18%-44% of occult tumours [15][16][17], whereas some authors have reported contralateral palatine tonsil tumour detection in 10%-23% of patients [17][18][19]. Whilst most cancer centres have an established diagnostic protocol for head and neck CUP as described above, primary site detection rates for metastatic cervical SCC remain variable, with current techniques not able to identify all tumours.…”

Section: Diagnostic Workupmentioning

confidence: 99%

Transoral Robotic Surgery and the Unknown Primary

Ofo

Spiers

Kim

et al. 2018

ORL

View full text Add to dashboard Cite

Carcinoma of unknown primary (CUP) comprises approximately 1%–5% of all head and neck malignancies. Primary site detection rates for metastatic cervical squamous cell carcinoma (SCC) remain variable, with current diagnostic imaging unable to identify all tumours. Prevailing evidence suggests that most head and neck CUP are located in the oropharynx. Diagnostic surgical efforts have been directed at sampling the entire oropharynx. Present techniques that make this possible include transoral robotic surgery (TORS). TORS Lingual tonsillectomy or tongue base mucosectomy performed in the setting of head and neck CUP increases the detection rate of occult tumour. The indication, surgical technique, evidence base, and controversies of performing TORS in the context of the unknown primary are presented.

show abstract

Section: Diagnostic Workupmentioning

confidence: 99%

Transoral Robotic Surgery and the Unknown Primary

Ofo

Spiers

Kim

et al. 2018

ORL

View full text Add to dashboard Cite

show abstract

“…For diagnostic purposes, HPV detection in cervical lymph nodes of patients presenting with an occult primary may be used to establish with high specificity, the location of the primary within the oropharynx. 38 Tonsillectomy has been shown in retrospective analyses to identify the primary site of cervical metastases as the contralateral 72,73 or ipsilateral 74,75 tonsil in approximately 30% and 10% of cases, respectively.…”

Section: Clinical Significance Of An Hpv-positive Tumormentioning

confidence: 99%

Clinical Implications of Human Papillomavirus in Head and Neck Cancers

Fakhry

Gillison

2006

JCO

441

329

View full text Add to dashboard Cite

Human papillomavirus (HPV) is now recognized to play a role in the pathogenesis of a subset of head and neck squamous cell carcinomas (HNSCCs), particularly those that arise from the lingual and palatine tonsils within the oropharynx. High-risk HPV16 is identified in the overwhelming majority of HPV-positive tumors, which have molecular-genetic alterations indicative of viral oncogene function. Measures of HPV exposure, including sexual behaviors, seropositivity to HPV16, and oral, high-risk HPV infection, are associated with increased risk for oropharyngeal cancer. HPV infection may be altering the demographics of HNSCC patients, as these patients tend to be younger, nonsmokers, and nondrinkers. There is sufficient evidence to conclude that a diagnosis of HPV-positive HNSCC has significant prognostic implications; these patients have at least half the risk of death from HNSCC when compared with the HPV-negative patient. The HPV etiology of these tumors may have future clinical implications for the diagnosis, therapy, screening, and prevention of HNSCC.

show abstract

“…In addition to being able to reliably detect HPV in a subset of oropharyngeal cancer when HPV is detected in cervical lymph nodes of patients presenting with an occult primary it may be used to establish with high specificity the location of the primary within the oropharynx [9]. Tonsillectomy has been shown in retrospective analyses to identify the primary site of cervical metastases as the contralateral or ipsilateral tonsil in approximately 10% and 30% of cases, respectively [10][11][12][13]. Therefore, HPV related cancer is a distinct entity that can be reliably diagnosed.…”

Section: Human Papilloma Virusmentioning

confidence: 99%

Current status of biomarkers in head and neck cancer

Chang

Califano

2008

Journal of Surgical Oncology

View full text Add to dashboard Cite

As our understanding of HNSCC increases so has biomarker development. HPV16 integration is a significant marker of favorable prognosis and response to therapy for HNSCC. EGFR-amplification and overexpression is a poor-prognostic indicator. For premalignant lesions, LOH of 3p&9p21 loci confers an elevated risk of malignant transformation. As molecular targets are identified, these will be candidates for biomarkers for detection, diagnosis, prognosis, and therapy. Validation of these biomarkers requires demonstration of independence of significance beyond known biomarkers.

show abstract

Cervical lymph node metastasis from an unknown primary: is a tonsillectomy necessary?

Cited by 85 publications

References 32 publications

Transoral Robotic Surgery and the Unknown Primary

Transoral Robotic Surgery and the Unknown Primary

Clinical Implications of Human Papillomavirus in Head and Neck Cancers

Current status of biomarkers in head and neck cancer

Contact Info

Product

Resources

About