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[Cervical lymph node metastasis from an unknown primary tumor].
Y Ikeda1, A Kubota, M Furukawa
1Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama.
Nihon Jibiinkoka Gakkai Kaiho
|June 15, 2000
Summary
Radiotherapy for metastatic cervical lymph nodes from unknown primary tumors achieved a 57% loco-regional control rate. Fine-needle aspiration (FNA) is recommended over open biopsy to reduce distant metastasis risk.
Area of Science:
- Oncology
- Radiotherapy
- Head and Neck Cancer
Context:
- Cervical lymph node metastases from an unknown primary tumor present a diagnostic and therapeutic challenge.
- Historically, treatment has involved addressing potential primary sites, but evidence for this approach is limited.
Purpose:
- To evaluate the efficacy of radiotherapy solely targeting cervical lymph nodes in patients with metastatic carcinoma of unknown primary.
- To assess the impact of diagnostic methods (FNA vs. open biopsy) on distant metastasis rates.
Summary:
- 18 patients with previously untreated metastatic cervical lymph nodes underwent radiotherapy (60-70 Gy) to metastatic sites only.
- A primary lesion was identified in only two cases post-treatment.
- The five-year survival rate was 31%, with a 57% loco-regional control rate.
- Distant metastasis was more frequent in patients who underwent open biopsy compared to fine-needle aspiration (FNA).
Impact:
- Radiotherapy limited to cervical lymph nodes can achieve reasonable loco-regional control.
- Fine-needle aspiration (FNA) is the preferred diagnostic method, as open biopsy may increase the risk of distant metastasis.
- Treatment of potential primary sites may not be necessary, simplifying management protocols for unknown primary head and neck cancers.