Cervical metastasis from an unknown primary

Summary--Forty-nine patients with cervical metastases from unknown primaries were treated during an 11-year period. Thirty-one (63%) of these patients were treated for cure rather than palliation. The three-year survival rate of these patients treated for cure was 39%. Although the treatment of these patients varied, a systematic mode of therapy has evolved: patients with histopathologic diagnosis of epidermoid carcinoma, or undifferentiated malignant tumor, metastatic to the neck from an unknown primary, are treated with full course radiation therapy (6000-7000 rads at 1000 rads per week). This is delivered to the nasopharynx, pyriform fossae, base of tongue, and the neck, and is followed by radical neck dissection in those patients in whom the neck nodes remain palpable. Six of the last 11 consecutive patients treated in this manner are long-term survivors. This paper describes the evaluation of patients with cervical metastases from unknown primaries as well as their therapy.