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Lymph node metastases in the neck from unknown primary tumour.
J Jakobsen1, P Aschenfeldt, J Johansen
1Department of Otorhinolaryngology, Odense University Hospital, Denmark.
Acta Oncologica (Stockholm, Sweden)
|January 1, 1992
Summary
Identifying the primary tumor in patients with neck lymph node metastases is crucial. Early detection and treatment, often involving surgery and radiotherapy, can improve survival rates for head and neck cancers.
Area of Science:
- Oncology
- Head and Neck Surgery
- Radiotherapy
Background:
- Lymph node metastases in the neck present a diagnostic challenge.
- A significant number of primary tumors remain undetected upon initial patient assessment.
Purpose of the Study:
- To investigate the origin of primary tumors in patients presenting with neck lymph node metastases.
- To evaluate the outcomes of treatment for these patients.
Main Methods:
- Retrospective analysis of 203 patients with neck lymph node metastases over 12 years.
- Tracking of primary tumor detection during routine examination and follow-up, including autopsy findings.
- Assessment of treatment response and survival rates for patients with small neck node metastases.
Main Results:
- The primary tumor was not detected in 37 out of 203 referred patients.
- Primary tumors were identified in 18 patients during follow-up and in 8 cases post-mortem.
- Most primary tumors were located in the head and neck region, amenable to curative treatment.
- Patients with small neck node metastases treated with neck dissection and radiotherapy achieved a 5-year crude survival rate of 53%.
Conclusions:
- A substantial proportion of neck lymph node metastases originate from occult primary tumors, predominantly in the head and neck.
- Prompt diagnosis and multimodal treatment, including surgery and radiotherapy, are vital for improving survival in these challenging oncological cases.