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Clinical outcomes of cervical node metastasis from an unknown primary in Songklanagarind Hospital
Krongthong Wongsritrang1, Sumet Fueangkamloon
1Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. wkroungt@medicine.psu.ac.th
Objective:
To study the clinical outcomes of cervical lymph node metastases from an unknown primary site.
Material And Method:
A retrospective review of 139 patients diagnosed with cervical neck node metastases from an unknown primary site in Songklanagarind Hospital between 2000 and 2010 was included. The data of patient and tumor characteristics, diagnostic procedures, and treatment outcomes were recorded. The disease-free and overall survival rates were calculated
Results:
Age ranged from 33 to 95 years with male predominance in 121 patients (87%). The majority of histological finding was squamous cell carcinoma and poorly differentiated grading was predominant. The 3- and 5-year disease-free/overall survival rates were 55.5/33.9% and 48.6/27.8%, respectively. The survival rate was lower significantly in level IV, N3 stage, extracapsular spread, and distant metastasis. The surgery followed by radiation seemed to improve the overall survival of 32.6% at five years. By the average follow-up time of 29.8 months, the emerging primary tumor was found in 12 patients (8.6%).
Conclusion:
The important prognostic factors are nodal status, metastasis, and extracapsular extension. Panendoscopy is recommended for routine diagnostic work-up, as well as the treatment with surgery followed by radiation is useful for improving the survival outcome.
