Chemoradiation as a definitive treatment for cervical lymph node metastases from unknown primary cancer

To assess the treatment outcomes of chemoradiation for cervical lymph node metastases from an unknown primary site (CUP), and to identify for prognostic factors.

Thirty patients diagnosed as having CUP, and receiving chemoradiation as a definitive treatment were included in the analysis. Locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) rates were estimated, and the factors affecting treatment outcomes were analyzed.

After a median follow-up period of 25 months for surviving patients, the two- and five-year LRC, DFS, and OS rates were 56%/45%, 46%/36%, and 69%/52%, respectively. On univariate analysis, lower performance status (PS; p=0.001), and limitation of disease to level 2 or 3 lymph nodes (p=0.009) were significantly associated with better DFS. Low PS (p=0.002) was significantly associated with better LRC. No late toxicity of grade 3 or greater was observed.

Definitive chemoradiation for CUP was well-tolerated, with improvement of DFS/LRC for those with good PS and disease limited to level 2 or 3 lymph nodes.