[What is the standard treatment approach for a cervical lymph node metastasis from a squamous cell carcinoma of...

The diagnostic work-up of cervical lymph node metastases from an occult primary tumour in the head and neck region is well established. PET-scan, which was controversial, is nowadays an integral part of it. Common therapeutic strategies include neck dissection followed by extensive irradiation of pharyngeal mucosa and bilateral lymph node areas. Chemotherapy is often added to these treatment modalities, especially if negative prognostic factors are present on the pathological specimen. However, its therapeutic benefit is not yet proven. There are numerous phase II studies available in the literature, sometimes with controversial conclusions. Therefore, as long as there are no data issued from randomized controlled trials, the treatment decisions are copied from the ones which are used when the primary tumour is well identified in the head and neck area.