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Cervical node metastasis of occult origin.

R H Spiro, G DeRose, E W Strong

    American Journal of Surgery
    |October 1, 1983
    PubMed
    Summary

    Radical neck dissection offers a 50% 5-year survival for epidermoid carcinoma metastatic to cervical lymph nodes. Survival depends on disease stage, with earlier stages showing better outcomes for this cancer of unknown primary.

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    Hürthle cell carcinoma: a critical histopathologic appraisal.

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology·2001

    Area of Science:

    • Oncology
    • Head and Neck Surgery

    Background:

    • Metastatic carcinoma to cervical lymph nodes with an unknown primary tumor presents a clinical challenge.
    • Management strategies vary, impacting patient prognosis significantly.

    Purpose of the Study:

    • To review a 12-year experience with 132 patients treated for metastatic cervical lymph nodes of unknown primary.
    • To evaluate the efficacy of radical neck dissection and other modalities based on tumor histology and stage.

    Main Methods:

    • Retrospective review of 132 patients treated over 12 years.
    • Primary treatment modality for epidermoid carcinoma was radical neck dissection.
    • Other histologies (adenocarcinoma, anaplastic carcinoma, melanoma) were treated with irradiation, chemotherapy, or radical neck dissection.

    Main Results:

    • For epidermoid carcinoma (79 patients), 5-year survival was 50% with radical neck dissection. Survival was 74% for N1 stage vs. 41% for N2/N3 stages.
    • Primary tumor identification post-therapy occurred in only 15% and had minimal impact on outcome.
    • Metastatic adenocarcinoma (29 patients) had poor outcomes with irradiation/chemotherapy; anaplastic carcinoma (13 patients) had 53% 5-year survival; melanoma (11 patients) had dismal prognosis.

    Conclusions:

    • Radical neck dissection is a viable primary treatment for cervical lymph node metastases of unknown primary, especially for epidermoid carcinoma.
    • Disease extent (N stage) is a critical prognostic factor.
    • Adjunctive radiotherapy may reduce recurrence, and outcomes vary significantly by histology, with adenocarcinoma and melanoma having poor prognoses.

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