[Cervical lymph node metastases in unknown primary tumor. Follow-up of 58 patients]

Fifty-eight patients presenting with lymph node metastases of the head and neck were treated at the Bremen ENT Clinic from 1970 to 1988. In none of the patients could a primary tumor be detected despite extensive diagnostic procedures. The 5-year survival rate was 26.3%. During the further course of the disease, six primary tumors were detected in the following areas: nasopharynx (2 cases), soft palate, oesophagus, bronchi and kidney. Prognosis decreased with increasing tumor stages, although histological grading had no influence on prognosis. Supraclavicular localization and male sex were high risk factors. Prognosis was also not improved when ampiric irradiation also included the pharynx as a possible site of the primary tumor.