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Titolo:
Neck dissection and ipsilateral radiotherapy in the management of cervicalmetastatic carcinoma from an unknown primary
Autore:
McMahon, J; Hruby, G; OBrien, CJ; McNeil, EB; Bagia, JS; Clifford, AR; Jackson, MA;
Indirizzi:
Royal Prince Alfred Hosp, Dept Head & Neck Surg, Camperdown, NSW 2050, Australia Royal Prince Alfred Hosp Camperdown NSW Australia 2050 SW 2050, Australia Royal Prince Alfred Hosp, Dept Radiat Oncol, Camperdown, NSW 2050, Australia Royal Prince Alfred Hosp Camperdown NSW Australia 2050 SW 2050, Australia
Titolo Testata:
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY
fascicolo: 4, volume: 70, anno: 2000,
pagine: 263 - 268
SICI:
0004-8682(200004)70:4<263:NDAIRI>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
LYMPH-NODE METASTASES; SQUAMOUS-CELL-CARCINOMA; OCCULT PRIMARY; SUPRAGLOTTIC LARYNX; PRIMARY SITE; CANCER; THERAPY; ORIGIN; IMPACT; HEAD;
Keywords:
lymphatic metastasis; neck; occult primary; squamous cell carcinoma; unknown primary;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: O'Brien, CJ Royal Prince Alfred Hosp, Med Ctr, Suite 209,100 Carillon Ave,Newtown, NSW 2042, Australia Royal Prince Alfred Hosp Suite 209,100 Carillon Ave Newtown NSW Australia 2042
Citazione:
J. McMahon et al., "Neck dissection and ipsilateral radiotherapy in the management of cervicalmetastatic carcinoma from an unknown primary", AUST NZ J S, 70(4), 2000, pp. 263-268

Abstract

Background: In a small proportion of patients presenting with metastases to cervical lymph nodes the primary cancer remains occult despite thorough evaluation. The present report examines patterns of failure and outcome following an initial treatment strategy directed principally at the clinically involved side of the neck. Methods: From a prospectively compiled computerized database 38 patients were identified with metastatic squamous cell carcinoma from an occult primary site. These patients were evaluated with respect to initial treatment, subsequent detection of a primary tumour, neck recurrence and survival characteristics. Results: Thirty-seven of 38 patients were treated with curative intent andall had neck dissection. Adjuvant radiotherapy was given to 34 of the 37 (90%; 32 postoperatively and two pre-operatively). Radiotherapy was directedat the ipsilateral neck alone in 24 patients while 10 received comprehensive treatment to both sides of the neck and potential occult primary sites. The rate of control of disease in the ipsilateral neck was 91% while the failure rate in the contralateral neck was 16% (six patients). A primary cancer was ultimately identified in five patients (13%). Disease-specific survival was 63% at 4 years. Clinical N-3 stage, extracapsular tumour extension and involved surgical margins predicted for poorer survival on univariate analysis. Analysis using multiple risk factors found that only involved surgical margins predicted for treatment failure. Conclusions: Despite generally advanced disease at presentation, patients presenting with cervical metastasis from an unknown primary carcinoma have a reasonable survival expectation and aggressive treatment is warranted, but approximately half will develop recurrent disease. Careful follow-up is required if effective salvage treatment is to be instituted.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/07/20 alle ore 08:13:54