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Unknown primary of the head and neck

Published online by Cambridge University Press:  29 June 2007

Yoav P. Talmi ,
Gregory T. Wolf ,
Mark Hazuka  and
Charles J. Krause
Yoav P. Talmi*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, the Chaim Sheba Medical Centre, Tel Hashomer, Israel
Gregory T. Wolf
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, the University of Michigan Medical Center, Ann Arbor, Michigan, USA
Mark Hazuka
Affiliation:
Department of Radiation Oncology, the University of Michigan Medical Center, Ann Arbor, Michigan, USA
Charles J. Krause
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, the University of Michigan Medical Center, Ann Arbor, Michigan, USA
*
Address for correspondence: Yoav P. Talmi, M.D., Department of Otolaryngology, Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, 52621Israel. Fax: 972-3-5376515
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Abstract

The occurrence of metastases to the cervical lymph nodes from an unknown primary tumour is seen in approximately three to six per cent of patients with cervical adenopathy and the primary tumour commonly remains elusive. Single modality treatment is occasionally advocated but combined treatment seems to obtain the best results.

A retrospective analysis of patients' charts with unknown primary of the head and neck in theUniversity of Michigan Medical Center was undertaken for the years 1978–1992. Forty-eight records met study criteria and were reviewed.

Our series' size and heterogeneity prevents drawing conclusions regarding treatment effectiveness. The majority (67.5 per cent) of our patients were treated by surgery followed by irradiation. Our overall survival rates compare favourably with the general statistics although it should be noted that longer follow-up in our first group of patients may alter our results. Extracapsular spread did not adversely affect survival in our small series of five cases. We discovered six primary sites within one year and three additional cases within four years. The primary site was included in the radiation fields in all instances of squamous cell tumours that were eventually found. It has been suggested that eventual manifestation of the primary site adversely affects prognosis, which is in agreement with our results.

Keywords

Neoplasm metastasisNeoplasms, unknown primaryHead and neck neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 4 , April 1996 , pp. 353 - 356
Copyright
Copyright © JLO (1984) Limited 1996

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