Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy

Introduction The purpose of the present retrospective study was to review outcome and patterns of failure of patients who were treated with radiotherapy for cervical lymph node metastases from an unknown primary site (CUP). Patients and Methods Between 2000 and 2009, 34 patients diagnosed with squam...

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Main Authors: Cihan Gani, Franziska Eckert, Arndt-Christian Müller, Paul-Stefan Mauz, John Thiericke, Michael Bamberg, Martin Weinmann
Format: Article
Language:English
Published: SAGE Publishing 2013-01-01
Series:Clinical Medicine Insights: Oncology
Online Access:https://doi.org/10.4137/CMO.S12169
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spelling doaj-eac09f4efcfd4bcbb7a870b91dc3adcb2020-11-25T03:40:12ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492013-01-01710.4137/CMO.S12169Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after RadiotherapyCihan Gani0Franziska Eckert1Arndt-Christian Müller2Paul-Stefan Mauz3John Thiericke4Michael Bamberg5Martin Weinmann6Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.Department of Otorhinolaryngology, University of Tübingen, Tübingen, Germany.Department of Otorhinolaryngology, University of Tübingen, Tübingen, Germany.Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.Klinik für Radioonkologie & Radiochirurgicum/Cyberknife Südwest, Göppingen, Germany.Introduction The purpose of the present retrospective study was to review outcome and patterns of failure of patients who were treated with radiotherapy for cervical lymph node metastases from an unknown primary site (CUP). Patients and Methods Between 2000 and 2009, 34 patients diagnosed with squamous cell CUP were admitted to radiotherapy in curative intent. In 26 of 34 patients (76%) neck dissection was performed prior to radiotherapy, extracapsular extension (ECE) was seen in 20 of 34 patients (59%). Target volumes included the bilateral neck and panpharyngeal mucosa. Concomitant chemotherapy was applied in 14 of 34 patients (41%). Results After a median follow-up of 45 months for the entire group, 2 of 34 patients (6%) presented with an isolated regional recurrence, another 2 of 34 patients (6%) developed both local and distant recurrence, and 6 of 34 patients (18%) had distant failure only. Estimated overall survival after 2- and 5 -years was 78% and 63%. All patients with N1 or N2a disease (n=6) were disease free after 5 years. ECE, concomitant chemotherapy and involvement of neck levels 4 and 5 were associated with worse overall survival on univariate analysis. Conclusion Radiotherapy of the panpharynx and bilateral neck leads to excellent local control while distant metastases are the most frequent site of failure and prognostically limiting. Therefore intensified concomitant or sequential systemic therapies should be evaluated in future trials.https://doi.org/10.4137/CMO.S12169
collection DOAJ
language English
format Article
sources DOAJ
author Cihan Gani
Franziska Eckert
Arndt-Christian Müller
Paul-Stefan Mauz
John Thiericke
Michael Bamberg
Martin Weinmann
spellingShingle Cihan Gani
Franziska Eckert
Arndt-Christian Müller
Paul-Stefan Mauz
John Thiericke
Michael Bamberg
Martin Weinmann
Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
Clinical Medicine Insights: Oncology
author_facet Cihan Gani
Franziska Eckert
Arndt-Christian Müller
Paul-Stefan Mauz
John Thiericke
Michael Bamberg
Martin Weinmann
author_sort Cihan Gani
title Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
title_short Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
title_full Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
title_fullStr Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
title_full_unstemmed Cervical Squamous Cell Lymph Node Metastases from an Unknown Primary Site: Survival and Patterns of Recurrence after Radiotherapy
title_sort cervical squamous cell lymph node metastases from an unknown primary site: survival and patterns of recurrence after radiotherapy
publisher SAGE Publishing
series Clinical Medicine Insights: Oncology
issn 1179-5549
publishDate 2013-01-01
description Introduction The purpose of the present retrospective study was to review outcome and patterns of failure of patients who were treated with radiotherapy for cervical lymph node metastases from an unknown primary site (CUP). Patients and Methods Between 2000 and 2009, 34 patients diagnosed with squamous cell CUP were admitted to radiotherapy in curative intent. In 26 of 34 patients (76%) neck dissection was performed prior to radiotherapy, extracapsular extension (ECE) was seen in 20 of 34 patients (59%). Target volumes included the bilateral neck and panpharyngeal mucosa. Concomitant chemotherapy was applied in 14 of 34 patients (41%). Results After a median follow-up of 45 months for the entire group, 2 of 34 patients (6%) presented with an isolated regional recurrence, another 2 of 34 patients (6%) developed both local and distant recurrence, and 6 of 34 patients (18%) had distant failure only. Estimated overall survival after 2- and 5 -years was 78% and 63%. All patients with N1 or N2a disease (n=6) were disease free after 5 years. ECE, concomitant chemotherapy and involvement of neck levels 4 and 5 were associated with worse overall survival on univariate analysis. Conclusion Radiotherapy of the panpharynx and bilateral neck leads to excellent local control while distant metastases are the most frequent site of failure and prognostically limiting. Therefore intensified concomitant or sequential systemic therapies should be evaluated in future trials.
url https://doi.org/10.4137/CMO.S12169
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