J Korean Soc Ther Radiol Oncol.  2005 Sep;23(3):137-142.

Treatment Outcome of Metastatic Carcinoma of Cervical Lymph Node from an Unknown Primary

• Kim K
• Chie EK
• Wu HG
• Kim KH
• Sung MW
• Heo DS
• Park CI

Abstract

PURPOSE: To analyze the outcome of radiation therapy for patients with a metastatic carcinoma of cervical lymph nodes from an unknown primary (MUO), and identify the prognostic factors for these patients.
MATERIALS AND METHODS
Between July 1981 and June 1999, 39 patients with MUO underwent radiation therapy with curative intent. Twelve patients were treated with radiation therapy alone (Group 1), 8 with neoadjuvant chemotherapy followed by radiation therapy (Group 2), and 19 with either an excision or neck dissection and postoperative radiation therapy (Group 3). There were 31 males and 8 females, with a median age of 55 years, ranging from 25 to 77 ears. The median duration of follow-up was 38 months, ranging from 3 to 249 months.
RESULTS
The 5-year overall survival rate was 55%. According to the treatment modality, the 5-year disease-free survival rates of Groups 1, 2 and 3 were 48, 19 and 75%, respectively (p=0.0324). In addition to the treatment modality, the appearance of the primary site was a significant prognostic factor for disease-free survival (p=0.0085).
CONCLUSION
Surgical resection and radiation therapy achieves a superior disease-free survival compared to radiation therapy alone, either with or without chemotherapy. Further investigation is needed to evaluate the role of chemotherapy in the treatment of MUO.

Keyword

Metastatic carcinoma of cervical lymph node; Unknown primary; Radiation therapy

MeSH Terms

Disease-Free Survival
Drug Therapy
Ear
Female
Follow-Up Studies
Humans
Lymph Nodes*
Male
Neck Dissection
Survival Rate
Treatment Outcome*