Head and neck carcinoma of unknown primary

Kennel, Titouan; Garrel, R.; Costes, Valérie; Boisselier, P.; Crampette, L.; Favier, Valentin

doi:10.1016/j.anorl.2019.04.002

Cited by 18 publications

(18 citation statements)

References 74 publications

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“…The primary detection rates varied from 45% to 80%, depending on the series. 13 Our methods have relatively good identification rates despite these being office‐based methods.…”

Section: Discussionmentioning

confidence: 91%

Tumor detection with transoral use of flexible endoscopy for unknown primary head and neck cancer

Ebisumoto

Sakai

Maki

et al. 2021

Laryngoscope Investig Oto

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Objectives: With the advent of new optical technologies, early pharyngolaryngeal cancerous lesions can be better visualized. Although the conventional transnasal approach offers great views of the hypopharynx and larynx, the visualization of the oropharynx and palatine tonsils is limited. Through the transoral insertion of a flexible video-laryngoscope, direct views of the oropharynx and oral cavity can be obtained.Thus, transoral examination may contribute to primary detection of cancers of unknown primary (CUP).Methods: Eighty-five CUP patients from Tokai University were included retrospectively in this study, from 2006 to 2017. Starting in 2010, we employed the transoral examination in addition to our conventional method. The primary detection rates were compared before and after 2010. Oropharyngeal primaries were further analyzed for tumor subsite and p16 status. Results:The overall primary detection rate did not improve with the addition of transoral examination. However, greater numbers of oropharyngeal primaries were detected. The oropharyngeal lesions detected by transoral examination were mainly p16 positive, located on the palatine tonsil. Conclusion:Transoral examination is a noninvasive, easy method to adopt in an outpatient setting, and a promising technique to improve tumor detection in this era of human papillomavirus-associated head and neck cancers.

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“…The primary detection rates varied from 45% to 80%, depending on the series. 13 Our methods have relatively good identification rates despite these being office‐based methods.…”

Section: Discussionmentioning

confidence: 91%

Tumor detection with transoral use of flexible endoscopy for unknown primary head and neck cancer

Ebisumoto

Sakai

Maki

et al. 2021

Laryngoscope Investig Oto

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“…Squamous cell carcinoma (SCC) is the most frequently incriminated in the histopathology of head and neck CUP, its frequency being between 53% and 77% 9,10 . Of these, approximately 58% represent the common form of SCC, 15% being represented by adenocarcinomas, undifferentiated carcinomas, seromucous, basaloid or papillary carcinomas 10,11 .…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

Head and neck cancers of unknown primary: A diagnostic and therapeutic challenge

Enache

Sarafoleanu

2023

Romanian Journal of Rhinology

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Head and neck cancers of unknown primary (CUP) represent up to 10% of all cancers located in the head and neck. True cancers of unknown primary, which remain of undetected primary origin after a correct clinical, imaging, surgical evaluation, have a reported frequency of between 1% and 2%. Cancers of unknown primary of the head and neck are a diagnostic challenge, considering that their main clinical manifestation is represented by the appearance of lymph node metastases in the cervical region. In general, the detection of cancers with an unknown starting point is late, difficult, with significant therapeutic failure. The diagnostic-therapeutic approach starts from the histopathological structure of the lymph node metastasis and continues with a correct and complete imaging evaluation. In this review are presented the diagnosis and therapeutic challenges and importance of head and neck cancers with unknown primary.

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“…Given the morbidity of large volume mucosal irradiation, sophisticated treatment planning techniques using either intensity modulated radiotherapy (IMRT) or protons are preferred ( 49 , 50 ). IMRT avoids healthy tissue exposure and has a lower toxicity profile ( 51 ).…”

Section: Radiation Fieldsmentioning

confidence: 99%

Updates in the management of unknown primary of the head and neck

et al. 2022

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Squamous cell carcinoma (SCC) from an unknown primary tumor (SCCUP) accounts for 2.0%–5.0% of all head and neck cancers. SCCUP presents as enlarged cervical lymph nodes without evidence of a primary tumor upon physical examination. Primary site detection is important to target treatment and avoid treatment-related morbidity. In this review, we discuss updates in SCCUP management. Diagnostic workup should focus on localization of the primary tumor in SCCUP. Initial workup centers on neck biopsy to confirm the presence of SCC. Given the increasing incidence of HPV-related SCC in the oropharynx, HPV testing is crucial. An HPV-positive status can localize the tumor to the oropharynx, a common site for occult tumors. Imaging includes neck CT and/or MRI, and PET/CT. After imaging, panendoscopy, palatine tonsillectomy or diagnostic transoral robotic surgery can facilitate high rates of primary tumor localization. Primary tumor localization influences treatments administered. SCCUP has traditionally been treated aggressively with large treatment fields to all potential disease sites, which can induce weight loss and swallowing dysfunction. As a result, primary localization can reduce radiation fields and provide possible de-escalation to primary surgical management. Advances in intensity-modulated radiation therapy and dose management also have the potential to improve functional outcomes in SCCUP patients. Given the improved prognosis associated with HPV-positive SCCs, HPV tumor status may also inform future treatment de-intensification to reduce treatment-related toxicity.

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Head and neck carcinoma of unknown primary

Cited by 18 publications

References 74 publications

Tumor detection with transoral use of flexible endoscopy for unknown primary head and neck cancer

Tumor detection with transoral use of flexible endoscopy for unknown primary head and neck cancer

Head and neck cancers of unknown primary: A diagnostic and therapeutic challenge

Updates in the management of unknown primary of the head and neck

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