Impact of Neck Dissection in Head and Neck Squamous Cell Carcinomas of Unknown Primary

Abu-Shama, Yazan; Salleron, Julia; Carsuzaa, Florent; Sun, Xu-Shan; Pflumio, Carole; Troussier, I.; Petit, Claire; Caubet, Matthieu; Beddok, Arnaud; Calugaru, Valentin; Servagi-Vernat, S.; Castelli, J.; Miroir, J.; Krengli, Marco; Giraud, P; Romano, Edouard; Khalifa, J.; Doré, M.; Blanchard, Enka; Dupin, Charles; Sumodhee, S.; Tao, Yungan; Roth, Vincent; Geoffrois, L.; Toussaint, B.; Nguyen, Duc Trung; Faivre, J; Thariat, Juliette

doi:10.3390/cancers13102416

Cited by 3 publications

(3 citation statements)

References 40 publications

(61 reference statements)

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“…Yoshii et al reported that neck dissection in 13 out of 15 (86.7%) cases of metastatic carcinoma of the cervical region of unknown primary was carried out, which showed an improvement in prognosis [10]. In a study conducted by Abu-Shama et al in 2021, findings indicated that combining neck dissection with radiotherapy led to enhanced nodal control and improved progression-free survival in cases of head and neck cancers with an unknown primary [11]. This positive effect was observed across all nodal stages.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Cervical Lymph Node Metastasis From an Unknown Primary Site: A Report of a Case Treated Using a Multidisciplinary Approach

Wadhwani,

Bhola,

Kambala

et al. 2024

Cureus

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Metastatic cervical carcinoma from an unknown primary source poses a diagnostic and therapeutic challenge, as it involves the spread of cancer to the neck lymph nodes without a discernible primary tumor despite thorough investigation. While the diagnosis and treatment of this uncommon condition lack definitive evidence, a review of existing literature offers some clinical guidance. A comprehensive diagnostic evaluation, which includes multiple imaging and endoscopic studies, is essential. Surgery is preferred whenever feasible due to its ability to offer more precise staging. This treatment entails an excisional biopsy, neck dissection, and tonsillectomy, but advanced cases necessitate a combination of treatments.This case report underscores this complexity, where, despite radical neck dissection on the affected side, recurrence manifested after two months with no discernible primary site. We emphasize the urgency for continued research and innovative approaches to enhance the diagnosis and management of metastatic cervical carcinoma from an unknown primary source.

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Section: Discussionmentioning

confidence: 99%

Recurrence of Cervical Lymph Node Metastasis From an Unknown Primary Site: A Report of a Case Treated Using a Multidisciplinary Approach

Wadhwani,

Bhola,

Kambala

et al. 2024

Cureus

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“…A PRISMA flowchart is demonstrated in figure 1. On review of full text articles 17 were removed as the series contained less than five patients that were treated with ND alone (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). A further 15 were removed as they comprised conference abstracts only (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) while six were non-English language (44)(45)(46)(47)(48)(49).…”

Section: Study Selectionmentioning

confidence: 99%

Head and neck squamous cell carcinoma of unknown primary - Who can be offered surgery as the sole treatment modality? A systematic review

Takhar

Wilkie

Srinivasan

et al. 2023

Preprint

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Objective Evaluate the role of neck dissection (ND) as the sole treatment modality for patients with cervical head and neck squamous cell carcinoma of unknown primary (HNSCCUP). Design Systematic review of observational cohort studies with qualitative synthesis. Setting PubMed, Ovid EMBASE, and Cochrane Controlled register of Trials (CENTRAL) were screened from January 2000 up to October 2021. Participants HNSCCUP patients undergoing ND. Main Outcome Measures The primary outcome was 3-year overall survival (OS). Secondary outcomes included disease-free survival (DFS), primary emergence, regional recurrence, and distant metastasis. Results Fourteen eligible studies were identified, including 1,780 patients, of whom 294 received ND as their sole treatment (seven studies) with 3-year OS ranging from 43.9% to 100%. 3-year DFS was reported in four studies (n=62) ranging from 42.8% to 67.0%. 5-year OS and DFS were available in three studies (n=31), ranging from 36.6% to 75.0%, and 43.6% to 67.0%, respectively. The rate of primary emergence ranged from 11.1% to 33.3% (seven studies, n=157), regional relapse from 0.0% to 50.0% (five studies, n=60), and distant metastasis from 0.0% to 3.3% (three studies, n=45). Patients undergoing ND as a sole treatment had predominantly p16 positive N1 (TNM7) disease without ECS. Conclusion Outcomes for HNSCCUP patients undergoing ND alone range widely in the literature but appear reasonable in a subset of patients with early stage p16 positive disease. Data is lacking for p16 negative disease where the potential primary site is more varied and primary emergence appears more common.

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“…7 Abu-Shama et al found that the duration between the point of diagnosing CUPS and the date of recurrence (progression-free survival) or locoregional relapse is a factor of the interval of more than 10 weeks between diagnosis and treatment. 44 The extent and number of the cervical lymph node involvement, supraclavicular nodal involvement and unhealthy lifestyle habits, such as betel nut chewing are other important prognostic factors. 5,15…”

Section: Prognosismentioning

confidence: 99%

Cervical metastasis of undetermined origin: evaluation and criteria for management

Ayodele

Ologe

2022

Int J Otorhinolaryngol Head Neck Surg

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Background: Cervical metastatic cancer of undetermined primary site is described as the presence of metastasis in the cervical lymph node(s) without any identifiable primary site, despite detailed clinical and investigative evaluations. Identification of primary origin is still a big challenge even in the phase of modern diagnostic options. This review was meant to lay open the challenges and offer options of evaluation and managing these cases in a resource limited environment.Methods: The literature search was carried out to retrieve relevant published articles, books, guidelines. The search was limited to articles in English while unpublished literatures were excluded. Results: The process of metastasis might begin before the obvious growth of the primary mass, making detection of primary site of a malignant tumour difficult to determine. There is no current worldwide consensus for evaluation and treatment of cervical metastasis of undetermined primary; however, the primary purpose for management should be towards cure along with locoregional control. This is always based on a well-studied natural history of the mucosal squamous cell cancers of the upper aerodigestive tract.Conclusions: The first step in the work up remains thorough clinical evaluation and the minimum evaluation should include computed tomography scan of the head and neck, core needle biopsy of the metastatic cervical lymph node(s) for histological analysis, panendoscopy and biopsies from suspicious sites in the upper airway. Treatment modalities can be classified into modified radical neck dissection with or without adjuvant radiotherapy, radiotherapy alone, and combination of surgical intervention and chemoradiation.

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Impact of Neck Dissection in Head and Neck Squamous Cell Carcinomas of Unknown Primary

Cited by 3 publications

References 40 publications

Recurrence of Cervical Lymph Node Metastasis From an Unknown Primary Site: A Report of a Case Treated Using a Multidisciplinary Approach

Recurrence of Cervical Lymph Node Metastasis From an Unknown Primary Site: A Report of a Case Treated Using a Multidisciplinary Approach

Head and neck squamous cell carcinoma of unknown primary - Who can be offered surgery as the sole treatment modality? A systematic review

Cervical metastasis of undetermined origin: evaluation and criteria for management

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