Metastatic cancer without a detectable primary site

Chemotherapy in the Management of Metastatic Cancer of Unknown Primary Site

“…These patients are seen and managed by the Otolaryngology, Radiotherapy, and Plastic Surgical Services. 23 patients (88%) were symptomatic when first seen, which is a higher incidence than that reported by the group at Tulane [10].…”

“…Indeed, apart from the head and neck literature, there is little published about any aspects of this problem [1][2][3][4][5][6][7][8][9][10]. In the past, there was little need for guidance in the management of such pa tients.…”

Management of Cervical Metastases with Occult Primary

“…This secondary-primary gap, i.e., the interval between the occurrence of secondary cervical métastasés and the detection of the primary tumor is quite variable. Smith et al (1967) found it to vary from 1 to 60 months while it was 30 months in our case No. 4.…”

“…This has become possible after correlating the site of the primary with that of the lymph node metastasis in cases of delayed occult primary, i.e., where the primary tumor makes its clinical appearance quite sometime after the appearance of lymph node metastases. The incidence of delayed occult primary was found to be 28.3 % by Smith et al (1967) and 30.9% by Barrie et al (1970). Thus no primary lesion is ever detected in about 70 % of the cases.…”

“…Winegar and Griffin (1973) advo cated radical neck surgery as they obtained a 5-year survival rate in 44.4 % of these patients. Smith et al (1967) were of the opinion that radiation alone produced the best results in undifferentiated carcinomatous métastasés while it should be followed by extirpation of the involved lymph node chain in cases with epidermoid carcinomatous métastasés. Systemic chemotherapy was not found to be of any use by these workers, although it gave a lasting cure in our case No.…”