PMID- 28314959 OWN - NLM STAT- MEDLINE DCOM- 20180116 LR - 20220409 IS - 1434-4726 (Electronic) IS - 0937-4477 (Linking) VI - 274 IP - 6 DP - 2017 Jun TI - Cancer of unknown primary (CUP) of the head and neck: retrospective analysis of 81 patients. PG - 2557-2566 LID - 10.1007/s00405-017-4525-8 [doi] AB - The treatment of patients with cervical lymph node metastases without detectable primary tumor remains an important challenge, until today, no standard therapy is available. The present study investigated the multimodal treatment of patients with head and neck CUP syndrome (HNCUP) and their follow-up retrospectively. 81 patients with cervical lymph node metastases without a primary tumor were treated at the Departments of Otorhinolaryngology as well as Radiotherapy and Radiation Oncology at the University of Saarland in Homburg, Germany in the period between 1991 and 2013. All patients received routine work-up consisting of CUP panendoscopy and imaging. Neck dissection was then performed in 77% of the patients. The most common histology was squamous cell carcinoma (80%). Ten percent of the patients had distant metastases. All patients underwent primary or adjuvant radiation therapy, or simultaneous radiochemotherapy. After a median follow-up of 3.5 years, the 5-year survival rate was 30%. There was a local recurrence that was known in 20/63 patients (31%) and distant metastases were documented in 19/61 M0 patients (31%). Higher grade late toxicity (grade 3-4) was observed in 12% of patients. Neck dissection and radiation therapy remains an integral part of HNCUP therapy, while the use of chemotherapy could be considered in selected cases. Prospective multicenter randomized trials would be necessary to identify the best target volume and to clarify the role of chemotherapy. FAU - Al Kadah, Basel AU - Al Kadah B AUID- ORCID: 0000-0001-8012-0448 AD - Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Strasse 100, 66421, Homburg/saar, Germany. basel.al-kadah@uks.eu. FAU - Papaspyrou, Giorgos AU - Papaspyrou G AD - Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Strasse 100, 66421, Homburg/saar, Germany. FAU - Linxweiler, Maximilian AU - Linxweiler M AD - Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Strasse 100, 66421, Homburg/saar, Germany. FAU - Schick, Bernhard AU - Schick B AD - Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Strasse 100, 66421, Homburg/saar, Germany. FAU - Rube, Christian AU - Rube C AD - Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg/saar, Germany. FAU - Buchler, Benjamin Simeon AU - Buchler BS AD - Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg/saar, Germany. FAU - Niewald, Marcus AU - Niewald M AD - Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg/saar, Germany. LA - eng PT - Journal Article DEP - 20170317 PL - Germany TA - Eur Arch Otorhinolaryngol JT - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JID - 9002937 RN - 0 (Antineoplastic Agents) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents/therapeutic use MH - Combined Modality Therapy MH - Female MH - Head and Neck Neoplasms/mortality/radiotherapy/*therapy MH - Humans MH - Lymph Nodes/pathology MH - Lymphatic Metastasis MH - Male MH - Middle Aged MH - Multivariate Analysis MH - *Neck Dissection MH - Neoplasm Recurrence, Local MH - Neoplasms, Unknown Primary/mortality/radiotherapy/*therapy MH - Proportional Hazards Models MH - Retrospective Studies MH - Survival Rate OTO - NOTNLM OT - CUP OT - Cervical lymph nodes OT - Chemotherapy OT - Neck dissection OT - Radiation therapy EDAT- 2017/03/21 06:00 MHDA- 2018/01/18 06:00 CRDT- 2017/03/19 06:00 PHST- 2016/08/25 00:00 [received] PHST- 2017/03/01 00:00 [accepted] PHST- 2017/03/21 06:00 [pubmed] PHST- 2018/01/18 06:00 [medline] PHST- 2017/03/19 06:00 [entrez] AID - 10.1007/s00405-017-4525-8 [pii] AID - 10.1007/s00405-017-4525-8 [doi] PST - ppublish SO - Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2557-2566. doi: 10.1007/s00405-017-4525-8. Epub 2017 Mar 17.