Metastatic Carcinoma of the Neck Node from an Unknown Primary Site

Kim, Jae Sung; Park, Charn Il

Abstract

From 1980 to 1986, 26 patients with metastatic carcinoma of the neck node from an unknown primary site were seen in the Department of Therapeutic Radiology of Seoul National University Hospital. Among these, three patients were excluded from further analysis due to incomplete treatment. So a retrospective analysis was undertaken on 23 patients who had complete treatment with radiation therapy alone or in combination with surgical treatment and chemotherapy. The overall three year actuarial survival rate was 32%. According to the staging system of the American Joint Committee on Cancer, the three year survival rates with N2 and N3 patients were 43% and 13%, respectively. In 16 patients with squamous cell carcinoma and seven with non-squamous cell carcinoma, the three year survival rates were 34% and 29%, respectively. Analysis according to site of nodal involvement was also done. Patients with cervical node and supraclavicular node involvement recorded 44% and 17% of three year survival rate, respectively. In the study, six patients eventually manifested the primary sites (three in the lung, one in the esophagus, one in the stomach, one in the nasopharynx). Presence of the primary site seemed to influence the prognosis (17% vs 38%). In analyzing the prognostic factors, the nodal stage and site of nodal involvement were important prognostic factors, and the presence of a primary site seemed to influence the patients' survival, but histology did not.