Clinical analysis of patients suspected of having cervical metastasis from an unknown primary carcinoma

This study analyzed 51 head and neck squamous cell carcinoma patients among 81 patients suspected to have cervical metastasis from an unknown primary carcinoma between 1972 and 2004 at National Kyushu Cancer Center. The primary lesion was known before the first treatment in 12 cases (24%), after first treatment in 9 cases (18%) and was not determined in 30 (58%) cases. Eight of the primary lesions were located in the hypopharynx, and 7 in the mesopharynx. The lesions located in the hypopharynx showed more metastasis to the lymph node, and the lymph nodes were larger following metastases from the nasopharynx. Localizing the site of the primary lesion before the first treatment was very important because it improved the prognosis in comparison to those where the site of the primary tumor was undetermined. The overall survival rate of the patients that underwent a neck dissection was 56% and in comparison to 25% in those that did not. Therefore, the control of neck metastasis by a neck dissection was thus considered to be very important. (author)