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The prognostic role of radiotherapy and radiotherapy target in cervical lymph node metastatic squamous cell carcinoma with unknown primary: a retrospective study

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Objectives

Aim to analyze the effect of radiotherapy for cervical lymph node metastatic carcinoma with unknown primary (CCUP) and compare the survival benefits between Comprehensive radiotherapy and Involved Field radiotherapy.

Materials and methods

The patients diagnosed with CCUP between 2009 and 2019 in our institution were analyzed retrospectively. The categorical variables were tested by χ2 test. Kaplan–Meier method was used for survival analysis. Log-rank test and Cox proportional hazards regression were performed with overall survival (OS) and disease-free survival (DFS) as the primary outcome variables.

Results

Of 139 patients, 64.7% (90/139) of them received radiotherapy. Of the 90 patients who underwent radiotherapy, 45.6% (41/90) received Involved Field radiotherapy and the rest 49 patients received Comprehensive radiotherapy. The median follow-up of 139 patients is 69 months. The 1-year, 3-year, and 5-year OS rates are 87%, 62%, and 39%, respectively, and the DFS rates are 73%, 45%, and 29%, respectively. Multivariate analysis of 139 patients with CCUP shows that differentiation grade, N stage, radiotherapy, and the length of the largest lymph node (DmaxLN) are the independent prognostic factors for both OS and DFS. Subgroup analysis of 90 patients who received radiotherapy shows that the Comprehensive radiotherapy group has a better OS (P < 0.001) and DFS (P < 0.001) compared with Involved Field radiotherapy.

Conclusion

Radiotherapy is the independent prognostic factor for CCUP. Comprehensive radiotherapy may be superior to Involved Field radiotherapy in survival benefits.

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Availability of data and materials

The datasets generated analyzed during the current study are not publicly available.

Code availability

All statistical analyses were performed using R statistical software (version 4.0.1; http://www.r-project.org/), and the “survival” R package was used for survival analysis. The code can be obtained by contacting the corresponding author, with reasonable requests.

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Funding

This study was funded by the National Natural Science Foundation of China (81672386 and 81402494), the Sichuan Province Science and Technology Support Program (No. 2021YFSY008), and the technology Innovation Project of Chengdu Science and Technology Bureau (No. 2019-YF05-00459-SN).

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Author notes

  1. Ruidan Li and Kai Liao have contributed equally to this work.

Authors and Affiliations

  1. The State Key Laboratory of Biotherapy, Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, Sichuan, People’s Republic of China

    Ruidan Li, Zhigong Wei, Zheran Liu, Yan He, Jingjing Wang, Ling He, Xiaoli Mu, Lianlian Yang, Yan Huang & Xingchen Peng

  2. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People’s Republic of China

    Kai Liao

  3. State Key Laboratory of Oral Diseases, Department of Cariology and Endodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, People’s Republic of China

    Libang He

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  1. Ruidan Li
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Contributions

Conceptualization and funding acquisition: XP; methodology and resources: XP, LH, and RL; data curation: RL, LH, XM, and LY; software and formal analysis: RL, KL, and YH; supervision and investigation: RL, ZW, and KL; validation: RL, ZL, and JW; visualization: RL, ZW, and YH; writing—original draft and writing—review and editing: RL, KL, and LH; project administration: XP and LH.

Corresponding authors

Correspondence to Libang He or Xingchen Peng.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study complies with the ethical standards of the institution, and follows the principles of the Helsinki Declaration. Approval was granted by the Ethics Committee of West China Hospital of Sichuan University.

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Because of the retrospective nature of this study, consent to participate for inclusion was waived.

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Because of the retrospective nature of this study, consent to publish was waived.

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Li, R., Liao, K., Wei, Z. et al. The prognostic role of radiotherapy and radiotherapy target in cervical lymph node metastatic squamous cell carcinoma with unknown primary: a retrospective study. J Cancer Res Clin Oncol 148, 1437–1445 (2022). https://doi.org/10.1007/s00432-021-03724-1

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