Abstract
Background
The results of treatment at the Free University Hospital of 44 patients with cervical lymph node metastasis of an unknown primary tumor were reviewed in order to establish an optimal treatment policy and to look for prognostic parameters. These results were compared with results of other treatment policies known from the literature.
Patients and Method
Thirty-three out of the 44 patients received a treatment with curative intent; 22 cases received a unilateral neck dissection and postoperative radiotherapy, 7 were irradiated after an excisional biopsy and 4 received radical radiotherapy alone.
Results
For the whole group 5- and 10-year overall survival was 50% and 44%, respectively, and for the group treated with curative intent 68% and 56%, respectively. Disease-free survival at 5 and 10 years after treatment for the whole group was 48% and 32%, respectively, and for the group treated with curative intent 63% and 37%, respectively.
Conclusions
Multivariate analysis showed only treatment with intent and histology as significant independent prognostic factors for the whole group. For the patients treated with curative intent no significant influences of variables were found.
Zusammenfassung
Hintergrund
Die Behandlungsergebnisse von 44 Patienten aus dem Freien Universitätsspital in Amsterdam wurden analysiert mit der Absicht, prognostische Faktoren und eine optimale Behandlungsstrategie zu finden. Diese Behandlungsergebnisse wurden verglichen mit Resultaten verschiedener Behandlungsstrategien aus der Literatur.
Patienten und Methode
33 der 44 Patienten wurden mit kurativer Absicht behandelt; 22 Patienten erhielten eine einseitige Neck-dissection und postoperative Radiotherapie, sieben Patienten wurden nach Exzisonbiopsie bestrahlt, und vier Patienten wurden ausschließlich bestrahlt.
Ergebnisse
Die totale Überlebensrate betrug für alle Patienten nach fünf Jahren 50% und nach zehn Jahren 44%, für die mit kurativer Absicht behandelte Gruppe 68% und 56%. Die kumulative Tumorkontrolle betrug für die ganze Gruppe nach fünf Jahren 48%, nach zehn Jahren 32%, für die mit kurativer Absicht behandelte Gruppe 63% und 37%.
Schlußfolgerungen
In einer multivariaten Analyse waren nur die Behandlungsintention (kurativ versus palliativ) und die Histologie prognostische Faktoren für das gesamte Patientenkollektiv. Innerhalb der mit kurativer Intention behandelten Gruppe konnten eigenständige prognostische Faktoren nicht identifiziert werden.
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van der Planken, H.J.M., Tiwari, R.M. & Karim, A.B.M.F. Treatment of cervical lymph node metastasis from an unknown primary tumor, with a review of the literature. Strahlenther. Onkol. 173, 163–169 (1997). https://doi.org/10.1007/BF03039275
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DOI: https://doi.org/10.1007/BF03039275