[Primary cervical lymph nodes of epidermoid type. Results of a series of 123 patients treated by the association surgery-radiotherapy or irradiation alone].
Between 1972 and 1986, 123 patients were treated with curative intent for a metastatic squamous cell carcinoma in cervical lymph nodes of an unknown primary. The lesions, staged according to the 1987 AJC classification were 24 N1, 59 N2, 34 N3 and 6 Nx. A hundred four patients underwent a cervical lymph node dissection and 9 an adenectomy. All these patients received post-operatively external beam therapy on the Waldeyer ring, the pharyngo-larynx, the cervical nodal areas (45 Gy); a boost (20 Gy) was delivered to nodes presenting with extracapsular spread. The 10 remaining patients were inoperable and were treated by radiation therapy alone to a total tumor dose of 70-75 Gy. In the group treated by surgery-radiation therapy, the 5-year overall nodal failure rate was 13.7% and it was 60% for the patients treated by radiation therapy alone. For the first group, this failure rate was correlated to the AJC stage (p = 0.01) and to the number of histologically involved nodes (p = 0.05). The failure rate was 7.7% if the node was clinically fixed versus 21% if it was not (p = 0.07). It was 18% when there was an extracapsular spread and 4.3% when it was absent (p = 0.11). Thirteen patients developed a subsequent primary lesion, in pre-irradiation volume in 5 cases (4%).(ABSTRACT TRUNCATED AT 250 WORDS)
Maulard
C
C
Centre de Radiothérapie, Hôpitaux Necker-Enfants Malades, Paris.
Housset
M
M
Brunel
P
P
Rozec
C
C
Ucla
L
L
Delanian
S
S
Baillet
F
F
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck; D009364:Neoplasm Recurrence, Local
Adénopathies primitives du cou de type épidermoïde. Résultats d'une série de 123 patients traités par association chirurgie-radiothérapie ou irradiation exclusive.