title: Impact of distant metastasis in patients with cervical lymph node metastases from cancer of an unknown primary site.
abstract: OBJECTIVE
  Treatment methods for patients with cervical cancer of an unknown primary site (CUP) are still under discussion. The purpose of this retrospective study was to analyze the oncological follow-up of 58 patients treated for cervical CUP.
  
  
  METHODS
  From 1986 to 2006, 58 patients with cervical CUP were treated at the authors' institution. Treatment consisted of neck dissection alone in 8, irradiation or chemoradiation in 5, combined surgery and radiotherapy in 28, and surgery and radiochemotherapy in 17.
  
  
  RESULTS
  The 3-year and 5-year overall survival rates for all patients were 52.9% and 40.9%, respectively. The 3-year and 5-year disease-specific survival rates were 50.9% and 39.7%, respectively. The 3-year and 5-year neck control rates were 73.7% and 67.3%, respectively. Neck dissection followed by radiochemotherapy was associated with the best 3-year and 5-year locoregional control rates. Extracapsular extension was a predictor of survival, but not of neck control. Distant metastases developed in about one third of all patients and were the most frequent cause of tumor-related death in cases of advanced neck disease.
  
  
  CONCLUSIONS
  Despite the fact that regional control can be achieved in many cases, survival rates may be limited by distant metastasis, especially in patients with advanced neck disease.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery University of Göttingen, Göttingen, Germany.
authors.forename: Ralph M W
authors.initials: RM
authors.lastname: Rödel
authors.forename: Christoph
authors.initials: C
authors.lastname: Matthias
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Blomeyer
authors.forename: Hendrik A
authors.initials: HA
authors.lastname: Wolff
authors.forename: Klaus
authors.initials: K
authors.lastname: Jung
authors.forename: Hans
authors.initials: H
authors.lastname: Christiansen
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D012189:Retrospective Studies; D015996:Survival Rate