title: Squamous cell carcinoma of unknown primary tumor metastatic to neck nodes: role of elective irradiation.
abstract: In patients with squamous cell carcinoma (SCC) metastases to neck lymph nodes and unknown primary tumor, the role of elective irradiation of uninvolved neck and potential mucosal primary sites is yet to be determined. The aim of this study was to review the experience treating SCC of unknown primary metastatic to neck nodes with surgery and postoperative radiotherapy (PORT) in Slovenia between 1995 and 2010 and to determine the importance of the extent of irradiated volume. For this purpose, the nationwide Cancer Registry of Slovenia database was used for identifying patients. 126 patients were identified. Involved-field PORT and extended-field PORT was used in 50 and 76 patients, respectively. At 5 years, locoregional control was 86 %, disease-specific survival 77 %, and overall survival 57 %. In multivariate analysis, the extent of irradiated volume has not been predictive for any outcome under study. Grade ≥3 acute and late radiotherapy-induced toxicities were more frequent in the extended-field PORT group. In conclusion, although not superior, involved-field PORT seems to be a preferred treatment option in SCC of unknown primary metastatic to neck nodes due to significantly reduced toxicity and better prospects for successful salvage.
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Zaloška 2, 1000, Ljubljana, Slovenia. pstrojan@onko-i.si.|Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. pstrojan@onko-i.si.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Zaloška 2, 1000, Ljubljana, Slovenia.
authors.forename: Marko
authors.initials: M
authors.lastname: Kokalj
authors.affiliation: Epidemiology and Cancer Registries, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Zadnik
authors.affiliation: University Department of Otorhinolaryngology and Cervicofacial Surgery, University Clinical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Aničin
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Zaloška 2, 1000, Ljubljana, Slovenia.
authors.forename: Gaber
authors.initials: G
authors.lastname: Plavc
authors.affiliation: Department of Maxillofacial and Oral Surgery, University Clinical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Vojislav
authors.initials: V
authors.lastname: Didanović
authors.affiliation: University Department of Otorhinolaryngology and Cervicofacial Surgery, University Clinical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Šifrer
authors.affiliation: Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Clinical Center Maribor, Maribor, Slovenia.
authors.forename: Boštjan
authors.initials: B
authors.lastname: Lanišnik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009333:Neck; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D009382:Neoplasms, Unknown Primary / Q000401:mortality*; D012042:Registries; D017524:Slovenia / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects
keywords: Cervical lymph node metastases; Postoperative radiotherapy; Squamous cell carcinoma; Surgery; Unknown primary tumor