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J Korean Soc Ther Radiol Oncol > Volume 23(3); 2005 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2005;23(3): 137-142.
Treatment Outcome of Metastatic Carcinoma of Cervical Lymph Node from an Unknown Primary
Kyubo Kim, Eui Kyu Chie, Hong Gyun Wu, Kwang Hyun Kim, Myung Whun Sung, Dae Seog Heo, Charn Il Park
1Department of Radiation Oncology, Seoul National University College of Medicine. wuhg@snu.ac.kr
2Department of Otolaryngology and Head & Neck Surgery, Seoul National University College of Medicine.
3Department of Internal Medicine, Seoul National University College of Medicine.
4Institute of Radiation Medicine, Medical Research Center, Seoul National University.
To analyze the outcome of radiation therapy for patients with a metastatic carcinoma of cervical lymph nodes from an unknown primary (MUO), and identify the prognostic factors for these patients.
Between July 1981 and June 1999, 39 patients with MUO underwent radiation therapy with curative intent. Twelve patients were treated with radiation therapy alone (Group 1), 8 with neoadjuvant chemotherapy followed by radiation therapy (Group 2), and 19 with either an excision or neck dissection and postoperative radiation therapy (Group 3). There were 31 males and 8 females, with a median age of 55 years, ranging from 25 to 77 ears. The median duration of follow-up was 38 months, ranging from 3 to 249 months.
The 5-year overall survival rate was 55%. According to the treatment modality, the 5-year disease-free survival rates of Groups 1, 2 and 3 were 48, 19 and 75%, respectively (p=0.0324). In addition to the treatment modality, the appearance of the primary site was a significant prognostic factor for disease-free survival (p=0.0085).
Surgical resection and radiation therapy achieves a superior disease-free survival compared to radiation therapy alone, either with or without chemotherapy. Further investigation is needed to evaluate the role of chemotherapy in the treatment of MUO.
Key Words: Metastatic carcinoma of cervical lymph node, Unknown primary, Radiation therapy
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