Delivered as an oral presentation at the Triological Society Annual Meeting, Chicago, Illinois, April 29–30, 2011.
Head and Neck
Article first published online: 26 APR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 6, pages 1279–1282, June 2012
How to Cite
Balaker, A. E., Abemayor, E., Elashoff, D. and St. John, M. A. (2012), Cancer of unknown primary: Does treatment modality make a difference?. The Laryngoscope, 122: 1279–1282. doi: 10.1002/lary.22424
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 1 JUN 2012
- Article first published online: 26 APR 2012
- Manuscript Accepted: 11 AUG 2011
- Manuscript Revised: 9 AUG 2011
- Manuscript Received: 12 APR 2011
- Head and neck cancer;
- unknown primary;
- survival outcomes;
- Level of Evidence: 2a
We systematically reviewed the published experience on the treatment outcomes of patients with head and neck cancer of unknown primary (CUP) to determine if treatment modality affects survival outcomes.
A comprehensive literature search was performed for articles reporting survival outcomes for CUP in the head and neck published within the last 12 years.
Eighteen studies with 1,726 patients met the inclusion criteria. All studies reported at least 5-year survival outcomes. Thirteen of the 18 studies also reported 5-year survival based on N stage, and six reported 5-year survival based on presence of extracapsular extension (EC). Overall 5-year survival in the entire group was 48.6%. Five-year survival based on N stage was as follows: N1 = 60.8%, all N2 = 51.1%, N2a = 63.6%, N2b = 42.5%, N2c = 37.5%, and N3 = 26.3%, with P < .001 on multivariate analysis. Patients who underwent surgical treatment with either postoperative radiation or chemoradiation had a 5-year survival of 52.4% compared to 46.6% for those treated with chemoradiation alone; however, this difference was not statistically significant. Patients with EC had a 5-year disease-specific survival of 56.9% compared to 81.5% for those without EC (P = .01).
In patients with CUP, survival outcomes are most significantly influenced by clinical stage at time of diagnosis. No significant 5-year survival difference was seen between patients treated with radiation or chemoradiation alone when compared to patients who also received surgical treatment.