Diagnostic lymph node extirpation in CUP syndrome -- useful or damaging?

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Bibliographic Details
Title:	Diagnostic lymph node extirpation in CUP syndrome -- useful or damaging?
Authors:	Wirth, Markus, Strassen, Ulrich, Johnson, Felix, Pickhard, Anja, Wirth, Magdalena, Pigorsch, Steffi
Source:	Acta Oto-Laryngologica (Supplement). Oct2018, Vol. 138 Issue 10, p926-929. 4p. 3 Charts, 1 Graph.
Subjects:	Cervical cancer diagnosis, Cervical cancer, Frozen tissue sections, Neck surgery, Squamous cell carcinoma, Cancer of unknown primary origin, Retrospective studies, Sentinel lymph node biopsy, Diagnosis
Abstract:	Objective: In a proportion of patients with cervical lymph node metastasis no primary can be found even with modern imaging and careful clinical examination (cancer of unknown primary syndrome=CUP syndrome). The ideal diagnostic approach is still debated on. Methods: The clinical data of 75 patients (median age: 61.8 years; 16 females and 59 males), which have been treated for cervical squamous cell carcinoma of unknown primary syndrome in our hospital were retrospectively analyzed. Results: In 12% of patients (n=9) the primary demarcated in a time period of up to 5.3 years after diagnosis. In the patients who did not receive adjuvant radiotherapy (n=13), primary became apparent in 38%. Diagnostic lymph node extirpation delayed time until therapeutic neck dissection on average for 3 weeks. In 62% of patients with previous lymph node extirpation (pN2a-N2c), a modified radical neck dissection was required compared to 41% when the surgical site was not operated on. Conclusions: In 12% of patients' primary demarcated in the course of the disease. A diagnostic lymph node extirpation was compared to direct therapeutic neck dissection after frozen section analysis associated with a three weeks delayed therapy and higher rate of modified radical neck dissection. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objective: In a proportion of patients with cervical lymph node metastasis no primary can be found even with modern imaging and careful clinical examination (cancer of unknown primary syndrome=CUP syndrome). The ideal diagnostic approach is still debated on. Methods: The clinical data of 75 patients (median age: 61.8 years; 16 females and 59 males), which have been treated for cervical squamous cell carcinoma of unknown primary syndrome in our hospital were retrospectively analyzed. Results: In 12% of patients (n=9) the primary demarcated in a time period of up to 5.3 years after diagnosis. In the patients who did not receive adjuvant radiotherapy (n=13), primary became apparent in 38%. Diagnostic lymph node extirpation delayed time until therapeutic neck dissection on average for 3 weeks. In 62% of patients with previous lymph node extirpation (pN2a-N2c), a modified radical neck dissection was required compared to 41% when the surgical site was not operated on. Conclusions: In 12% of patients' primary demarcated in the course of the disease. A diagnostic lymph node extirpation was compared to direct therapeutic neck dissection after frozen section analysis associated with a three weeks delayed therapy and higher rate of modified radical neck dissection. [ABSTRACT FROM AUTHOR]
ISSN:	03655237
DOI:	10.1080/00016489.2018.1484563