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

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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]
Copyright of Acta Oto-Laryngologica (Supplement) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Diagnostic lymph node extirpation in CUP syndrome -- useful or damaging?
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  Data: <searchLink fieldCode="AR" term="%22Wirth%2C+Markus%22">Wirth, Markus</searchLink><br /><searchLink fieldCode="AR" term="%22Strassen%2C+Ulrich%22">Strassen, Ulrich</searchLink><br /><searchLink fieldCode="AR" term="%22Johnson%2C+Felix%22">Johnson, Felix</searchLink><br /><searchLink fieldCode="AR" term="%22Pickhard%2C+Anja%22">Pickhard, Anja</searchLink><br /><searchLink fieldCode="AR" term="%22Wirth%2C+Magdalena%22">Wirth, Magdalena</searchLink><br /><searchLink fieldCode="AR" term="%22Pigorsch%2C+Steffi%22">Pigorsch, Steffi</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Oto-Laryngologica+%28Supplement%29%22">Acta Oto-Laryngologica (Supplement)</searchLink>. Oct2018, Vol. 138 Issue 10, p926-929. 4p. 3 Charts, 1 Graph.
– Name: Subject
  Label: Subjects
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  Data: <searchLink fieldCode="DE" term="%22Cervical+cancer+diagnosis%22">Cervical cancer diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Cervical+cancer%22">Cervical cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Frozen+tissue+sections%22">Frozen tissue sections</searchLink><br /><searchLink fieldCode="DE" term="%22Neck+surgery%22">Neck surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Squamous+cell+carcinoma%22">Squamous cell carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+of+unknown+primary+origin%22">Cancer of unknown primary origin</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Sentinel+lymph+node+biopsy%22">Sentinel lymph node biopsy</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Oto-Laryngologica (Supplement) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/00016489.2018.1484563
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      – Code: eng
        Text: English
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        PageCount: 4
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      – SubjectFull: Cervical cancer diagnosis
        Type: general
      – SubjectFull: Cervical cancer
        Type: general
      – SubjectFull: Frozen tissue sections
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      – SubjectFull: Neck surgery
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      – SubjectFull: Squamous cell carcinoma
        Type: general
      – SubjectFull: Cancer of unknown primary origin
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      – SubjectFull: Retrospective studies
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      – SubjectFull: Sentinel lymph node biopsy
        Type: general
      – SubjectFull: Diagnosis
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      – TitleFull: Diagnostic lymph node extirpation in CUP syndrome -- useful or damaging?
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            NameFull: Wirth, Markus
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            NameFull: Strassen, Ulrich
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            NameFull: Johnson, Felix
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            NameFull: Pickhard, Anja
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              M: 10
              Text: Oct2018
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              Y: 2018
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              Value: 138
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