Diagnostic and treatment modalities for patients with cervical lymph node metastases of unknown primary site - current status and challenges

被引:31
作者
von der Gruen, Jens Mueller [1 ]
Tahtali, Aykut [2 ]
Ghanaati, Shahram [3 ]
Roedel, Claus [1 ,4 ,5 ]
Balermpas, Panagiotis [1 ,4 ,5 ]
机构
[1] Goethe Univ Frankfurt, Univ Hosp, Dept Radiat Oncol, Theodor Stern Kai 7, D-60590 Frankfurt, Germany
[2] Goethe Univ Frankfurt, Dept Otolaryngol & Head & Neck Surg, Frankfurt, Germany
[3] Goethe Univ Frankfurt, Dept Maxillofacial Surg, Frankfurt, Germany
[4] German Canc Res Ctr, Heidelberg, Germany
[5] German Canc Consortium DKTK, Frankfurt, Germany
关键词
CUP; Cancer of unknown primary; Cervical; Lymph node; Head and neck cancer; SQUAMOUS-CELL CARCINOMA; EPSTEIN-BARR-VIRUS; POSITRON-EMISSION-TOMOGRAPHY; HUMAN-PAPILLOMAVIRUS; OROPHARYNGEAL CANCER; PRIMARY ORIGIN; PRIMARY TUMORS; NECK-CANCER; POSTOPERATIVE RADIOTHERAPY; CONTEMPORARY MANAGEMENT;
D O I
10.1186/s13014-017-0817-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and Purpose: This review aims to provide a comprehensive overview of the literature and elucidate open questions for future clinical trials concerning diagnostics and treatment modalities for cervical cancer of unknown primary (CUP). Methods: A literature search for head and neck CUP was performed with focus on diagnostics and therapies as well as molecular markers. Results: High level evidence on CUP is limited. However, it seems that a consensus exists regarding the optimal diagnostic procedures. The correct implementation of biomarkers for patient stratification and treatment remains unclear. An even greater dispute dominates about the ideal treatment with publications ranging from sole surgery to surgery with postoperative bilateral radiotherapy with inclusion of the mucosa and concomitant chemotherapy. Conclusions: Cervical CUP represents a very heterogeneous malignant disease. On this account many aspects concerning treatment optimization remain unclear, despite a considerable number of publications in the past. Future research in form of prospective randomized trials is needed in order to better define patient stratification criteria and enable tailored treatment.
引用
收藏
页数:12
相关论文
共 107 条
[1]   Clinical Applications of FDG PET and PET/CT in Head and Neck Cancer [J].
Al-Ibraheem, Akram ;
Buck, Andreas ;
Krause, Bernd Joachim ;
Scheidhauer, Klemens ;
Schwaiger, Markus .
JOURNAL OF ONCOLOGY, 2009, 2009
[2]   Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer [J].
Ang, K. Kian ;
Harris, Jonathan ;
Wheeler, Richard ;
Weber, Randal ;
Rosenthal, David I. ;
Nguyen-Tan, Phuc Felix ;
Westra, William H. ;
Chung, Christine H. ;
Jordan, Richard C. ;
Lu, Charles ;
Kim, Harold ;
Axelrod, Rita ;
Silverman, C. Craig ;
Redmond, Kevin P. ;
Gillison, Maura L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (01) :24-35
[3]  
[Anonymous], 1994, MANAGEMENT HEAD NECK
[4]  
[Anonymous], NECK DISSECTION MANA
[5]   Metastatic carcinoma to the cervical nodes from an unknown head and neck primary site: Is there a need for neck dissection? [J].
Aslani, Maryam ;
Sultanem, Khalil ;
Voung, Te ;
Hier, Michael ;
Niazi, Tamim ;
Shenouda, George .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2007, 29 (06) :585-590
[6]  
BATAINI JP, 1987, LARYNGOSCOPE, V97, P1080
[7]   Role of radiotherapy in the treatment of cervical lymph node metastases from an unknown primary site: Retrospective analysis of 113 patients [J].
Beldi, Debora ;
Jereczek-Fossa, Barbara A. ;
D'Onofrio, Alberto ;
Gambaro, Giuseppina ;
Fiore, Maria Rosaria ;
Pia, Francesco ;
Chiesa, Fausto ;
Orecchia, Roberto ;
Krengli, Marco .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2007, 69 (04) :1051-1058
[8]   Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer [J].
Bernier, J ;
Domenge, C ;
Ozsahin, M ;
Matuszewska, K ;
Lefèbvre, JL ;
Greiner, RH ;
Giralt, J ;
Maingon, P ;
Rolland, F ;
Bolla, M ;
Cognetti, F ;
Bourhis, J ;
Kirkpatrick, A ;
van Glabbeke, M .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (19) :1945-1952
[9]   Cervical lymph node metastases from occult squamous cell carcinoma: Analysis of 82 cases [J].
Boscolo-Rizzo, Paolo ;
Da Mosto, Maria Cristina ;
Gava, Alessandro ;
Marchiori, Carlo .
ORL-JOURNAL FOR OTO-RHINO-LARYNGOLOGY AND ITS RELATED SPECIALTIES, 2006, 68 (04) :189-194
[10]   Unknown primary head and neck squamous cell carcinoma: Molecular identification of the site of origin [J].
Califano, J ;
Westra, WH ;
Koch, W ;
Meininger, G ;
Reed, A ;
Yip, L ;
Boyle, JO ;
Lonardo, F ;
Sidransky, D .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1999, 91 (07) :599-604