Kirurško zdravljenje s pooperacijskim obsevanjem zasevkov ploščatoceličnega karcinoma neznanega izvora v bezgavkah na vratu = Combined surgery and postoperative radiotherapy for cervical lymph node metastases of squamous cell carcinoma of unknown origin
Strojan, Primož ; Aničin, Aleksandar
Purpose: During the 20-year period of this study, 56 patients with squamous cell carcinoma cervical lymph node metastases of unknown origin were treated with surgery and postoperative radiotherapy. ...Patients and methods: There were six females and 50 males (median age 56 years). Neck dissection was performed in 48 patients, while eight patients underwent extirpation of a single lymph node metastasis. The disease was assessed as pN1 in six patients, pN2 in 37 patients and pN3 in 13 patients. Extracapsular tumour spread was found in 37 out of 48 examined specimens. Postoperatively, the irradiation field covered sites of a possible occult primary tumour in 48 patients and in eight it was limited to the affected side of the neck, with median tumour doses of 58 and 55 Gy, respectively. Results: After a median follow-up of 8.6 years, 23 patients were alive with no evidence of the disease, 14 died due to non-cancer-related causes and 19 due to progression of the disease. The 5- and10-year disease-specific survival rates were 66% and 52%, respectively, andthe overall survival rates were 52% and 22%, respectively. The survival of the patients significantly correlated (P < 0.05) with extracapsular tumour spread and the size of the irradiation field. Conclusions: With a superior control rate of the neck disease and survival results favourably comparable tothose obtained by a single modality approach, our study supports the use of combined therapy.
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