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Article: Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era

TitleMetastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era
Authors
Keywordscervical adenopathy with unknown primary
HPV related head and neck cancer
non-HPV related head and neck cancer
molecular diagnoses occult primary
upper aerodigestive tract cancers
Issue Date2020
PublisherFrontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology
Citation
Frontiers in Oncology, 2020, v. 10, p. article no. 593164 How to Cite?
AbstractBackground: Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SCC), although other histologies do occur. Methods: We comprehensively reviewed the literature, compared available guidelines, and conferred with an international team of experts. Results: Positron emission tomography-computed tomography (PET-CT) and fine needle aspiration (FNA) under ultrasound guidance increase accuracy of diagnosis. Immunohistochemistry (IHC), determination of human papilloma virus (HPV) status, by p16 staining or by in situ hybridization (ISH), and next-generation gene sequencing can guide us regarding probable primary sites and tumor biology. Narrow Band Imaging (NBI) has been introduced for the early detection of subtle mucosal lesions. Direct laryngoscopy (DL) and tonsillectomy have long been procedures used in the search for a primary site. More recently, TransOral Robotic Surgery (TORS) or Transoral LASER Microsurgery (TLM) have been introduced for lingual tonsillectomy. Conclusions: New technologies have been developed which can better detect, diagnose, and treat occult primary tumors. Decisions regarding therapy are based on the primary tumor site (if discovered) and N stage. Options include neck dissection with or without postoperative adjuvant therapy, primary irradiation, or combined chemotherapy with irradiation. The preferred treatment of patients whose primary remains unidentified is controversial.
Persistent Identifierhttp://hdl.handle.net/10722/293330
ISSN
2023 Impact Factor: 3.5
2023 SCImago Journal Rankings: 1.066
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCivantos, FJ-
dc.contributor.authorVermorken, JB-
dc.contributor.authorShah, JP-
dc.contributor.authorRinaldo, A-
dc.contributor.authorSuárez, C-
dc.contributor.authorKowalski, LP-
dc.contributor.authorRodrigo, JP-
dc.contributor.authorOlsen, K-
dc.contributor.authorStrojan, P-
dc.contributor.authorMäkitie, AA-
dc.contributor.authorTakes, RP-
dc.contributor.authorde Bree, R-
dc.contributor.authorCorry, J-
dc.contributor.authorPaleri, V-
dc.contributor.authorShaha, AR-
dc.contributor.authorHartl, DM-
dc.contributor.authorMendenhall, W-
dc.contributor.authorPiazza, C-
dc.contributor.authorHinni, M-
dc.contributor.authorRobbins, KT-
dc.contributor.authorNg, WT-
dc.contributor.authorSanabria, A-
dc.contributor.authorCoca-Pelaz, A-
dc.contributor.authorLangendijk, JA-
dc.contributor.authorHernandez-Prera, J-
dc.contributor.authorFerlito, A-
dc.contributor.authorThe International Head and Neck Scientific Group-
dc.date.accessioned2020-11-23T08:15:12Z-
dc.date.available2020-11-23T08:15:12Z-
dc.date.issued2020-
dc.identifier.citationFrontiers in Oncology, 2020, v. 10, p. article no. 593164-
dc.identifier.issn2234-943X-
dc.identifier.urihttp://hdl.handle.net/10722/293330-
dc.description.abstractBackground: Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SCC), although other histologies do occur. Methods: We comprehensively reviewed the literature, compared available guidelines, and conferred with an international team of experts. Results: Positron emission tomography-computed tomography (PET-CT) and fine needle aspiration (FNA) under ultrasound guidance increase accuracy of diagnosis. Immunohistochemistry (IHC), determination of human papilloma virus (HPV) status, by p16 staining or by in situ hybridization (ISH), and next-generation gene sequencing can guide us regarding probable primary sites and tumor biology. Narrow Band Imaging (NBI) has been introduced for the early detection of subtle mucosal lesions. Direct laryngoscopy (DL) and tonsillectomy have long been procedures used in the search for a primary site. More recently, TransOral Robotic Surgery (TORS) or Transoral LASER Microsurgery (TLM) have been introduced for lingual tonsillectomy. Conclusions: New technologies have been developed which can better detect, diagnose, and treat occult primary tumors. Decisions regarding therapy are based on the primary tumor site (if discovered) and N stage. Options include neck dissection with or without postoperative adjuvant therapy, primary irradiation, or combined chemotherapy with irradiation. The preferred treatment of patients whose primary remains unidentified is controversial.-
dc.languageeng-
dc.publisherFrontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology-
dc.relation.ispartofFrontiers in Oncology-
dc.rightsThis Document is Protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectcervical adenopathy with unknown primary-
dc.subjectHPV related head and neck cancer-
dc.subjectnon-HPV related head and neck cancer-
dc.subjectmolecular diagnoses occult primary-
dc.subjectupper aerodigestive tract cancers-
dc.titleMetastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era-
dc.typeArticle-
dc.identifier.emailNg, WT: ngwt1@hkucc.hku.hk-
dc.identifier.authorityNg, WT=rp02671-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3389/fonc.2020.593164-
dc.identifier.pmid33244460-
dc.identifier.pmcidPMC7685177-
dc.identifier.scopuseid_2-s2.0-85096648683-
dc.identifier.hkuros319700-
dc.identifier.volume10-
dc.identifier.spagearticle no. 593164-
dc.identifier.epagearticle no. 593164-
dc.identifier.isiWOS:000591890000001-
dc.publisher.placeSwitzerland-
dc.identifier.issnl2234-943X-

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