Diagnosis and treatment of isolated neck metastases of adenocarcinomas
Aims: Cervical metastases of adenocarcinoma or undifferentiated large cell carcinoma (ULCC) (non-squamous cell carcinoma) of unknown primary origin are rare and often accompanied by distant metastases at multiple sites in the body. Nevertheless, in the past decades, several patients have presented i...
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description | Aims: Cervical metastases of adenocarcinoma or undifferentiated large cell carcinoma (ULCC) (non-squamous cell carcinoma) of unknown primary origin are rare and often accompanied by distant metastases at multiple sites in the body. Nevertheless, in the past decades, several patients have presented in our clinic with isolated neck metastases of this type of malignancy. The aim of our study is to evaluate the clinical behaviour of these cases and to define the role of surgery and radiotherapy. Methods: Over the past 24 years, we selected 15 out of 270 patients (6%) with isolated cervical lymph node metastases of adenocarcinoma (six) or ULCC (nine) of unknown primary origin. Diagnosis was made either by histology or by fine needle aspiration cytology. Treatment consisted of (selective) neck dissection and/or radiotherapy. Results: The clinical presentation of isolated cervical metastases of adenocarcinoma compared with ULCC is equivalent, with an overall median survival time of 25 months (confidence interval 21–29 months). Combined therapy was correlated with an increased and persistent regional control and was associated with longer duration of survival. Conclusions: Patients with isolated cervical neck node metastases of adenocarcinoma or ULCC of unknown primary origin are rare and the diagnostic process to identify this subgroup requires a systemic work-up. In selected cases treatment should concentrate on (selective) neck dissection combined with radiotherapy to achieve a prolonged survival. |
doi_str_mv | 10.1053/ejso.2001.1222 |
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Nevertheless, in the past decades, several patients have presented in our clinic with isolated neck metastases of this type of malignancy. The aim of our study is to evaluate the clinical behaviour of these cases and to define the role of surgery and radiotherapy. Methods: Over the past 24 years, we selected 15 out of 270 patients (6%) with isolated cervical lymph node metastases of adenocarcinoma (six) or ULCC (nine) of unknown primary origin. Diagnosis was made either by histology or by fine needle aspiration cytology. Treatment consisted of (selective) neck dissection and/or radiotherapy. Results: The clinical presentation of isolated cervical metastases of adenocarcinoma compared with ULCC is equivalent, with an overall median survival time of 25 months (confidence interval 21–29 months). Combined therapy was correlated with an increased and persistent regional control and was associated with longer duration of survival. Conclusions: Patients with isolated cervical neck node metastases of adenocarcinoma or ULCC of unknown primary origin are rare and the diagnostic process to identify this subgroup requires a systemic work-up. In selected cases treatment should concentrate on (selective) neck dissection combined with radiotherapy to achieve a prolonged survival.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1053/ejso.2001.1222</identifier><identifier>PMID: 11884050</identifier><identifier>CODEN: EJSOE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>adenocarcinoma ; Adenocarcinoma - mortality ; Adenocarcinoma - secondary ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy, Needle ; Carcinoma, Large Cell - mortality ; Carcinoma, Large Cell - secondary ; Carcinoma, Large Cell - therapy ; cervical metastasis ; Combined Modality Therapy ; diagnosis ; Female ; Head and Neck Neoplasms - mortality ; Head and Neck Neoplasms - secondary ; Head and Neck Neoplasms - therapy ; Humans ; large cell undifferentiated carcinoma ; Lymph Nodes - pathology ; Male ; Medical sciences ; Middle Aged ; Neck Dissection - methods ; Neoplasms, Unknown Primary - pathology ; Neoplasms, Unknown Primary - therapy ; Otorhinolaryngology (head neck, general aspects and miscellaneous) ; Otorhinolaryngology. Stomatology ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; treatment ; Treatment Outcome ; Tumors</subject><ispartof>European journal of surgical oncology, 2002-03, Vol.28 (2), p.147-152</ispartof><rights>2002 Elsevier Science Ltd</rights><rights>2002 INIST-CNRS</rights><rights>Copyright Harcourt Publishers Limited.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-83842a27d5cfe8e3006983fa43b8395105bf0d6627ea170e667f7a08c48ad2e93</citedby><cites>FETCH-LOGICAL-c436t-83842a27d5cfe8e3006983fa43b8395105bf0d6627ea170e667f7a08c48ad2e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/ejso.2001.1222$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13583868$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11884050$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zuur, C.L.</creatorcontrib><creatorcontrib>van Velthuysen, M.L.F.</creatorcontrib><creatorcontrib>Schornagel, J.H.</creatorcontrib><creatorcontrib>Hilgers, F.J.M.</creatorcontrib><creatorcontrib>Balm, A.J.M.</creatorcontrib><title>Diagnosis and treatment of isolated neck metastases of adenocarcinomas</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Aims: Cervical metastases of adenocarcinoma or undifferentiated large cell carcinoma (ULCC) (non-squamous cell carcinoma) of unknown primary origin are rare and often accompanied by distant metastases at multiple sites in the body. Nevertheless, in the past decades, several patients have presented in our clinic with isolated neck metastases of this type of malignancy. The aim of our study is to evaluate the clinical behaviour of these cases and to define the role of surgery and radiotherapy. Methods: Over the past 24 years, we selected 15 out of 270 patients (6%) with isolated cervical lymph node metastases of adenocarcinoma (six) or ULCC (nine) of unknown primary origin. Diagnosis was made either by histology or by fine needle aspiration cytology. Treatment consisted of (selective) neck dissection and/or radiotherapy. Results: The clinical presentation of isolated cervical metastases of adenocarcinoma compared with ULCC is equivalent, with an overall median survival time of 25 months (confidence interval 21–29 months). Combined therapy was correlated with an increased and persistent regional control and was associated with longer duration of survival. Conclusions: Patients with isolated cervical neck node metastases of adenocarcinoma or ULCC of unknown primary origin are rare and the diagnostic process to identify this subgroup requires a systemic work-up. In selected cases treatment should concentrate on (selective) neck dissection combined with radiotherapy to achieve a prolonged survival.</description><subject>adenocarcinoma</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - secondary</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Needle</subject><subject>Carcinoma, Large Cell - mortality</subject><subject>Carcinoma, Large Cell - secondary</subject><subject>Carcinoma, Large Cell - therapy</subject><subject>cervical metastasis</subject><subject>Combined Modality Therapy</subject><subject>diagnosis</subject><subject>Female</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - secondary</subject><subject>Head and Neck Neoplasms - therapy</subject><subject>Humans</subject><subject>large cell undifferentiated carcinoma</subject><subject>Lymph Nodes - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neck Dissection - methods</subject><subject>Neoplasms, Unknown Primary - pathology</subject><subject>Neoplasms, Unknown Primary - therapy</subject><subject>Otorhinolaryngology (head neck, general aspects and miscellaneous)</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Prognosis</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>treatment</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEFv1TAMgCMEYo_BlSPqhd36cJK2SY9oMECaxIWdI7_ERRltMuI-pP17Ur0n7TTJsg_-bNmfEO8l7CX0-hPdc94rALmXSqkXYid7rVole_NS7MB0tjWj1RfiDfM9AIzajK_FhZTWdtDDTtx8ifg7ZY7cYArNWgjXhdLa5KmJnGdcKTSJ_J9moRW5BvHWw0Apeyw-prwgvxWvJpyZ3p3rpbi7-frr-nt7-_Pbj-vPt63v9LC2VttOoTKh9xNZ0gBDvW7CTh-sHvv60WGCMAzKEEoDNAxmMgjWdxaDolFfiqvT3oeS_x6JV7dE9jTPmCgf2RnZA9RUwf0J9CUzF5rcQ4kLlkcnwW3m3GbObebcZq4OfDhvPh4WCk_4WVUFPp4BZI_zVDD5yE-c7ut3g62cPXFUPfyLVBz7SMlTiIX86kKOz93wH2nHiW4</recordid><startdate>20020301</startdate><enddate>20020301</enddate><creator>Zuur, C.L.</creator><creator>van Velthuysen, M.L.F.</creator><creator>Schornagel, J.H.</creator><creator>Hilgers, F.J.M.</creator><creator>Balm, A.J.M.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020301</creationdate><title>Diagnosis and treatment of isolated neck metastases of adenocarcinomas</title><author>Zuur, C.L. ; van Velthuysen, M.L.F. ; Schornagel, J.H. ; Hilgers, F.J.M. ; Balm, A.J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-83842a27d5cfe8e3006983fa43b8395105bf0d6627ea170e667f7a08c48ad2e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>adenocarcinoma</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - secondary</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Needle</topic><topic>Carcinoma, Large Cell - mortality</topic><topic>Carcinoma, Large Cell - secondary</topic><topic>Carcinoma, Large Cell - therapy</topic><topic>cervical metastasis</topic><topic>Combined Modality Therapy</topic><topic>diagnosis</topic><topic>Female</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - secondary</topic><topic>Head and Neck Neoplasms - therapy</topic><topic>Humans</topic><topic>large cell undifferentiated carcinoma</topic><topic>Lymph Nodes - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neck Dissection - methods</topic><topic>Neoplasms, Unknown Primary - pathology</topic><topic>Neoplasms, Unknown Primary - therapy</topic><topic>Otorhinolaryngology (head neck, general aspects and miscellaneous)</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Prognosis</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>treatment</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zuur, C.L.</creatorcontrib><creatorcontrib>van Velthuysen, M.L.F.</creatorcontrib><creatorcontrib>Schornagel, J.H.</creatorcontrib><creatorcontrib>Hilgers, F.J.M.</creatorcontrib><creatorcontrib>Balm, A.J.M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zuur, C.L.</au><au>van Velthuysen, M.L.F.</au><au>Schornagel, J.H.</au><au>Hilgers, F.J.M.</au><au>Balm, A.J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and treatment of isolated neck metastases of adenocarcinomas</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2002-03-01</date><risdate>2002</risdate><volume>28</volume><issue>2</issue><spage>147</spage><epage>152</epage><pages>147-152</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><coden>EJSOE7</coden><abstract>Aims: Cervical metastases of adenocarcinoma or undifferentiated large cell carcinoma (ULCC) (non-squamous cell carcinoma) of unknown primary origin are rare and often accompanied by distant metastases at multiple sites in the body. Nevertheless, in the past decades, several patients have presented in our clinic with isolated neck metastases of this type of malignancy. The aim of our study is to evaluate the clinical behaviour of these cases and to define the role of surgery and radiotherapy. Methods: Over the past 24 years, we selected 15 out of 270 patients (6%) with isolated cervical lymph node metastases of adenocarcinoma (six) or ULCC (nine) of unknown primary origin. Diagnosis was made either by histology or by fine needle aspiration cytology. Treatment consisted of (selective) neck dissection and/or radiotherapy. Results: The clinical presentation of isolated cervical metastases of adenocarcinoma compared with ULCC is equivalent, with an overall median survival time of 25 months (confidence interval 21–29 months). Combined therapy was correlated with an increased and persistent regional control and was associated with longer duration of survival. Conclusions: Patients with isolated cervical neck node metastases of adenocarcinoma or ULCC of unknown primary origin are rare and the diagnostic process to identify this subgroup requires a systemic work-up. In selected cases treatment should concentrate on (selective) neck dissection combined with radiotherapy to achieve a prolonged survival.</abstract><cop>Amsterdam</cop><pub>Elsevier Ltd</pub><pmid>11884050</pmid><doi>10.1053/ejso.2001.1222</doi><tpages>6</tpages></addata></record> |
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subjects | adenocarcinoma Adenocarcinoma - mortality Adenocarcinoma - secondary Adenocarcinoma - therapy Adult Aged Aged, 80 and over Biological and medical sciences Biopsy, Needle Carcinoma, Large Cell - mortality Carcinoma, Large Cell - secondary Carcinoma, Large Cell - therapy cervical metastasis Combined Modality Therapy diagnosis Female Head and Neck Neoplasms - mortality Head and Neck Neoplasms - secondary Head and Neck Neoplasms - therapy Humans large cell undifferentiated carcinoma Lymph Nodes - pathology Male Medical sciences Middle Aged Neck Dissection - methods Neoplasms, Unknown Primary - pathology Neoplasms, Unknown Primary - therapy Otorhinolaryngology (head neck, general aspects and miscellaneous) Otorhinolaryngology. Stomatology Prognosis Radiotherapy, Adjuvant Retrospective Studies Survival Analysis treatment Treatment Outcome Tumors |
title | Diagnosis and treatment of isolated neck metastases of adenocarcinomas |
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