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Robert C. Wang, MD; Helmuth Goepfert, MD; Annabel E. Barber, MD; Pat Wolf

Arch Otolaryngol Head Neck Surg. 1990;116(12):1388-1393.

Abstract
• We analyzed retrospectively 157 cases of metastatic neck squamous cell carcinoma from unknown primary sites, treated with surgery, radiotherapy, excisional biopsy, and combined modalities. Median follow-up was 74 months, and overall actuarial survival was 55% at 5 years. The surgery-treated group, despite a higher rate of manifesting primary tumors, had significantly better survival at 5 years compared with those receiving radiation therapy, of whom 23% had residual disease after treatment. Primary tumors were discovered during follow-up in 16% overall. Different treatments yielded comparable results in lower-staged neck disease (NX, N1, N2a), while surgery appeared more effective in controlling advanced disease (N2b, N3a). Factors that affected survival include neck stage, connective tissue invasion, and presence of recurrent or residual disease after treatment.

(Arch Otolaryngol Head Neck Surg. 1990;116:1388-1393)

Author Affiliations
From the Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston.

Footnotes
Accepted for publication August 7, 1990.

Presented at the annual meeting of the American Society for Head and Neck Surgery, San Francisco, Calif, April 6, 1989.

Reprint requests to Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (Dr Goepfert).

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