Radiotherapy of cervical metastasis from the unknown primary site

Twenty nine patients with cervical metastases from an unknown primary site were treated for cure by surgery and/or radiotherapy (RT). According to the 1987 UICC classification, there were 1 N1, 14 N2, and 14 N3 lesions. Eleven patients underwent cervical lymph node dissection or adenectomy with external irradiation (Ope+RT group), and 18 had radiotherapy alone (RT group). Irradiation doses to cervical lesions were between 50–78 Gy. Overall 5-year disease free survival was 40%. Those of the N1-2b and the N2c-3 groups were 61% and 22%, respectively, and the N1-2b group showed significantly better survival than the N2c-3 (p=0.003). Comparing the treatment modalities, the 5-year survival rate of patients who underwent surgery and RT was better than that of patients with RT alone (59% vs 33%, p=0.004). Cumulative incidences of local control of patients with N1-2b and N2c-3 lesions were 73% and 34%, respectively. Local control was significantly better in patients with N1-2b leison like as the survival (p=0.026). That of the Ope+RT group was also significantly better than the RT group (76% vs 36%, p=0.010). It was suggested that local control of cervical lesions was important for better survival in patients with cervical metastases from an unknown primary site, and cervical metastases should be dissected as possible as we can.