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Head and neck unknown primary

In O'Sullivan B, Brierley JD, D'Cruz AK et al. editor. UICC Manual of Clinical Oncology, 9th ed. Oxford: Wiley-Blackwell.
By: Ghosh Laskar S.
Contributor(s): Mummudi NB | Murthy V | Pantvaidya G.
Material type: materialTypeLabelArticlePublisher: Oxford: Wiley-Blackwell, 2015Description: p. 597-608.ISBN: 978-1-4443-3244-5.Subject(s): Unknown primary | Head and neck cancer | Neck nodes | Cervical lymphadenopathy In: O'Sullivan B, Brierley JD, D'Cruz AK et al. editor. UICC Manual of Clinical Oncology, 9th ed. Oxford: Wiley-BlackwellSummary: This chapter focuses on carcinoma of unknown primary (CUP) metastasizing to the neck nodes, discussing its incidence, aetiology, screening, diagnosis, presentation, pathology, and follow-up. It is proposed that angiogenic incompetence of the primary tumour leads to marked apoptosis and cell turnover. Staging of unknown primary is according to the clinical suspicion of the primary tumour with the T-category classified as T0 while the N-category and stage grouping are based on the clinical suspicion of the corresponding primary site of origin. The rationale for the treatment of patients with CUP has been extrapolated from the corresponding management of the neck in known head and neck primaries with cervical nodal metastases. Patients with Stage N1 neck disease with no extracapsular extension can be managed by surgery alone. Conventional RT techniques using two parallel, opposed fields and a low anterior neck field have been associated with significant long-term morbidity.
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This chapter focuses on carcinoma of unknown primary (CUP) metastasizing to the neck nodes, discussing its incidence, aetiology, screening, diagnosis, presentation, pathology, and follow-up. It is proposed that angiogenic incompetence of the primary tumour leads to marked apoptosis and cell turnover. Staging of unknown primary is according to the clinical suspicion of the primary tumour with the T-category classified as T0 while the N-category and stage grouping are based on the clinical suspicion of the corresponding primary site of origin. The rationale for the treatment of patients with CUP has been extrapolated from the corresponding management of the neck in known head and neck primaries with cervical nodal metastases. Patients with Stage N1 neck disease with no extracapsular extension can be managed by surgery alone. Conventional RT techniques using two parallel, opposed fields and a low anterior neck field have been associated with significant long-term morbidity.

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