Does detection of the occult primary tumor result in improved survival in head and neck squamous cell carcinoma?
Explore this issue:September 2014
Background: The management of patients with unknown primary squamous cell carcinoma presenting with cervical metastases is evolving, with the recognition that human papilloma virus (HPV) disease often arises from the oropharynx and the advent of new transoral techniques such as transoral robotic surgery (TORS) that allow removal of lingual tonsillar tissue to improve the yield of unknown primary detection.
Study design: Retrospective chart review of adult patients diagnosed with unknown primary squamous cell carcinoma presenting with cervical metastases between 1980 and 2010. Patients without an obvious primary after complete head and neck exam including flexible laryngoscopy, operative laryngoscopy, and imaging by CT, MRI, or PET comprised the study population. A subset of patients in whom the primary was subsequently found was matched to patients without a known primary by nodal stage and age and comprised the study population.