An evaluation of the diagnostic methods in head and neck cancer of unknown primary site. (3rd October 2018)

• Record Type: Journal Article
• Authors: Aro, Katri; Bäck, Leif; Mäkitie, Antti; Tapiovaara, Laura
• Is Part Of: Acta oto-laryngologica. Volume 138:Number 10(2018)
• Page Start: 930
• Page End: 936
• Publication Date: 2018-10-03
• Subjects: Diagnostics -- head and neck cancer -- metastasis -- survival -- unknown primary; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2018.1484567
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: Various detection methods to identify the primary in head and neck cancer of unknown primary (HN-CUP) require evaluation to improve and standardize management. Objectives: To evaluate the use of different diagnostic methods, which aim at decreasing the incidence of HN-CUP. Material and methods: We conducted a retrospective analysis of patients with HN-CUP at the Helsinki University Hospital during 1995–2011. We evaluated clinical assessment, definitive treatment, histopathology, and follow up. We analyzed the success in identifying the primary site to show any changes in diagnostic methods over time. Results: Frequency of HN-CUP and success in identifying the primary site have remained constant despite the addition of PET-CT and determination of human papilloma virus (HPV) status in diagnostics. Among 133 patients, the diagnostic work up identified the primary site in 53% and the oropharynx predominated (69%). This left 85 patients with HN-CUP and 5-year overall and disease-free survival rates were 71 and 69%, respectively. Conclusions: Panendoscopy including tonsillectomy should not be omitted in the work up. Significance: We demonstrate a steady frequency of HN-CUP and constant success in identifying the primary site. Detection of a primary later in the follow up did not impact the survival.