Cervical metastasis of occult origin—Treatment options and outcome

Abstract

Ninety one patients with metastases of unknown origin in cervical nodes seen between 1986 and 1990 were respectively analysed. Majority of the patients (58%) presented with a nodal mass of more than 6 cm size. Jugulodigastric node was the commonest site of involvement seen in 74%, 76% and 69% of patients who presented with single node, multiple ipsilateral nodes and bilateral nodes respectively. Two year disease free survival (DFS) was 17% with radical radiotherapy alone and 48% with combined radiotherapy and radical neck dissection. Overall 2 year DFS with N1, N2and N3 disease were 100%, 35% and 14% respectively, with combined therapy offering better results in patients with a nodal size of more than 3 cm. 14% of the patients who received curative therapy developed a primary, with a majority (10%) within the field of irradiation. Use of combined surgery and radiation, successful salvage of locoregional failures and possibly use of adjuvant systemic therapy would result in improved DFS in patients with advanced nodal disease.