Dorobisz Karolina, Wlodarska-Polinska Iwona, Pazdro-Zastawny Katarzyna, Rutkowski Tomasz, Palka Piotr, Dworzecki Tomasz, Zatonski Tomasz
Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland.
Department of Radiotherapy, Oncotherapy International Center, Walbrzych, Poland.
Cancer Manag Res. 2019 Jul 16;11:6603-6614. doi: 10.2147/CMAR.S204346. eCollection 2019.
Carcinoma of unknown primary site (CUP) refers to 1-5% of all head and neck neoplasms. Very often, the primary site remains difficult to determine. Squamous cell carcinoma is the most frequent histopathological type diagnosed in the head and neck region. According to statistics, a primary site is usually located in the oropharynx.
The study presents diagnostic difficulties and the methods of diagnosing and the therapy of CUP and primary sites in patients treated in the region of Lower Silesia and Silesia. The aim of the study was to show a retrospective analysis of 233 CUP patients to assess how clinical features, diagnosis and treatment affect the survival of patients.
The diagnostics of patients included panendoscopy with specimen collection (nasoendoscopy, laryngoscopy, esophagoscopy, brochoscopy), computed tomography examination of the neck, chest, abdomen and pelvis minor, as well as positron emission tomography examination. Tonsilletomy was performed in 37 patients. Neck dissection was carried out in 109 subjects and 165 patients were treated bt radiotherapy, and 135 by chemotherapy.
Tonsillectomy is required in CUP patients with the negative results of biopsy and imaging tests. It gives a possibility of detecting the primary site and improves the results of treatment and survival of CUP patients.Combination therapy, including surgical treatment and chemoradiotherapy, gives the best therapeutic results in CUP patients. The general condition of patient and younger age have an impact on prognosis and survival.
原发部位不明的癌(CUP)占所有头颈部肿瘤的1%-5%。很多时候,原发部位仍难以确定。鳞状细胞癌是头颈部最常见的组织病理学类型。据统计,原发部位通常位于口咽。
本研究介绍了下西里西亚和西里西亚地区治疗的CUP患者及其原发部位的诊断困难、诊断方法和治疗方法。本研究的目的是对233例CUP患者进行回顾性分析,以评估临床特征、诊断和治疗如何影响患者的生存。
患者的诊断包括全身内镜检查及标本采集(鼻内镜检查、喉镜检查、食管镜检查、支气管镜检查)、颈部、胸部、腹部和盆腔的计算机断层扫描检查,以及正电子发射断层扫描检查。37例患者进行了扁桃体切除术。109例患者进行了颈部清扫术,165例患者接受了放射治疗,135例患者接受了化疗。
活检和影像学检查结果为阴性的CUP患者需要进行扁桃体切除术。这有可能检测到原发部位,并改善CUP患者的治疗效果和生存率。包括手术治疗和放化疗在内的联合治疗在CUP患者中取得了最佳治疗效果。患者的一般状况和较年轻的年龄对预后和生存有影响。