Cervical nodal metastases of unknown origin.

A study of 48 patients with metastatic carcinoma in the neck from an unknown primary site has revealed several facts. Among patients with squamous cell carcinoma, the three-year survival rate was 40%. Whether treated with surgery (radical neck dissection) or with radical irradiation alone, the response of these tumors was similar in smaller N1 nodes; when treated with a combined therapeutic approach, they responded well in larger (N2 and N3) cervical nodes. Whether or not the primary tumor was fond did not affect survival rates; the stage of the presenting nodal metastases did not appear to correlate with survival. A large group of patients with adenocarcinoma metastatic to cervical lymph nodes all died of the disease within two years. All appeared with metastases in the supraclavicular fossa; no modality of treatment to the neck, whether by surgery or irradiation, was effective.