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Protocolul terapeutic pentru metastazele limfoganglionare laterocervicale de carcinom spinocelular cu punct de plecare neprecizat. Source: Romanian Journal of Medical Practice.
Identifi cation of subgroups with favorable prognosis is of decisive importance for the therapy of patients with CUP syndrome, including prolonged survival from directed treatment. The patients with neck node metastases from occult metastatic cancer no primary and neck cancer have clinical features and prognosis similar to other head and neck malignancies.
Treatment of patients with metastatic cancer no primary squamous cell carcinoma involving cervical lymph nodes of an unknown primary origin should be similar to that of patients with locally advanced carcinoma of the head and metastatic cancer no primary.
Therapeutic approaches include surgery lymph node excision or neck dissectionwith or without postoperative radiotherapy, radiotherapy alone and radiotherapy followed by surgery. In early stages N1neck dissection and radiotherapy seem to have similar efficacy, whereas more advanced cases N2- N3 necessitate combined approaches.
The extent of radiotherapy irradiation of bilateral neck and mucosa versus ipsilateral neck radiotherapy remains debatable. A potential benefit from extensive radiotherapy should be weighted against its acute and late morbidity and difficulties in re-irradiation in the case of subsequent primary emergence.
The metastatic cancer no primary of other methods, such as chemotherapy and hyperthermia, remains to be determined.
A male patient, years-old, from urban area, presents at clinic in July History: April - he presents at the hospital for laterocervical lymph nodes, surgically removed. Risk factors: non-smoker, without professional exposure, alcohol occasionally.
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How Cancer Spreads (Metastasis) - Michael Henry, PhD
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