Aim: To assess the treatment outcomes of chemoradiation for cervical lymph node metastases from an unknown primary site (CUP), and to identify for prognostic factors.
Patients and methods: Thirty patients diagnosed as having CUP, and receiving chemoradiation as a definitive treatment were included in the analysis. Locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) rates were estimated, and the factors affecting treatment outcomes were analyzed.
Results: After a median follow-up period of 25 months for surviving patients, the two- and five-year LRC, DFS, and OS rates were 56%/45%, 46%/36%, and 69%/52%, respectively. On univariate analysis, lower performance status (PS; p=0.001), and limitation of disease to level 2 or 3 lymph nodes (p=0.009) were significantly associated with better DFS. Low PS (p=0.002) was significantly associated with better LRC. No late toxicity of grade 3 or greater was observed.
Conclusion: Definitive chemoradiation for CUP was well-tolerated, with improvement of DFS/LRC for those with good PS and disease limited to level 2 or 3 lymph nodes.
Keywords: Primary unknown; cervical lymph node metastasis; chemoradiation; lymph node level.