Management of unilateral head and neck carcinoma of unknown primary: Retrospective analysis of the impact of postoperative radiotherapy target volumes

Head Neck. 2020 Feb;42(2):302-311. doi: 10.1002/hed.26007. Epub 2019 Nov 18.


Background: We compared the outcome of postoperative unilateral cervical nodes radiotherapy (UL-RT) vs bilateral cervical nodes plus total mucosal irradiation (COMP-RT) in the management of head and neck carcinoma of unknown primary (HNCUP).

Methods: HNCUP, defined by the absence of primary despite a PET-CT combined with a panendoscopy, were treated with curative intent by initial ipsilateral neck dissection. Sixty-nine patients with unilateral HNCUP were included: 23 received UL-RT while 46 received COMP-RT. Carcinologic outcomes and long-term quality of life (QOL) according to the QOL Questionnaire for Head and Neck 35 were assessed.

Results: Within 6.3 years of median follow-up, there was no significant difference in primary tumor emergence rate (P = .68), cervical node recurrence rate (P = .34), or overall survival (P = .33) between UL-RT and COMP-RT groups. A trend toward QOL improvement was observed in the UL-RT group.

Conclusion: UL-RT seems to provide similar outcomes as COMP-RT in unilateral HNCUP management.

Keywords: carcinoma unknown primary; head and neck; postoperative radiotherapy; quality of life.

MeSH terms

  • Carcinoma*
  • Head and Neck Neoplasms* / radiotherapy
  • Humans
  • Neoplasm Recurrence, Local
  • Neoplasms, Unknown Primary* / therapy
  • Positron Emission Tomography Computed Tomography
  • Quality of Life
  • Retrospective Studies