颈部原发不明转移癌的治疗与转归

目的 探索颈部原发不明转移癌的最佳治疗方式。方法 回顾分析我院１９７６年２月￣１９９８年１０月间１１４例颈部原发不明转移癌患者的临床资料。结果 中上颈低分化转移癌最好的治疗方式是放疗，转移性鳞癌则采用术前放疗加手术治疗，转移性腺癌中的乳头状腺癌治疗应采取甲状腺癌联合根治术，它们的５年生存率分别为４５．２％、５３．８％和６２．５％。锁骨上区转移癌以化疗为首选。随诊中有１１．２％颈部原发不明转移癌的患

Treatment and outcome of cervical lymph nodal metastases of unknown primary sites

Objective To ascertain the optimal management of cervical nodal metasta of unknown primary sites. Methods The clinical data of 114 patients of cervical nodal metastases of unknown primary sites were retrospectively analyzed. Results For metatic masses of the upper and/or middle part of the neck, the optimal approach varied depnding on the histologic type. Poorly differentiated carcinoma was treated with radiotherapy, squamous cell carcinoma was treated with radiotherapy plus surgery, while papillary adenocarcinoma was treated by combined radical thyroidectomy. Their 5 year survival rate was 45.2%, 53.8% and 62.5%, respectively. For metastatic masses in the supraclavicular region, chemotherapy was the first treatment of choice in all patients. In only 12 of the 114 patients (11.2%) the primary sites were found in the follow up period. Conclusion For patients with cervical lymph node metastases from unknown primary sites, the management should be given according to the location of lymph node involved and histopathologic type of the tumor.