In this retrospective study of 35 patients, the authors followed a systematic protocol for the detection and management of malignant cervical lymph nodes without an apparent primary lesion. Although their one, three and five year survival results are consistent with the international literature, the study has some flaws. They did not submit their patients to a PET-scan, although it is in the recommendations of the French ENT society, they did not biopsy the nasopharynx (only a tonsillar biopsy in 25 cases), and a fine needle aspiration cytology was only performed in 19 cases whereas all cases underwent a preliminary open biopsy and frozen section examination during the presumptive definitive surgery. Although it confirms the dire prognosis of this cohort of patients, the group was rather heterogeneous as were the treatment protocols.
The unknown primary again
Reviewed by Badr E. Mostafa
Treatment of head and neck squamous cell carcinoma of an unknown primary (HNCCUP): oncologic analysis of 35 cases.
CONTRIBUTOR
Badr Eldin Mostafa
Ain-Shams Faculty of Medicine, Almaza , Heliopolis, Egypt.
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