Author/Editor		Strojan, Primož; Aničin, Aleksander
Title		Kirurško zdravljenje s pooperacijskim obsevanjem zasevkov ploščatoceličnega karcinoma neznanega izvora v bezgavkah na vratu
Translated title		Combined surgery and postoperative radiotherapy for cervical lymph node metastases of squamous cell carcinoma of unknown origin
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 3
Publication year		2000
Volume		str. 53-7
Language		slo
Abstract		Purpose: During the 20-year period of this study, 56 patients with squamous cell carcinoma cervical lymph node metastases of unknown origin were treated with surgery and postoperative radiotherapy. Patients and methods: There were six females and 50 males (median age 56 years). Neck dissection was performed in 48 patients, while eight patients underwent extirpation of a single lymph node metastasis. The disease was assessed as pN1 in six patients, pN2 in 37 patients and pN3 in 13 patients. Extracapsular tumour spread was found in 37 out of 48 examined specimens. Postoperatively, the irradiation field covered sites of a possible occult primary tumour in 48 patients and in eight it was limited to the affected side of the neck, with median tumour doses of 58 and 55 Gy, respectively. Results: After a median follow-up of 8.6 years, 23 patients were alive with no evidence of the disease, 14 died due to non-cancer-related causes and 19 due to progression of the disease. The 5- and 10-year disease-specific survival rates were 66% and 52%, respectively, and the overall survival rates were 52% and 22%, respectively. The survival of the patients significantly correlated (P < 0.05) with extracapsular tumour spread and the size of the irradiation field. Conclusions: With a superior control rate of the neck disease and survival results favourably comparable to those obtained by a single modality approach, our study supports the use of combined therapy.
Summary		Namen: V obdobju dvajsetih let smo kirurško s pooperacijskim obsevanjem zdravili 56 bolnikov z zasevki ploščatoceličnega karcinoma neznanega izvora v bezgavkah na vratu. Bolniki in metode: V raziskavo smo vključili 6 žensk in 50 moških z mediano starosti 56 let. Pri 48 bolnikih smo naredili disekcijo na vratu, pri 8 pa le odstranitev samega zasevka. Zasevke na vratu smo ocenili kot pN1 pri 6 bolnikih, pN2 pri 37 bolnikih ter pN3 pri 13 bolnikih. Preraščanje ovojnice bezgavk smo ugotovili pri 37 od 48 pregledanih disekcijskih preparatov. Pri 48 bolnikih smo z obsevalnimi polji pokrili tudi možna področja prikritega primarnega tumorja, pri 8 obsevali le prizadeto stran vratu, z mediano tumorske doze 58 oziroma 55 Gy. Rezultati: Po mediani opazovanja od 8,6 let je bilo 23 bolnikov živih brez znakov bolezni, 19 bolnikov je umrlo zaradi napredovanja bolezni in pri 14 vzrok smrti ni bil v povezavi z rakom. 5- in 10-letno specifično preživetje je bilo 66% oziroma 52% in skupno preživetje 52% oziroma 22'%. Preživetje bolnikov v naši raziskavi je bilo značilno povezano (p<0,05) s preraščanjem ovojnice bezgavk in obsegom obsevalnih polj. Zaključki: V naši raziskavi je bilo kombinirano kirurško zdravljenje s pooperacijskim obsevanjem učinkovitejše pri preprečevanju ponovitve bolezni na vratu in preživetje daljše kot poročajo za uporabo enega načina zdravljenja.
Descriptors		LYMPHATIC METASTASIS NECK NEOPLASMS, UNKNOWN PRIMARY CARCINOMA, SQUAMOUS CELL COMBINED MODALITY THERAPY NEOPLASM STAGING TREATMENT OUTCOME SURVIVAL ANALYSIS