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. 2022 Jun;148(6):1437-1445.
doi: 10.1007/s00432-021-03724-1. Epub 2021 Jul 10.

The prognostic role of radiotherapy and radiotherapy target in cervical lymph node metastatic squamous cell carcinoma with unknown primary: a retrospective study

Ruidan Li #  1 , Kai Liao #  2 , Zhigong Wei  1 , Zheran Liu  1 , Yan He  1 , Jingjing Wang  1 , Ling He  1 , Xiaoli Mu  1 , Lianlian Yang  1 , Yan Huang  1 , Libang He  3 , Xingchen Peng  4
Affiliations

The prognostic role of radiotherapy and radiotherapy target in cervical lymph node metastatic squamous cell carcinoma with unknown primary: a retrospective study

Ruidan Li et al. J Cancer Res Clin Oncol. 2022 Jun.

Abstract

Objectives: Aim to analyze the effect of radiotherapy for cervical lymph node metastatic carcinoma with unknown primary (CCUP) and compare the survival benefits between Comprehensive radiotherapy and Involved Field radiotherapy.

Materials and methods: The patients diagnosed with CCUP between 2009 and 2019 in our institution were analyzed retrospectively. The categorical variables were tested by χ2 test. Kaplan-Meier method was used for survival analysis. Log-rank test and Cox proportional hazards regression were performed with overall survival (OS) and disease-free survival (DFS) as the primary outcome variables.

Results: Of 139 patients, 64.7% (90/139) of them received radiotherapy. Of the 90 patients who underwent radiotherapy, 45.6% (41/90) received Involved Field radiotherapy and the rest 49 patients received Comprehensive radiotherapy. The median follow-up of 139 patients is 69 months. The 1-year, 3-year, and 5-year OS rates are 87%, 62%, and 39%, respectively, and the DFS rates are 73%, 45%, and 29%, respectively. Multivariate analysis of 139 patients with CCUP shows that differentiation grade, N stage, radiotherapy, and the length of the largest lymph node (DmaxLN) are the independent prognostic factors for both OS and DFS. Subgroup analysis of 90 patients who received radiotherapy shows that the Comprehensive radiotherapy group has a better OS (P < 0.001) and DFS (P < 0.001) compared with Involved Field radiotherapy.

Conclusion: Radiotherapy is the independent prognostic factor for CCUP. Comprehensive radiotherapy may be superior to Involved Field radiotherapy in survival benefits.

Keywords: Cervical lymph node metastatic carcinoma with unknown primary; Prognosis; Radiotherapy; Target delineation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The survival curves of 139 patients. A The overall survival (OS) of 139 patients. B The disease-free survival (DFS) of 139 patients
Fig. 2
Fig. 2
The survival curves of univariate analysis. Kaplan–Meier overall survival (OS) and disease-free survival (DFS) curves for 139 patients with CCUP stratified by age (A, J), gender (B, K), differentiation (C, L), N stage (D, M), lesion (E, N), DmaxLN (F, O), ENE (G, P), surgery (H, Q), and radiotherapy (I, R)
Fig. 3
Fig. 3
The survival curves of patients with Comprehensive Radiotherapy and Involved Field Radiotherapy. A The overall survival (OS) of patients receiving Comprehensive RT and Involved Field RT. B The disease-free survival (DFS) of patients receiving Comprehensive RT and Involved Field RT
See this image and copyright information in PMC

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