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Head and Neck Carcinoma of Unknown Primary

MedGen UID:
1703702
•Concept ID:
C5206676
•
Neoplastic Process
Synonym: Head and Neck CUP

Definition

A carcinoma that has metastasized to the head and neck region from an unknown primary anatomic site. Metastatic squamous cell carcinoma in the neck lymph nodes accounts for the vast majority of these lesions. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVHead and Neck Carcinoma of Unknown Primary

Professional guidelines

PubMed

Management of unilateral head and neck carcinoma of unknown primary: Retrospective analysis of the impact of postoperative radiotherapy target volumes.
Podeur F, Pommier P, Crozes C, Monchet E, Ton Van J, Roux PE, Poupart M, Zrounba P, Julieron M, Deneuve S
Head Neck 2020 Feb;42(2):302-311. Epub 2019 Nov 18 doi: 10.1002/hed.26007. PMID: 31737971
HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes.
Cheraghlou S, Torabi SJ, Husain ZA, Otremba MD, Osborn HA, Mehra S, Yarbrough WG, Burtness BA, Judson BL
Laryngoscope 2019 Mar;129(3):684-691. Epub 2018 Aug 27 doi: 10.1002/lary.27475. PMID: 30151832

Recent clinical studies

Etiology

Management of unilateral head and neck carcinoma of unknown primary: Retrospective analysis of the impact of postoperative radiotherapy target volumes.
Podeur F, Pommier P, Crozes C, Monchet E, Ton Van J, Roux PE, Poupart M, Zrounba P, Julieron M, Deneuve S
Head Neck 2020 Feb;42(2):302-311. Epub 2019 Nov 18 doi: 10.1002/hed.26007. PMID: 31737971
Pharyngeal-sparing radiation for head and neck carcinoma of unknown primary following TORS assisted work-up.
Grewal AS, Rajasekaran K, Cannady SB, Chalian AA, Ghiam AF, Lin A, LiVolsi V, Lukens JN, Mitra N, Montone KT, Newman JG, O'Malley BW Jr,, Rassekh CH, Weinstein GS, Swisher-McClure S
Laryngoscope 2020 Mar;130(3):691-697. Epub 2019 Aug 14 doi: 10.1002/lary.28200. PMID: 31411747
HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes.
Cheraghlou S, Torabi SJ, Husain ZA, Otremba MD, Osborn HA, Mehra S, Yarbrough WG, Burtness BA, Judson BL
Laryngoscope 2019 Mar;129(3):684-691. Epub 2018 Aug 27 doi: 10.1002/lary.27475. PMID: 30151832
Unknown primary head and neck squamous cell carcinoma in the era of fluorodeoxyglucose-positron emission tomography/CT and intensity-modulated radiotherapy.
de Ridder M, Klop M, Hamming-Vrieze O, de Boer J, Jasperse B, Smit L, Vogel W, van den Brekel M, Al-Mamgani A
Head Neck 2017 Jul;39(7):1382-1391. Epub 2017 Mar 28 doi: 10.1002/hed.24762. PMID: 28370570
Outcomes of patients with head-and-neck cancer of unknown primary origin treated with intensity-modulated radiotherapy.
Shoushtari A, Saylor D, Kerr KL, Sheng K, Thomas C, Jameson M, Reibel J, Shonka D, Levine P, Read P
Int J Radiat Oncol Biol Phys 2011 Nov 1;81(3):e83-91. Epub 2011 Mar 4 doi: 10.1016/j.ijrobp.2011.01.014. PMID: 21377283

Diagnosis

Relevance of the time interval between surgery and adjuvant radio (chemo) therapy in HPV-negative and advanced head and neck carcinoma of unknown primary (CUP).
Balk M, Rupp R, Mantsopoulos K, Allner M, Grundtner P, Mueller SK, Traxdorf M, Eckstein M, Speer S, Semrau S, Fietkau R, Iro H, Hecht M, Gostian AO
BMC Cancer 2021 Nov 18;21(1):1236. doi: 10.1186/s12885-021-08885-3. PMID: 34794411Free PMC Article
Transoral robotic surgery for the benefit of patients with head and neck cancer of unknown primary: our experience at St George's University Hospital, London.
Mistry R, Walker A, Kim D, Ofo E
Ann R Coll Surg Engl 2020 Jul;102(6):442-450. Epub 2020 Apr 29 doi: 10.1308/rcsann.2020.0071. PMID: 32347742Free PMC Article
Head and neck carcinoma of unknown primary.
Kennel T, Garrel R, Costes V, Boisselier P, Crampette L, Favier V
Eur Ann Otorhinolaryngol Head Neck Dis 2019 Jun;136(3):185-192. Epub 2019 Apr 17 doi: 10.1016/j.anorl.2019.04.002. PMID: 31005456
HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes.
Cheraghlou S, Torabi SJ, Husain ZA, Otremba MD, Osborn HA, Mehra S, Yarbrough WG, Burtness BA, Judson BL
Laryngoscope 2019 Mar;129(3):684-691. Epub 2018 Aug 27 doi: 10.1002/lary.27475. PMID: 30151832
Unknown primary head and neck cancer treated with intensity-modulated radiation therapy: to what extent the volume should be irradiated.
Lu H, Yao M, Tan H
Oral Oncol 2009 Jun;45(6):474-9. Epub 2008 Sep 18 doi: 10.1016/j.oraloncology.2008.06.006. PMID: 18804408

Therapy

The effect of dexamethasone on functional pain following Transoral Robotic Surgery: a randomized double blinded clinical trial.
Larsen MHH, Channir HI, Madsen AKØ, Rubek N, O'Leary P, Kjærgaard T, Kehlet H, von Buchwald C
Acta Otolaryngol 2023 Oct;143(10):894-901. Epub 2024 Jan 5 doi: 10.1080/00016489.2023.2269998. PMID: 37902607
Evaluation of risk-tailored individualized selection of radiation therapy target volume for head and neck carcinoma of unknown primary.
Ghatasheh H, Huang SH, Su J, Xu W, Bratman SV, Cho J, Giuliani M, Hahn E, Hope A, Kim J, O'Sullivan B, Ringash J, Waldron J, Chepeha DB, Irish JC, Goldstein DP, Spreafico A, Tong L, de Almeida JR, Hosni A
Radiother Oncol 2022 Oct;175:56-64. Epub 2022 Jul 26 doi: 10.1016/j.radonc.2022.07.016. PMID: 35905781
Radiotherapy Characteristics and Outcomes for Head and Neck Carcinoma of Unknown Primary vs T1 Base-of-Tongue Carcinoma.
Hosni A, Dixon PR, Rishi A, Au M, Xu W, Song Y, Chepeha DB, Goldstein DP, Huang SH, Kim J, O'Sullivan B, Waldron J, Bratman SV, de Almeida JR
JAMA Otolaryngol Head Neck Surg 2016 Dec 1;142(12):1208-1215. doi: 10.1001/jamaoto.2016.3083. PMID: 27812692
Total Mucosal Irradiation with Intensity-modulated Radiotherapy in Patients with Head and Neck Carcinoma of Unknown Primary: A Pooled Analysis of Two Prospective Studies.
Richards TM, Bhide SA, Miah AB, Del Rosario L, Bodla S, Thway K, Gujral DM, Rooney KP, Schick U, McGovern T, Grove L, Newbold KL, Harrington KJ, Nutting CM
Clin Oncol (R Coll Radiol) 2016 Sep;28(9):e77-e84. Epub 2016 May 11 doi: 10.1016/j.clon.2016.04.035. PMID: 27180092
Unknown primary head and neck cancer treated with intensity-modulated radiation therapy: to what extent the volume should be irradiated.
Lu H, Yao M, Tan H
Oral Oncol 2009 Jun;45(6):474-9. Epub 2008 Sep 18 doi: 10.1016/j.oraloncology.2008.06.006. PMID: 18804408

Prognosis

Primary Tumour Detection in Carcinoma of Unknown Primary with Transoral Robotic Surgery (TORS) Tongue Base Mucosectomy: A Meta-analysis.
Gupta KK, Khan H, Mughal Z, De M, Sharma N, Garas G
Ann Surg Oncol 2024 Sep;31(9):6065-6076. Epub 2024 Jul 9 doi: 10.1245/s10434-024-15758-z. PMID: 38980583
Evaluation of risk-tailored individualized selection of radiation therapy target volume for head and neck carcinoma of unknown primary.
Ghatasheh H, Huang SH, Su J, Xu W, Bratman SV, Cho J, Giuliani M, Hahn E, Hope A, Kim J, O'Sullivan B, Ringash J, Waldron J, Chepeha DB, Irish JC, Goldstein DP, Spreafico A, Tong L, de Almeida JR, Hosni A
Radiother Oncol 2022 Oct;175:56-64. Epub 2022 Jul 26 doi: 10.1016/j.radonc.2022.07.016. PMID: 35905781
Relevance of the time interval between surgery and adjuvant radio (chemo) therapy in HPV-negative and advanced head and neck carcinoma of unknown primary (CUP).
Balk M, Rupp R, Mantsopoulos K, Allner M, Grundtner P, Mueller SK, Traxdorf M, Eckstein M, Speer S, Semrau S, Fietkau R, Iro H, Hecht M, Gostian AO
BMC Cancer 2021 Nov 18;21(1):1236. doi: 10.1186/s12885-021-08885-3. PMID: 34794411Free PMC Article
HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes.
Cheraghlou S, Torabi SJ, Husain ZA, Otremba MD, Osborn HA, Mehra S, Yarbrough WG, Burtness BA, Judson BL
Laryngoscope 2019 Mar;129(3):684-691. Epub 2018 Aug 27 doi: 10.1002/lary.27475. PMID: 30151832
Unknown primary head and neck squamous cell carcinoma in the era of fluorodeoxyglucose-positron emission tomography/CT and intensity-modulated radiotherapy.
de Ridder M, Klop M, Hamming-Vrieze O, de Boer J, Jasperse B, Smit L, Vogel W, van den Brekel M, Al-Mamgani A
Head Neck 2017 Jul;39(7):1382-1391. Epub 2017 Mar 28 doi: 10.1002/hed.24762. PMID: 28370570

Clinical prediction guides

Evaluation of risk-tailored individualized selection of radiation therapy target volume for head and neck carcinoma of unknown primary.
Ghatasheh H, Huang SH, Su J, Xu W, Bratman SV, Cho J, Giuliani M, Hahn E, Hope A, Kim J, O'Sullivan B, Ringash J, Waldron J, Chepeha DB, Irish JC, Goldstein DP, Spreafico A, Tong L, de Almeida JR, Hosni A
Radiother Oncol 2022 Oct;175:56-64. Epub 2022 Jul 26 doi: 10.1016/j.radonc.2022.07.016. PMID: 35905781
Influence of postoperative radiotherapy target volumes in unilateral head and neck carcinoma of unknown primary: A multicentric study using propensity score.
Brenet E, Philouze P, Schiffler C, Pommier P, Crozes C, Benzerdjeb N, Monchet E, Boulagnon-Rombi C, Ton Van J, Podeur F, Servagi-Vernat S, Liem X, Merol JC, Ceruse P, Serre AA, Chabaud S, Julieron M, Deneuve S
Radiother Oncol 2021 Jul;160:1-8. Epub 2021 Apr 27 doi: 10.1016/j.radonc.2021.04.002. PMID: 33845043
Management of unilateral head and neck carcinoma of unknown primary: Retrospective analysis of the impact of postoperative radiotherapy target volumes.
Podeur F, Pommier P, Crozes C, Monchet E, Ton Van J, Roux PE, Poupart M, Zrounba P, Julieron M, Deneuve S
Head Neck 2020 Feb;42(2):302-311. Epub 2019 Nov 18 doi: 10.1002/hed.26007. PMID: 31737971
Pharyngeal-sparing radiation for head and neck carcinoma of unknown primary following TORS assisted work-up.
Grewal AS, Rajasekaran K, Cannady SB, Chalian AA, Ghiam AF, Lin A, LiVolsi V, Lukens JN, Mitra N, Montone KT, Newman JG, O'Malley BW Jr,, Rassekh CH, Weinstein GS, Swisher-McClure S
Laryngoscope 2020 Mar;130(3):691-697. Epub 2019 Aug 14 doi: 10.1002/lary.28200. PMID: 31411747
Outcomes of patients with head-and-neck cancer of unknown primary origin treated with intensity-modulated radiotherapy.
Shoushtari A, Saylor D, Kerr KL, Sheng K, Thomas C, Jameson M, Reibel J, Shonka D, Levine P, Read P
Int J Radiat Oncol Biol Phys 2011 Nov 1;81(3):e83-91. Epub 2011 Mar 4 doi: 10.1016/j.ijrobp.2011.01.014. PMID: 21377283

Recent systematic reviews

Primary Tumour Detection in Carcinoma of Unknown Primary with Transoral Robotic Surgery (TORS) Tongue Base Mucosectomy: A Meta-analysis.
Gupta KK, Khan H, Mughal Z, De M, Sharma N, Garas G
Ann Surg Oncol 2024 Sep;31(9):6065-6076. Epub 2024 Jul 9 doi: 10.1245/s10434-024-15758-z. PMID: 38980583

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