Although uncommon, @entity5 of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of @entity1 . Accordingly, knowledge gained from retrospective studies and experience from treating @entity1 with known @entity135 form the basis of therapeutic strategies in CUP. This review provides a critical appraisal of various treatment approaches described in the literature. Emerging treatment options for CUP with @entity3 to cervical lymph nodes are discussed in view of recent innovations in the field of head and neck oncology and suitable therapeutic strategies for particular clinical scenarios are presented. For @entity3121 or @entity17470 disease without extracapsular extension (ECE), selective neck dissection or radiotherapy offer high rates of regional control. For more @entity1442 , intensive combined treatment is required, either a combination of neck dissection and radiotherapy, or initial (chemo)radiotherapy followed by neck dissection if a complete response is not recorded on imaging. Each of these approaches seems to be equally effective. Use of extensive @entity33 must be weighed against @entity137 , availability of close follow-up with elective neck imaging and guided @entity400 ( @entity400 ) when appropriate, the @entity1082 ) status of the @entity5 , and particularly against the distribution pattern (oropharynx in the majority of cases) and the emergence rate of hidden primary lesions (<10% after comprehensive workup). The addition of systemic agents is expected to yield similar improvement in outcome as has been observed for known @entity135 .

Contemporary management of lymph node XXXX from an unknown primary to the neck: II. a review of therapeutic options.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity135 :: ('MESH:D006258', 'Disease') :: ['head and neck primary tumors'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer'] @entity33 :: ('MESH:D052016', 'Disease') :: ['bilateral neck/mucosal irradiation'] @entity17470 :: ('84618', 'Gene') :: ['cN1'] @entity3121 :: ('5270', 'Gene') :: ['pN1'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced neck disease'] @entity400 :: ('MESH:D014202', 'Disease') :: ['fine-needle aspiration biopsy', 'FNAB'] @entity1082 :: ('10566', 'Species') :: ['human papillomavirus (HPV'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity3 :: (MESH:D009362,Disease) :: ['metastases']
