Management of the Neck and Unknown Primary of the Head and Neck

  • Jason Chan
  • Sue S. Yom


This chapter will discuss the management of the neck and unknown primary of the head and neck.


Unknown primary Head and neck cancer 



We thank Tania Kaprealian MD for her work on the prior edition of this chapter.


  1. Balaker AE, Abemayor E, Elashoff D, et al. Cancer of unknown primary: does treatment modality make a difference? Laryngoscope. 2012;122:1279–82.CrossRefGoogle Scholar
  2. Galloway TJ, Ridge JA. Management of squamous cancer metastatic to cervical nodes with an unknown primary site. J Clin Oncol. 2015;33(29):3328–37.CrossRefGoogle Scholar
  3. Grau C, et al. Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology. Radiother Oncol. 2000;55(2):121–9.CrossRefGoogle Scholar
  4. Grégoire V, Ang K, Budach W, et al. Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol. 2014;110(1):172–81.CrossRefGoogle Scholar
  5. Johansen J, et al. Prospective study of 18FDG-PET in the detection and management of patients with lymph node metastases to the neck from an unknown primary tumor. Results from the DAHANCA-13 study. Head Neck. 2008;30(4):471–8.CrossRefGoogle Scholar
  6. Keller LM, et al. p16 status, pathologic and clinical characteristics, biomolecular signature, and long-term outcomes in head and neck squamous cell carcinomas of unknown primary. Head Neck. 2014;36(12):1677–84.CrossRefGoogle Scholar
  7. Liauw SL, Mancuso AA, Amdur RJ, et al. Postradiotherapy neck dissection for lymph node-positive head and neck cancer: the use of computed tomography to manage the neck. J Clin Oncol. 2006;24(9):1421–7.CrossRefGoogle Scholar
  8. McDowell LJ, et al. p16-positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: no association with high-risk human papillomavirus or prognosis and implications for the workup of the unknown primary. Cancer. 2016;122(8):1201–8.CrossRefGoogle Scholar
  9. Mehanna H, et al. PET-CT surveillance versus neck dissection in advanced head and neck cancer. N Engl J Med. 2016;374:1–11.CrossRefGoogle Scholar
  10. Mendenhall WM, Mancuso AA, Parsons JT, Stringer SP, Cassisi NJ. Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site. Head Neck. 1998;20(8):739–44.CrossRefGoogle Scholar
  11. Motz K, et al. Changes in unknown primary squamous cell carcinoma of the head and neck at initial presentation in the era of human papillomavirus. JAMA Otolaryngol Head Neck Surg. 2016;142(3):223–8.CrossRefGoogle Scholar
  12. Mourad WF, et al. Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck. Anticancer Res. 2014;34(1):243–8.PubMedGoogle Scholar
  13. Nagel TH, et al. Transoral laser microsurgery for the unknown primary: role for lingual tonsillectomy. Head Neck. 2014;36(7):942–6.CrossRefGoogle Scholar
  14. Narayan K, Crane CH, Kleid S, Hughes PG, Peters LJ. Planned neck dissection as an adjunct to the management of patients with advanced neck disease treated with definitive radiotherapy: for some or for all? Head Neck. 1999;21(7):606–13.CrossRefGoogle Scholar
  15. Nieder C, Gregoire V, Ang KK. Cervical lymph node metastases from occult squamous cell carcinoma: cut down a tree to get an apple? Int J Radiat Oncol Biol Phys. 2001;50(3):727–33.CrossRefGoogle Scholar
  16. Patel RS, et al. Squamous cell carcinoma from an unknown head and neck primary site: a “selective treatment” approach. Arch Otolaryngol Head Neck Surg. 2007;133(12):1282–7.CrossRefGoogle Scholar
  17. Patel SA, et al. Robotic surgery for primary head and neck squamous cell carcinoma of unknown site. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1203–11.CrossRefGoogle Scholar
  18. Rudmik L, et al. Clinical utility of PET/CT in the evaluation of head and neck squamous cell carcinoma with an unknown primary: a prospective clinical trial. Head Neck. 2011;33(7):935–40.CrossRefGoogle Scholar
  19. Wallace A, Richards GM, Harari PM, et al. Head and neck squamous cell carcinoma from an unknown primary site. Am J Otolaryngol. 2011;32(4):286–90.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA

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