Value of neck dissection in patients with squamous cell carcinoma of unknown primary

Lymph node metastases of cancer of an unknown primary (CUP syndrome) are re sponsible for 3-5% of the malignant diseases in the head and neck area. Mor e than 70% of these patients show lymph node metatases of an unknown squamo us cell carcinoma. The survival depends immediately on number and location of lymph node metastases. For a curative approach modified radical neck dis section combined with postoperative radiation therapy with or without chemo therapy should be considered in N1-N3 lymph node status. A radical neck dis section with postoperative radiation therapy should only be approved in cas es of infiltration of the internal jugular vein, the accessory nerve and/or the sternocleidoid muscle. The different prognosis of patients with upper cervical and lower cerival lymph nodes should influence the indication and the extent of a neck dissection in the contralateral N0 neck.