Background: Despite the vivid progress in molecular and genetic profiling, extensive diagnosis and multiple therapeutic modalities, cancers of unknown primary in the head and neck region continue to be a formidable challenge.
Aim: The purpose of the review is to present the most recent and well-established findings concerning cancers of unknown primary (CUPs) in the head and neck patients and consequently to provide medical specialists with essential information regarding the biology, pathology, histology, diagnosis and treatment of CUP in the head and neck region.
Material and Methods: The Medline/PubMed database was searched by using the following keywords “CUP”, “cancer of unknown primary”, “CUP biology”, “head and neck”. The references of the publications of interest were also screened for relevant papers. There were no limitations in regard to the publication date.
Conclusion: Unique biology and pathophysiology prompt the management of CUP to be demanding. The vivid rise in HPV-related CUPs during the last 20 years has put more focus on this phenomenon. New findings concerning the enigmatic biology of CUP provide fundaments for targeted therapy. Despite the availability of various diagnostic methods, the diagnosis of CUP continues to be a time-consuming, strenuous process that eventually provides answers. It remains controversial as to what combination of treatment methods is the most effective. There is no consensus on the value of combining chemotherapy with radiotherapy. Highly specific surgical treatments for particular histological types of CUP produce more satisfactory results. It is paramount to establish reliable guidelines concerning the diagnosis and treatment of CUP patients.



中文翻译：

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头颈部未知原发性癌症的系统评价

背景：尽管在分子和遗传分析、广泛诊断和多种治疗方式方面取得了显着进展，但头颈部区域原发性未知的癌症仍然是一项艰巨的挑战。
目的：审查的目的是介绍有关头颈部患者未知原发性癌症 (CUP) 的最新和公认的发现，从而为医学专家提供有关生物学、病理学、组织学、诊断的基本信息和治疗头颈部区域的 CUP。
材料与方法：Medline/PubMed 数据库使用以下关键词“CUP”、“未知原发性癌症”、“CUP 生物学”、“头颈部”进行搜索。还筛选了感兴趣的出版物的参考文献以获取相关论文。出版日期没有限制。
结论：独特的生物学和病理生理学促使 CUP 的管理要求很高。在过去的 20 年中，HPV 相关 CUP 的显着上升使人们更加关注这一现象。关于 CUP 神秘生物学的新发现为靶向治疗提供了基础。尽管有各种诊断方法可供使用，但 CUP 的诊断仍然是一个耗时、费力的过程，最终提供了答案。关于哪种治疗方法的组合最有效仍然存在争议。化疗与放疗相结合的价值尚未达成共识。针对特定组织学类型的 CUP 的高度特异性手术治疗产生更令人满意的结果。建立可靠的 CUP 患者诊断和治疗指南至关重要。