Building around the four basic problems, the diagnosis and treatment principles of the guidelines for head and neck squamous cancer with unknown primary causes.

head and neck squamous cancer, !---- which is unknown to the primary brain, is a type of heterogeneous clinical syndrome, with neck metastatic cancer as the first manifestation or first detected by the clinic, after a series of examinations and the primary lesions are not clear malignant tumors.in recent years, with the advance of imaging diagnostic technology and molecular biology technology such as immunohiscitis chemistry, the level of diagnosis of such diseases has gradually improved, and has brought new opportunities and challenges to treatment.had the privilege of inviting Professor Zhao Chong to Sun Yat-sen University Affiliated Oncology Hospital to elaborate on ASCO's newly released guidelines for the diagnosis and treatment of head and neck squamous cancer with unknown primary lesions.Zhao Chong, Director Of Physicians, Director of Oncology Prevention and Control Center, Sun Yat-sen University Oncology Center, Director of Radiotherapy/Nasopharypharypharypharypharypharypharyphd, National Science and Technology Award Review Specialist, Deputy Group Leader of Radiotherapy Immunology Group of the Chinese Medical Association Radiology Treatment Association, Member of the Nasopharypharynga Cancer Group of the Chinese Medical Association, Member of the Radiotherapy Professional Committee of the Anti-Cancer Association, Member of the Standing Committee of the Professional Committee of the Chinese Anti-Cancer Association, Member of the Nasopharynga Cancer Professional Committee of the Chinese Association of Cancer Association, Deputy Group Leader of the Radiotherapy Nutrition Group of the Chinese Association of Cancer Cancer, Secretary of the Clinical Phased Working Committee of China Nasopharynga Cancer, Standing Committee of the Pan-Pearl River Regional Cancer Radiation Therapy Collaboration Group, Member of the 4th Committee of the Guangdong Anti-Cancer Association, AndainPh, Vice Chairman of the Medical Science And Medicine Committee of Guangdong Province, Member of the Oncology Credit Committee of Guangdong Medical Association and Deputy Group Leader of the Nasopharyngeal Cancer Group.this year's asco's primary and cervical squamous cancer (SCCUP) guidelines, based on previous guidelines, focusing on four issues.the first aspect of how to conduct preoperative evaluation of patients with suspected malignancies in the neck.for neck lumps suspected to be squamous cell carcinoma (SCC), patients should be examined in detail for medical history and physical examination, including fiber or electronic nasopharyngeal/throat screening, and can be supplemented with more advanced visualization techniques, such as narrow-band imaging endoscopy, to facilitate the detection of anatomical locations of hidden primary tumors and to indicate potential treatment options For clinically suspicious neck lumps, a fine needle puncture or tissue needle puncture should also be performed, for the metastasized neck lymph nodes, neck-enhanced CT should be the preferred imaging test, if after clinical evaluation and neck-enhanced CT examination, the primary lesions are still unclear, the whole body PET-CT examination should be the next step of examination and evaluation.the second aspect, the original cause of unknown head and neck scale cancer appropriate surgical procedures.for patients with one-sided lymph node metastasis, patients with bilateral lymph node metastasis, patients with hidden primary lesions at the mucous membrane site, which method should be used in surgical diagnosis, and its diagnosis is closely related to treatment.third aspect, what factors need to be considered in the treatment of SCCUP surgery.for one-sided, individual neck metastasized lymph nodes, and for patients with two-sided single neck metastasized lymph nodes, but no evidence of clinical or imaging evidence of extra-encased endometriosis, root surgery or radiation therapy can be decided after multidisciplinary discussion; Patients with multiple metastasized lymph nodes or extra-encapsulation of the neck are recommended for ecstatic chemotherapy, and if the mouth and pharynx are suspected to be the original lesions or confirmed as SCCUP, the lymph nodes of the IIA, III and IV regions should be regularly removed.last focus is on radiotherapy and systemic therapy.receiving radiation therapy or synchronous chemotherapy should be the preferred treatment strategy for CUP patients, for the transfer of neck lymph nodes, the risk area where there may be micro-lesions in the neck, and the area of anatomical mucosa at risk of hidden lesions of primary lesions, the specific scope of treatment will depend on the patient's clinical pathological performance after the completion of the surgical diagnosis; Patients with strained lymph nodes, suspected mucous membrane hidden primary lesions of SCC or EBV-positive II-IV.A (AJCC 8th) and ambiguous primary fever should receive both cisplatin chemotherapy and root radiation therapy if there is no cisplatin contraindication.in general, because of the low incidence of head and neck cancer, only about 3% of the head and neck tumors, so there are still many improvements in its diagnosis and treatment, but also because of its low incidence caused by the development of forward-looking research difficulties, so the development of the guide is mainly based on retrospective research data, the results of meta-analysis and other recommendations of the guidelines, it is more concerned with ncCN guidelines than the specific refinement.the role of multidisciplinary diagnosis and treatment of primary head and neck scale cancer in the primary hair lesions is indeed very complex, and is a very heterogeneous tumor.reason is: First, its heterogeneous, manifested in the head and neck tumor includes a lot of sites, organs, its tissue source, development are different, which determines that its treatment methods are obviously different, clinical needs according to the clinical characteristics of the disease and the desired treatment effect, comprehensive consideration and decision of the treatment of head and neck cancer, ASCO-related guidelines are also based on such a central idea, so multidisciplinary treatment should play a pivotal role in the treatment;is reflected in, such as after a standardized preoperative evaluation and surgical diagnostic procedures, consider the existence of nasopharyngeal primary cancer or other head and neck squamous cancer, so that the choice is based on radiotherapy-based non-surgical treatment or neck cleaning-based surgical treatment; therefore, the head and neck metastasis cancer after careful and comprehensive examination did not find the primary lesions and diagnosed as the primary lesions of the unknown neck metastasis cancer, should be under the guidance of multidisciplinary treatment mode, wherein the individual treatment is to better balance the treatment effect and the quality of life of patients, which is also the most important issue in the guide. clinical practice how to weigh the efficacy and adverse reactions in clinical practice, the balance of therapeutic efficacy and adverse reactions has always been the focus of the topic of cancer treatment, Europe and the United States and other developed countries first attach importance to the quality of life of patients, and in the past, China is more emphasis on efficacy, ignoring the quality of life and impact of patients. but with the diversification of treatment methods, the improvement of efficacy, the improvement of quality of life is also more and more attention by Chinese experts, the primary cause of unknown head and neck scale cancer ASCO treatment guide is also for patients are one side or two sides, single or multiple neck metastasis lymph nodes, as well as metastasis lymph nodes have been recommended for interuterine aggression, such as the recommendation of different treatment models, to guide clinicians how to choose appropriate clinical means, in order to ensure the efficacy of the premise, improve the quality of life of patients. Jo Source: Tumor Information, !-- End of Content Presentation -- !-- Determine Signed-Up End.