{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:15:31Z","timestamp":1779293731117,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this clinical survey was to assess variations in head and neck squamous cell carcinoma from an unknown primary (HNSCCUP) diagnostic practices across international centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical practice survey of experts nominated by Head and Neck Cancer International Group (HNCIG) and International Federation of Head and Neck Oncologic Societies (IFHNOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses were received from 48\/49 (97.9%) participants. Outpatient laryngoscopy, CT, and 18\u2010FDG\u2010PETCT were used always or most of the time by 81.3%, 77.1%, and 79.2%, but only 50% regularly used MRI. Unilateral and bilateral tonsillectomy were frequently performed in 41.6% and 27.1% of unilateral nodal disease, and in 18.8% and 52.1% for bilateral disease. Ipsilateral Tongue Base Mucosectomy (TBM) was used always or most of the time in 12.5% of unilateral and 6.3% of bilateral HNSCCUP. Bilateral TBM was used in 10.4% for unilateral and 22.9% for bilateral cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While there is broad agreement regarding examination and cross\u2010sectional imaging, there are considerable differences in the surgical strategies used to identify occult primaries.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.28065","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T09:44:33Z","timestamp":1736415873000},"page":"1478-1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trends in Investigations for Suspected Head and Neck Carcinoma of the Unknown Primary: A <scp>HNCIG<\/scp> and\u00a0<scp>IFHNOS<\/scp> International Survey of Practice"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3861-4847","authenticated-orcid":false,"given":"Andrew","family":"Williamson","sequence":"first","affiliation":[{"name":"International Centre for Recurrent Head and Neck Cancer (IReC) The Royal Marsden Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Nankivell","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE), Department of Cancer and Genomics University of Birmingham  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad K.","family":"Abou\u2010Foul","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE), Department of Cancer and Genomics University of Birmingham  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE), Department of Cancer and Genomics University of Birmingham  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisham","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE), Department of Cancer and Genomics University of Birmingham  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"HNCIG and IFHNOS CUP programme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.145"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21898"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.14167"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20638"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1194-4"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006713"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.14272"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13565"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.02.018"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105748"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010024\u201008976\u20104"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00275"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221512400032X"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.11.020"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkae031"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"e_1_2_10_18_1","first-page":"118","article-title":"Step Serial Sectioning in Head and Neck Squamous Cell Carcinoma of Unknown Primary","volume":"150","author":"Hardman J. 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