{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:31:49Z","timestamp":1785799909026,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,12,16]],"date-time":"2015-12-16T00:00:00Z","timestamp":1450224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Head and neck squamous cell carcinomas of unknown primary (HNSCCUP) accounts for up to 10% of presenting head and neck squamous cell carcinomas. Identification of the primary site allows for directed therapy. Where initial investigations have failed to locate the primary site, 18\u2010fludeoxyglucose positron emission tomography\u2010computed tomography (PET\/CT) has emerged as a useful tool with improved sensitivity over positron emission tomography alone. Following PET\/CT scan, the role of subsequent panendoscopy \u00b1 biopsy has not been fully assessed. We aim to evaluate and quantify the role of PET\/CT and subsequent panendoscopy in HNSCCUP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with HNSCCUP presenting between January 2005 and December 2010 at a regional oncology referral center were studied. All patients who presented with a metastatic neck node and unknown primary who had undergone PET\/CT prior to panendoscopy were included. The accuracy of PET\/CT was calculated and compared with panendoscopy and histopathological findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two patients were included. Twenty\u2010seven PET\/CT scans suggested a primary site. Calculated diagnostic parameters were 83% sensitivity, 87% specificity, positive predictive value 89%, and negative predictive value 80%. Three false\u2010positive PET\/CT scans were noted after panendoscopy and normal histology. Importantly, three confirmed tongue base tumors were found on panendoscopy, which were undetected on PET\/CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PET\/CT is a valuable resource for locating tumors in HNSCCUP. It helps direct biopsy and aids in the detection of local and distant metastases along with synchronous primary tumors. Importantly, due to both false\u2010positive and false\u2010negative PET\/CT rates, panendoscopy and biopsy remains an essential adjunct investigation irrespective of PET\/CT results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 126:1354\u20131358, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25783","type":"journal-article","created":{"date-parts":[[2015,12,16]],"date-time":"2015-12-16T10:36:25Z","timestamp":1450262185000},"page":"1354-1358","source":"Crossref","is-referenced-by-count":19,"title":["Role of 18\u2010Fludeoxyglucose positron emission tomography\u2010computed tomography and subsequent panendoscopy in head and neck squamous cell carcinoma of unknown primary"],"prefix":"10.1002","volume":"126","author":[{"given":"Navin","family":"Mani","sequence":"first","affiliation":[{"name":"Head and Neck Oncology Department The Christie NHS Trust Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish M.","family":"George","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department The Christie NHS Trust Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nash","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department The Christie NHS Trust Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Anwar","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department The Christie NHS Trust Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarrod J.","family":"Homer","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department The Christie NHS Trust Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1194-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1371-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.145"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0b013e328302cd26"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.626"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-002-0470-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1013107732572"},{"key":"e_1_2_7_9_1","first-page":"273","volume-title":"Head and Neck Cancer: Multidisciplinary Management Guidelines","author":"ENT UK","year":"2011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2008.05.010"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21566"},{"key":"e_1_2_7_12_1","first-page":"131","article-title":"Treatment of head and neck squamous cell carcinoma of an unknown primary (HNCCUP): oncologic analysis of 35 cases [in French]","volume":"134","author":"Berta E","year":"2013","journal-title":"Rev Laryngol Otol Rhinol (Bord)"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21898"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.06.038"},{"key":"e_1_2_7_15_1","unstructured":"National Collaborating Centre for Cancer.Metastatic malignant disease of unknown primary origin. Diagnosis and management of metastatic malignant disease of unknown primary origin. Clinical guideline; no. 104. London United Kingdom: National Institute for Health and Clinical Excellence (NICE);2010. Available at:https:\/\/www.nice.org.uk\/guidance\/cg104\/documents\/metastatic-malignant-disease-of-unknown-primary-origin-prepublication-check-full-guideline2. Accessed December 8 2014."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-011-0624-y"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20687"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-509X.138240"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21635"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4274\/Mirt.344"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-013-0225-z"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2013.06.002"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131109000818"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200212000-00020"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-200102000-00008"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002590050293"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.107.047787"},{"key":"e_1_2_7_28_1","first-page":"E1","article-title":"Metastatic cervical carcinoma from an unknown primary: literature review","volume":"93","author":"Arrangoiz R","year":"2014","journal-title":"Ear Nose Throat J"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20017"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(00)70143-4"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2014.03.005"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199812)20:8<739::AID-HED13>3.0.CO;2-0"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.114309"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199811000-00004"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2007.11.017"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.10.018"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2013.07.003"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.03.015"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.22901"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21825"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21968"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23372"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21743"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-846"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-013-2633-2"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25783","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25783","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.25783","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T18:14:40Z","timestamp":1695492880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.25783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,16]]},"references-count":44,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1002\/lary.25783"],"URL":"https:\/\/doi.org\/10.1002\/lary.25783","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,16]]}}}