{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:20:46Z","timestamp":1791231646463,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,8]],"date-time":"2018-09-08T00:00:00Z","timestamp":1536364800000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>With positron emission tomography\/computed tomography (PET\/CT) now commonplace as a diagnostic tool, new questions have arisen regarding the utility and cost\u2010effectiveness of panendoscopy. In this retrospective review of a large cohort of head and neck squamous cell carcinoma of unknown primary (HNSCC\u2010UP), we describe the enduring utility of panendoscopy in the detection of the primary site of mucosal disease even when PET\/CT is negative.<\/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>A retrospective analysis of patients presenting to the senior author (<jats:sc>y.d.<\/jats:sc>) from July 1 1997 to July 1 2017 with fine\u2010needle aspiration\u2013proven metastatic squamous cell carcinoma to the neck. All patients underwent formal panendoscopy (direct laryngoscopy, bronchoscopy, and rigid esophagoscopy). Presence of squamous cell carcinoma on final pathology was examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 190 patients had HNSCC\u2010UP, with 87 positive and 103 negative on PET\/CT. Of the PET\/CT\u2010negative patients, 71 patients retained the HNSCC\u2010UP designation after panendoscopy. Eighteen patients (56% of cases) were found to have primary tonsillar squamous cell carcinoma. Eight of 32 primary sites were found in the base of tongue (25%), with HPV positivity in two of these patients. The sensitivity and negative predictive value of PET\/CT in detecting the primary site in unknown primary head and neck squamous cell carcinoma in the total study population were 73.1% and 68.9%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgical panendoscopy has an important role in the workup of patients with unknown primary head and neck squamous cell carcinoma. There is a high rate of cancer diagnosis, even in PET\/CT negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 2573\u20132575, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27268","type":"journal-article","created":{"date-parts":[[2018,9,8]],"date-time":"2018-09-08T20:40:35Z","timestamp":1536439235000},"page":"2573-2575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Combination of panendoscopy and positron emission tomography\/computed tomography increases detection of unknown primary head and neck carcinoma"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-8532","authenticated-orcid":false,"given":"Mofiyinfolu","family":"Sokoya","sequence":"first","affiliation":[{"name":"Department of Otolaryngology  University of Colorado School of Medicine Aurora Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshad","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology  University of Colorado School of Medicine Aurora Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5811-3791","authenticated-orcid":false,"given":"Sameep","family":"Kadakia","sequence":"additional","affiliation":[{"name":"Department of Facial Plastic and Reconstructive Surgery  Otolaryngology and Facial Plastic Surgery Associates Fort Worth Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadranko","family":"Ducic","sequence":"additional","affiliation":[{"name":"Department of Facial Plastic and Reconstructive Surgery  Otolaryngology and Facial Plastic Surgery Associates Fort Worth Texas 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