For an unknown primary manifested in a left supraclavicular node, what area would you treat with radiation therapy?

Is it adenocarcinoma or squamous cell carcinoma as suspected primary could be in head and neck region or abdominothoracic region

in practice I have treated once for squammous cell cancer and opted to treat ipsilateral involved site only with adjoining level 4 and 5 region.

I think we need a lot more information before you can decide what volumes and nodal levels to treat.

- Age

- Histology, HPV status

- smoking history

- workup (DL, upper endoscopy, PET Neck/C/A/P)

So let's assume this is SCC.

If all the workup is done and negative for a primary site, including upper endoscopy, PET, CT, and DL, then I think you have to treat as a head-and-neck primary since these are the most common to present with a neck node without mucosal disease.

If the patient is a moderate-...