Abstract: Objectives : This study was designed to analyze the patterns of relapse and management options in UPCMC as well as to discuss its treatment strategies. Methods : Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and long-term survival were compared among different groups. Results : Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusions : UPCMC should primarily be treated by radiotherapy except for cases with N₁ or N₂ neck whose carcinoma is in-sensitive to radiation. Comprehensive neck radiotherapy is the optimal choice in terms of neck radio-therapy. Selective radiotherapy is recommended for potential primary treatment.