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CUP-Syndrom

Epidemiologie, Prognosegruppen und therapeutische Strategie

CUP syndrome

Epidemiology, prognostic groups, and therapeutic strategy

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Zusammenfassung

Das CUP-Syndrom („cancer of unknown primary“, Krebserkrankung mit unbekanntem Primärtumor) ist eine häufige und heterogene Erkrankung mit einem breiten Spektrum an Manifestationsformen. Sie ist eine der 10 häufigsten Tumorerkrankungen mit hoher Mortalität. Sehr variabel ist auch die Prognose – vom Langzeitüberleben bis hin zu einer kurzen Überlebenswahrscheinlichkeit von wenigen Wochen. Klar definierte Prognosegruppen sind international anerkannt. Die Kenntnis dieser Gruppen ist wegweisend für die Auswahl der bestmöglichen Therapie. Etwa 15–20% der Patienten fallen in eine der günstigen Prognosegruppen mit jeweils klarem Therapiekonzept. Die übrigen Patienten weisen ein ungünstiges Risikoprofil auf und bedürfen einer evidenzbasierten empirischen Chemotherapie oder der Behandlung innerhalb einer Studie. Die klassische Behandlung nach der Arbeitsdiagnose („best guess“) ist nicht mehr zeitgemäß und sollte einer an den Prognosegruppen ausgerichteten therapeutischen Strategie weichen.

Abstract

CUP (cancer of unknown primary) is a common and heterogeneous disease with a wide spectrum of manifestations. It is one of the 10 most common cancer types and has a high mortality. Prognosis is of considerable variation, ranging from long-term survival to survival for only a few weeks. Clearly defined prognostic groups are internationally established, and knowledge about these groups is important to select optimal treatment. Some 15–20% of patients belong to one of the favorable prognostic groups, each of them having a specific therapeutic concept. The remaining patients show unfavorable characteristics and require an empirical chemotherapeutic regimen or treatment within a clinical trial. The classic way of treating along the “best guess” is outdated and should be replaced by a strategy driven by the prognostic groups.

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Authors and Affiliations

  1. Hämatologie und Internistische Onkologie, Sana Kliniken Ostholstein GmbH, Mühlenkamp 5, 23758, Oldenburg in Holstein, Deutschland

    G. Hübner

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  1. G. Hübner
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Correspondence to G. Hübner.

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Hübner, G. CUP-Syndrom. Onkologe 19, 8–14 (2013). https://doi.org/10.1007/s00761-012-2312-0

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  • DOI: https://doi.org/10.1007/s00761-012-2312-0

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