Abstract
Background
Primary unknown cancer (PUC) is not rare neoplasm. The clinical features and survival time of these patients are heterogeneous. We analyzed cases that were referred to the National Cancer Center Hospital East with preliminary diagnosed PUC to evaluate the natural history and clinical features.
Methods
We retrospectively reviewed medical records of PUC patients who were referred to our institution between August 2005 and December 2008.
Results
One hundred and twenty-six patients with preliminary diagnoses of PUC were referred to the National Cancer Center Hospital East from community hospitals. The median age was 63 years (range 31–89 years). Almost all patients (85.7%) had good performance status (0–1). The mean interval between the first visit to a community hospital and referral to our hospital was 3.66 months (range 0–60 months). In 41 patients (32.5%), primary malignancies were identified by immunohistochemical studies and radiographical workup after referral to our hospital. Twenty-eight patients (22.2%) were defined as belonging to favorable subsets. About 50% of patients with unfavorable subsets received chemotherapy. None of the patients were autopsied.
Conclusion
In about half of the patients with preliminary diagnosed PUC, the primary origin could be identified, or it was possible to distinguish subsets with favorable prognosis.
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References
Hillen HF (2000) Unknown primary tumours. Postgrad Med J 76:690–693
Levi F, Te VC, Erler G et al (2002) Epidemiology of unknown primary tumours. Eur J Cancer 38:1810–1812
Nystrom JS, Weiner JM, Heffelfinger-Juttner J et al (1977) Metastatic and histologic presentations in unknown primary cancer. Semin Oncol 4:53–58
Nystrom JS, Weiner JM, Wolf RM et al (1979) Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roentgenographic procedures. JAMA 241:381–383
Pavlidis N, Briasoulis E, Hainsworth J et al (2003) Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer 39:1990–2005
Culine S, Kramar A, Saghatchian M et al (2002) Development and validation of a prognostic model to predict the length of survival in patients with carcinomas of an unknown primary site. J Clin Oncol 20:4679–4683
van de Wouw AJ, Janssen-Heijnen ML, Coebergh JW et al (2002) Epidemiology of unknown primary tumours; incidence and population-based survival of 1285 patients in Southeast Netherlands, 1984–1992. Eur J Cancer 38:409–413
Yakushiji S, Ando M, Yonemori K et al (2006) Cancer of unknown primary site: review of consecutive cases at the National Cancer Center Hospital of Japan. Int J Clin Oncol 11:421–425
Abbruzzese JL, Abbruzzese MC, Hess KR et al (1994) Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients. J Clin Oncol 12:1272–1280
Altman E, Cadman E (1986) An analysis of 1539 patients with cancer of unknown primary site. Cancer 57:120–124
Milliken ST, Tattersall MH, Woods RL et al (1987) Metastatic adenocarcinoma of unknown primary site. A randomized study of two combination chemotherapy regimens. Eur J Cancer Clin Oncol 23:1645–1648
Falkson CI, Cohen GL (1998) Mitomycin C, epirubicin and cisplatin versus mitomycin C alone as therapy for carcinoma of unknown primary origin. Oncology 55:116–121
Eagan RT, Therneau TM, Rubin J et al (1987) Lack of value for cisplatin added to mitomycin–doxorubicin combination chemotherapy for carcinoma of unknown primary site. A randomized trial. Am J Clin Oncol 10:82–85
NCCN Practice Guidelines for Occult Primary Tumors (1998) National Comprehensive Cancer Network. Oncology (Williston Park) 12:226–309
Su AI, Welsh JB, Sapinoso LM et al (2001) Molecular classification of human carcinomas by use of gene expression signatures. Cancer Res 61:7388–7393
Bloom G, Yang IV, Boulware D et al (2004) Multi-platform, multi-site, microarray-based human tumor classification. Am J Pathol 164:9–16
Varadhachary GR, Talantov D, Raber MN et al (2008) Molecular profiling of carcinoma of unknown primary and correlation with clinical evaluation. J Clin Oncol 26:4442–4448
Mayordomo JI, Guerra JM, Guijarro C et al (1993) Neoplasms of unknown primary site: a clinicopathological study of autopsied patients. Tumori 79:321–324
Bugat R, Bataillard A, Lesimple T et al (2003) Summary of the Standards, Options and Recommendations for the management of patients with carcinoma of unknown primary site (2002). Br J Cancer 89(Suppl 1):S59–S66
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Matsubara, N., Mukai, H., Nagai, S. et al. Review of primary unknown cancer: cases referred to the National Cancer Center Hospital East. Int J Clin Oncol 15, 578–582 (2010). https://doi.org/10.1007/s10147-010-0112-3
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DOI: https://doi.org/10.1007/s10147-010-0112-3