Open AccessCancer of unknown primary site
Author(s) -
Nicholas Pavlidis,
George Pentheroudakis
Publication year - 2012
Publication title -
lancet
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 13.103
H-Index - 762
eISSN - 1474-547X
pISSN - 0140-6736
DOI - 10.1016/s0140-6736(11)61178-1
Subject(s) - medicine , taxane , histopathology , oncology , chemotherapy , disease , pathology , primary tumor , adenocarcinoma , immunohistochemistry , tissue microarray , prospective cohort study , cancer , metastasis , breast cancer
Cancer of unknown primary site (CUP) is a well recognised clinical disorder, accounting for 3-5% of all malignant epithelial tumours. CUP is clinically characterised as an aggressive disease with early dissemination. Diagnostic approaches to identify the primary site include detailed histopathological examination with specific immunohistochemistry and radiological assessment. Gene-profiling microarray diagnosis has high sensitivity, but further prospective study is necessary to establish whether patients' outcomes are improved by its clinical use. Metastatic adenocarcinoma is the most common CUP histopathology (80%). CUP patients are divided into subsets of favourable (20%) and unfavourable (80%) prognosis. Favourable subsets are mostly given locoregional treatment or systemic platinum-based chemotherapy. Responses and survival are similar to those of patients with relevant known primary tumours. Patients in unfavourable subsets are treated with empirical chemotherapy based on combination regimens of platinum or taxane, but responses and survival are generally poor.