Risk factors for survival from neuroendocrine neoplasia with unknown primary tumor site

2014 ◽  
Vol 219 (4) ◽  
pp. e84
Author(s):  
Nehara Begum ◽  
Ulrich F. Wellner ◽  
Christoph Thorns ◽  
Martin Hoffmann ◽  
Conny G. Bürk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Tumor ◽  
Unknown Primary ◽  
Tumor Site ◽  
Unknown Primary Tumor ◽  
Primary Tumor Site ◽  
Neuroendocrine Neoplasia ◽  
Risk Factors For Survival

Carcinoma of unknown primary site: treatment with 1-hour paclitaxel, carboplatin, and extended-schedule etoposide.

1997 ◽  
Vol 15 (6) ◽  
pp. 2385-2393 ◽  
Author(s):  
J D Hainsworth ◽  
J B Erland ◽  
L A Kalman ◽  
M T Schreeder ◽  
F A Greco
Keyword(s):  
Primary Tumor ◽  
Site Response ◽  
Response Rates ◽  
Unknown Primary ◽  
Tumor Site ◽  
Unknown Primary Tumor ◽  
Primary Tumor Site ◽  
Carcinoma Of Unknown Primary ◽  
Poorly Differentiated Neuroendocrine Carcinoma ◽  
Poorly Differentiated

PURPOSE To evaluate the efficacy and toxicity of a novel chemotherapy combination that includes paclitaxel, carboplatin, and extended-schedule etoposide in the treatment of patients with carcinoma of unknown primary tumor site. PATIENTS AND METHODS Fifty-five patients with carcinoma of unknown primary tumor site were treated with the following regimen, administered every 21 days: paclitaxel 200 mg/m2 by 1-hour intravenous (I.V.) infusion on day 1, carboplatin at an estimated area under the concentration-time curve (AUC) of 6.0 on day 1, and etoposide 50 mg alternated with 100 mg orally on days 1 through 10. Responding patients received a total of four courses of treatment. The following histologies were included: adenocarcinoma, 30 patients; poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA), 21; poorly differentiated neuroendocrine carcinoma, three; and squamous carcinoma, one. RESULTS Twenty-five of 53 assessable patients (47%; 95% confidence interval [CI], 33% to 61%) had major objective responses to treatment (seven complete responses). Response rates were similar in patients with adenocarcinoma versus PDC (45% and 48%, respectively). The actuarial median survival time for the entire group was 13.4 months. The regimen was well tolerated, with only seven hospitalizations for treatment of neutropenia and fever (4% of courses) and no treatment-related deaths. CONCLUSION The combination of paclitaxel, carboplatin, and extended-schedule etoposide is highly active and well tolerated in patients with carcinoma of unknown primary tumor site. Response rates and survival in this multicenter community-based trial compare favorably with all previously studied empiric regimens. In addition, this regimen is substantially less toxic and easier to administer than the cisplatin-based regimens previously used in this setting. If this level of efficacy is confirmed, this treatment should be considered standard first-line therapy in patients with carcinoma of unknown primary tumor site.

scholarly journals UNKNOWN PRIMARY TUMOR SITES IN SPINAL METASTASIS

2021 ◽  
Vol 20 (1) ◽  
pp. 64-67
Author(s):  
Priscila Barile Marchi Candido ◽  
Rômulo Pedroza Pinheiro ◽  
Fernanda Maris Peria ◽  
Vinicius Nogueira Toledo ◽  
Herton Rodrigo Tavares Costa ◽  
...  
Keyword(s):  
Clinical Features ◽  
Primary Tumor ◽  
Spinal Metastasis ◽  
Survival Rates ◽  
Unknown Primary ◽  
Unknown Primary Tumor ◽  
Treatment Results ◽  
Level Of Evidence ◽  
Primary Tumor Site ◽  
Epidural Compression

ABSTRACT Objective: The goal of the study was to report the prevalence of spinal metastasis with unknown primary tumor, clinical features, treatment results and patient survival. Methods: A retrospective evaluation of 103 patients with spinal metastasis and epidural compression, who underwent surgical treatment between March 2009 and August 2015. The prevalence of metastatic spinal tumor with unknown primary tumor was evaluated, as well clinical features, survival and treatment results. Results: Of 103 patients with spinal metastasis and epidural compression, seven patients (6.8%) with unknown primary tumor site were identified; five (71.4%) male and two (28.6%) female, with ages ranging from 37 to 67 years (50.7 years). The metastasis was located in the thoracic spine in six of the patients (85.7%) and in the cervical spine in one (14.3%). The mean survival time was 44.8 days. Conclusion: Spinal metastasis with unknown primary tumor was found in 6.8% of patients. The prognosis and outcomes were poor, and patients had poor survival rates. Level of evidence III; Experimental study.

Can Computed Tomography Characteristics of the Oropharynx in Cancer of Unknown Primary Predict Primary Tumor Site?

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P157-P158
Author(s):  
Ryan P. McSpadden ◽  
Thomas P. Sullivan ◽  
Jordan Rosenblum ◽  
Carol M. Bier-laning
Keyword(s):  
Computed Tomography ◽  
Primary Tumor ◽  
Cancer Of Unknown Primary ◽  
Unknown Primary ◽  
Tumor Site ◽  
Primary Tumor Site

scholarly journals Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

2020 ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

The role of whole body 18F-FDG PET/CT scan in patients with carcinoma of unknown primary

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22051-e22051
Author(s):  
M. Hu ◽  
J. Yu ◽  
N. Liu ◽  
L. Kong ◽  
P. Zhang
Keyword(s):  
Ct Scan ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Primary Site ◽  
Unknown Primary ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

e22051 Background: Carcinoma of unknown primary (CUP) is a heterogeneous group of tumors and usually follows an aggressive biological and clinical behavior. Difficult challenges in oncology which the identification of the primary tumor and a complete disease staging could offer a more rational and efficient treatment in order to improve the survival time. Our aim was to evaluate the role of 18F-FDG PET/CT scan with two aspects: detection of the primary site, and estimation of tumor biological behavior which essential for the development of new, individual and targeted effective therapies. Methods: One hundred and seventeen patients presenting with histologically confirmed metastatic carcinoma (76 lymph nodes, 41 visceral biopsy proven) of unknown primary site were included in this retrospective study. The evaluations as follows had not revealed a primary site: detailed medical history, full physical and laboratory examinations, and diagnostic imaging methods. All patients underwent PET/CT. Results: In 42 (35.90%) patients, a primary tumor site which was confirmed by follow-up or surgery was showed by PET/CT. In 15 (12.82%) patients, the primary tumor site was suggested by PET/CT but not confirmed. In 60 (51.28%) patients, the primary tumor site was not localized modifying the stage of disease. In the other 17 (14.53%) patients, PET/CT scan identified further unexpected metastases. Overall, the following oncological treatment was influenced by the PET/CT scan, in a total of 38 (32.47%) patients. Between the adenocarcinoma and squamous cell carcinoma groups, no significant difference in SUVmax was found ( t=1.191, p = 0.244). A significantly higher SUVmax was found among patients with poorly or undifferentiated carcinoma compared with patients with well to moderately ( t=4.013, p<0.01) differentiation; In 42 patients with a confirmed primary tumor site, the SUVmax of Metastatic tumours have a closely relationship correlate with those of primary tumours, ( r=0.738, p<0.01). Furthermore, a significantly higher SUVmax was found among metastases compared with primary tumors ( t=3.470, p<0.01). Conclusions: Our data strongly support 18F-FDG PET/ CT imagings not only provide new insights in the diagnosis and staging of patients with CUP, but also evaluate biologic characters of tissue. 1 No significant financial relationships to disclose.

scholarly journals Risk Factors for Osteoradionecrosis of the Jaw in Patients With Head and Neck Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14%, and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

scholarly journals Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose–volume histogram (DVH) parameters. Methods We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range 3–145) months. The median time to ORNJ development was 27 (range 2–127) months. DVH analysis revealed that V30–V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 > 14% were identified as important factors. In multivariate analyses, V60 > 14% (p = 0.0065) and primary tumor site (p = 0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤ 14% and > 14%, respectively (p < 0.0001), and 9.3% and 1.4% in patients with oropharyngeal or oral cancer and other cancers, respectively (p < 0.0001). Conclusions V60 > 14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

Cancer of unknown primary

BMJ ◽  
2020 ◽  
pp. m4050
Author(s):  
Michael S Lee ◽  
Hanna K Sanoff
Keyword(s):  
Primary Tumor ◽  
Standard Treatment ◽  
Unknown Primary ◽  
Tumor Site ◽  
Current Standard ◽  
Primary Tumor Site ◽  
Histopathologic Evaluation ◽  
Current Standard Treatment ◽  
Genomic Aberrations ◽  
Generation Sequencing

ABSTRACTCancers of unknown primary (CUPs) are histologically confirmed, metastatic malignancies with a primary tumor site that is unidentifiable on the basis of standard evaluation and imaging studies. CUP comprises 2-5% of all diagnosed cancers worldwide and is characterized by early and aggressive metastasis. Current standard evaluation of CUP requires histopathologic evaluation and identification of favorable risk subtypes that can be more definitively treated or have superior outcomes. Current standard treatment of the unfavorable risk subtype requires assessment of prognosis and consideration of empiric chemotherapy. The use of molecular tissue of origin tests to identify the likely primary tumor site has been extensively studied, and here we review the rationale and the evidence for and against the use of such tests in the assessment of CUPs. The expanding use of next generation sequencing in advanced cancers offers the potential to identify a subgroup of patients who have actionable genomic aberrations and may allow for further personalization of therapy.

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