Simple prognostic model to predict survival in patients with undifferentiated carcinoma of unknown primary site.

1995 ◽  
Vol 13 (7) ◽  
pp. 1720-1725 ◽  
Author(s):  
A van der Gaast ◽  
J Verweij ◽  
A S Planting ◽  
W C Hop ◽  
G Stoter
Keyword(s):  
Alkaline Phosphatase ◽  
Prognostic Factors ◽  
Median Survival ◽  
Performance Status ◽  
Primary Site ◽  
Survival Duration ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Median Survival Duration

PURPOSE We performed this study to identify prognostic factors in a subgroup of patients with carcinoma of unknown primary site treated with cisplatin combination chemotherapy. PATIENTS AND METHODS Seventy-nine patients with poorly differentiated adenocarcinoma or undifferentiated carcinoma of unknown primary site were treated on two consecutive phase II chemotherapy protocols. The first protocol consisted of treatment with 3-week courses of cisplatin, etoposide, and bleomycin (BEP). In the second protocol, cisplatin was administered weekly combined with oral administration of etoposide (DDP/VP). To identify prognostic factors, univariate and multivariate analyses were conducted. RESULTS In the univariate analysis, performance status, histology, liver or bone metastases, and serum levels of alkaline phosphatase and AST were significant variables to predict survival. In the multivariate analysis, performance status and alkaline phosphatase were the most important prognostic factors. CONCLUSION Good-prognosis patients had a performance score of 0 (World Health Organization [WHO]) and an alkaline phosphatase serum level less than 1.25 times the upper limit of normal (N). These patients had a median survival duration greater than 4 years. Intermediate-prognosis patients were characterized by either a WHO performance status < or = 1 or an alkaline phosphatase level > or = 1.25 N. These patients had a median survival duration of 10 months and a 4-year survival rate of only 15%. The poor-prognosis group had both a WHO performance status > or = 1 and an alkaline phosphatase level > or = 1.25 N. These patients had a median survival duration of only 4 months and none survived beyond 14 months. Treatment strategies for these three groups are discussed. It is suggested that this prognostic model be validated in other patients series.

Gemcitabine, Carboplatin, and Paclitaxel for Patients With Carcinoma of Unknown Primary Site: A Minnie Pearl Cancer Research Network Study

2002 ◽  
Vol 20 (6) ◽  
pp. 1651-1656 ◽  
Author(s):  
F. Anthony Greco ◽  
Howard A. Burris ◽  
Sharlene Litchy ◽  
John H. Barton ◽  
James E. Bradof ◽  
...  
Keyword(s):  
Performance Status ◽  
Primary Site ◽  
Research Network ◽  
Weekly Paclitaxel ◽  
Unknown Primary ◽  
Entire Group ◽  
Unknown Primary Site ◽  
Actuarial Survival ◽  
Carcinoma Of Unknown Primary ◽  
Prognostic Features

PURPOSE: To evaluate the efficacy and toxicity of the novel chemotherapy combination that includes gemcitabine, carboplatin, and paclitaxel in the treatment of patients with carcinoma of unknown primary site. PATIENTS AND METHODS: One hundred twenty patients were treated with the following regimen, administered every 21 days for a planned four courses: gemcitabine 1,000 mg/m2 intravenously (IV) on days 1 and 8, carboplatin at an estimated area under the concentration-time curve of 5 mg min/mL IV on day 1, and paclitaxel 200 mg/m2 IV on day 1. After four courses, stable and responding patients were given weekly paclitaxel 70 mg/m2 IV for 6 weeks for three 8-week courses. All patients had relatively poor prognostic features. Sixty-three patients had well-differentiated adenocarcinoma, 56 patients had poorly differentiated carcinoma, and 104 patients had performance status of 0 or 1. RESULTS: Twenty-eight (25%) of 113 assessable patients (95% confidence interval, 22% to 30%) had major objective responses to treatment. Response rates were similar in the two major histologic types. Response rate did not seem to be improved by continued therapy with weekly paclitaxel. The median progression-free survival time was 6 months. Median survival for the entire group was 9 months, and the actuarial survival at 1 and 2 years was 42% and 23%, respectively. CONCLUSION: Combination chemotherapy with gemcitabine, carboplatin, and paclitaxel followed by weekly paclitaxel is an active and tolerable treatment for patients with carcinoma of unknown primary site. The survival seen in this poor-prognosis group of patients in this multicenter community-based trial is notable and similar to other taxane-based regimens for these patients. Study of additional combinations or sequences of newer drugs, as well as the exploration of targeted biologic agents for patients with an identified target in their tumors, is warranted.

Prognostic factors in metastatic carcinoma of unknown primary.

1986 ◽  
Vol 4 (11) ◽  
pp. 1652-1657 ◽  
Author(s):  
R Pasterz ◽  
N Savaraj ◽  
M Burgess
Keyword(s):  
Prognostic Factors ◽  
Median Survival ◽  
Combination Chemotherapy ◽  
Performance Status ◽  
Objective Response ◽  
Metastatic Carcinoma ◽  
Unknown Primary ◽  
Carcinoma Of Unknown Primary ◽  
Good Performance Status ◽  
Metastatic Sites

From January 1980 to June 1984, 70 patients with metastatic carcinoma of unknown primary treated with combination chemotherapy were analyzed for prognostic factors influencing objective response and survival. Suspicious germ-cell tumors and neuroendocrine tumors were excluded since patients with these malignancies tend to live longer than those with metastatic carcinoma of unknown primary. Objective response rate to combination chemotherapy was 28%. Median survival of all patients responding to combination chemotherapy was better than those not responding (16 v 3 months). In patients with good performance status, median survival was longer in responders than nonresponding patients (17 v 7 months). External lymph nodes or subcutaneous disease as the only site of disease and good performance status favorably influenced both objective response and survival, while the number of different metastatic sites favorably influenced only survival. Neutropenia and thrombocytopenia were appreciable but not fatal or a great cause of morbidity in those with good performance status. Thus, patients with metastatic carcinoma of unknown primary with good performance status or only external nodes or subcutaneous disease should be treated with combination chemotherapy regardless of age, histology, or number of different metastatic sites of disease.

Prognostic Factors in Recent Head and Neck Squamous Cell Carcinoma of Unknown Primary Site (HNSCCUP)

2013 ◽  
Vol 149 (2_suppl) ◽  
pp. P187-P187
Author(s):  
Kenya Kobayashi ◽  
Go Omura ◽  
Yuki Saito ◽  
Yasuhiro Ebihara ◽  
Takahiro Asakage ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Primary Site ◽  
Neck Squamous Cell Carcinoma ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary

scholarly journals Comprehensive Genomic Profiling of Carcinoma of Unknown Primary Site

JAMA Oncology ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 40 ◽  
Author(s):  
Jeffrey S. Ross ◽  
Kai Wang ◽  
Laurie Gay ◽  
Geoff A. Otto ◽  
Emily White ◽  
...  
Keyword(s):  
Primary Site ◽  
Unknown Primary ◽  
Genomic Profiling ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Comprehensive Genomic Profiling

A 46 year old man with carcinoma of unknown primary site

BMJ ◽  
2012 ◽  
Vol 345 (aug02 2) ◽  
pp. e5144-e5144
Author(s):  
E. Liniker ◽  
S. Al-Jilaihawi ◽  
D. Propper ◽  
S. Slater ◽  
S. Pacey
Keyword(s):  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary

scholarly journals Resection Of A Retroperitoneal Cancer Of Unknown Primary Site After Chemoradiation Therapy: A Case Report

2020 ◽  
Author(s):  
Tomonari Suetsugu ◽  
Nobuhisa Matsuhashi ◽  
Hiroshi Tsuchiya ◽  
Takao Takahashi ◽  
Masahiro Fukada ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Iliac Artery ◽  
Cancer Of Unknown Primary ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Multidisciplinary Therapy ◽  
Carcinoma Of Unknown Primary

Abstract Background: Complete recovery from retroperitoneal squamous cell carcinoma of unknown primary site treated by multidisciplinary therapy is extremely rare.Case presentation: A 78-year-old man was referred to our hospital due to a mass measuring 8 cm in size in the left pelvic retroperitoneal area, which was diagnosed as a cancer of unknown primary site. The pathological type was squamous cell carcinoma. The left iliac artery/vein and ureter were involved in the tumor, and the tumor caused severe left leg pain. Although inflammation and symptoms were severe, palliative radiotherapy was considered. After that, biweekly combined therapy with docetaxel, cisplatin, and fluorouracil was planned. After 5 courses of chemotherapy, the tumor diameter reduced from 11.6 cm to 4 cm in size. In addition, the border between the iliac vessels, urinary tract and tumor became apparent. The patient underwent radical resection of the tumor 8 months after the treatment started. The left ureter and the external/internal iliac artery were preserved, but the external iliac vein was sacrificed because of the possibility of tumor invasion. The postoperative course was free of complications, and the patient was discharged 10 days after the operation. The histopathological findings showed no residual viable tumor cells or foreign body-type giant cells with necrosis. The pathological effect of chemotherapy was defined as Grade 3 (pathological complete response). The patient has experienced no recurrence or distant metastasis for 4 years.Conclusions: Multidisciplinary therapy succeeded in treating a retroperitoneal squamous cell carcinoma of unknown primary site with preservation of organ function.

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