scholarly journals THE ROLE OF DIAGNOSTIC OESOPHAGO-GASTRODUODENOSCOPY (OGD) AND COLONOSCOPY IN CANCER OF UNKNOWN PRIMARY

2021 ◽  
Vol 71 (6) ◽  
pp. 2166-69
Author(s):  
Muhammad Ismail ◽  
Rao Saad Ali Khan ◽  
Farrukh Saeed ◽  
Muhammed Aasim Yusuf
Keyword(s):  
Primary Tumour ◽  
Diagnostic Procedures ◽  
Carbohydrate Antigen ◽  
Cancer Of Unknown Primary ◽  
Definitive Diagnosis ◽  
Primary Data ◽  
Research Centre ◽  
Unknown Primary ◽  
Tissue Diagnosis

Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy (OGD) and colonoscopy, in helping to establish a definitive primary tumour site in cancer of unknown primary. Study Design: Prospective observational study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 115 patients included in the study were those, who underwent OGD and a colonoscopy for the diagnosis of a cancer of unknown primary. Data collected included demographics, baseline clinical characteristics, definitive diagnosis, tissue diagnosis and immune-histochemical stains. Primary outcome was the attainment of a definitive diagnosis via OGD and/or colonoscopy. Results: A total of 115 patients underwent a diagnostic gastrointestinal procedure. Of these 70 (61%) were males. Mean age was 63 ± 12.6 years (range 22-88 years). Abdominal pain comprised the most common presenting complaint, found in 61 (53%). The most common tissue diagnosis of the metastatic sites was adenocarcinoma 81 (70.45%). Tumour markers including carcinoembryonic antigen, alpha-fetoprotein and carbohydrate antigen 19-9 were checked in 90 (78.2%), 46 (40%) and 69 (60%) patients respectively. No patient reached a definitive diagnosis by means of OGD and/or colonoscopy. Conclusion: OGD and colonoscopy when done collectively as diagnostic procedures to look for a primary tumour, have no value in the evaluation of patients with cancer of unknown primary.

Detection of unknown primary neuroendocrine tumors (CUP-NET) using 68Ga DOTA-NOC receptor PET/CT

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4599-4599
Author(s):  
D. Hörsch ◽  
V. Prasad ◽  
V. Ambrosini ◽  
M. Hommann ◽  
S. Fanti ◽  
...  
Keyword(s):  
Neuroendocrine Tumours ◽  
Primary Tumour ◽  
Unknown Primary ◽  
Low Grade ◽  
Pet Ct ◽  
Pancreatic Net ◽  
The Mean ◽  
Standardised Uptake Values ◽  
F 33

4599 Background: This bi-centric study aimed at determining the role of receptor PET/CT using 68Ga-DOTA-NOC in the detection of undiagnosed primary sites of neuroendocrine tumours (NETs). Methods: Overall 59 patients (M: F 33:26, age 65±9 yr) with documented NET and unknown primary, were enrolled. PET/CT was performed after injection of approximately 100 MBq (46–260 MBq) of 68Ga-DOTA-NOC. The maximum standardised uptake values (SUVmax) were calculated and compared with SUVmax in known pancreatic NET (pNET) and ileum / jejunum / duodenum (SI-NET). The results of PET/CT were also correlated with CT alone. Results: In 35/59 (59%) of patients, 68Ga-DOTA-NOC PET/CT localised the site of the primary: ileum/jejunum (14), pancreas (16), rectum (2), lungs (2) and paraganglioma (1). CT alone (on retrospective analyses) confirmed the findings in 12/59 (20%) patients. The mean SUVmax of identified previously unknown pNET and SI-Net were 18.6 ± 9.8 (range 7.8–34.8) and 9.1± 6.0 (range 4.2–27.8), respectively. SUVmax in patients with previously known pNET and SI-NET were 26.1± 14.5 (range 8.7–42.4) and 11.3±3.7 (range 5.6- 17.9). The SUVmax of the unknown pNET and SI-NET were significantly lower (p< 0.05) as compared to the ones with known primary tumour sites. 19% of the patients had high grade, and 81% low grade NET. In 4/59 patients the primary tumour was subsequently resected (2 pancretic, one ileal and one rectal tumour). Conclusions: Our data indicate that 68Ga- DOTA-NOC PET/CT is highly superior to 111In Octreoscan (17% detection rate for CUP according to literature) and can play a major role in the management of patients with CUP-NET. No significant financial relationships to disclose.

Identification of the occult tumor in cancer of unknown primary (CUP): A priority based on histology.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1605-1605 ◽  
Author(s):  
Chong Sung Kim ◽  
Malek Bassam Hannouf ◽  
Muriel Brackstone ◽  
Eric Winquist ◽  
Gregory S Zaric
Keyword(s):  
Cancer Registry ◽  
Primary Tumour ◽  
Cancer Of Unknown Primary ◽  
Rank Test ◽  
Unknown Primary ◽  
Metastatic Tumour ◽  
Tumour Site ◽  
Log Rank Test ◽  
Ontario Cancer Registry ◽  
Primary Tumour Site

1605 Background: The poor prognosis of cancer of unknown primary (CUP) patients is likely to improve with knowledge of the primary site. CUP patients form a diverse clinicopathological group; however, there remains doubt as CUP may indeed represent a unique clinical classification. Methods: We used the Ontario Cancer Registry to identify all patients diagnosed with cancer from January 2000 to December 2005. We linked these patients with the Canadian Institute of Health Information Same Day Surgery and Discharge Abstract Database to identify those who were initially diagnosed with a metastatic tumour. Information on clinical and pathological characteristics including age, gender, primary tumour site, histology, and second primary were available from the Ontario Cancer Registry. We stratified results according to primary tumour site and histology. Five-year survival data were available for all patients and were obtained from the Ontario Cancer Registry. Results: Of 52,619 patients diagnosed with metastatic tumour at the time of their initial cancer diagnosis, 4,866 (9.2%) patients were diagnosed with CUP and 47,753 (90.8%) patients were diagnosed with metastasis of known primary. The 5-year Kaplan-Meier estimate of CUP overall survival (OS) differed significantly with patients diagnosed with metastasis of known primary (median OS= 1.0 versus 10.4 months, respectively, log–rank test p<0.0001). In subgroup analyses, the 5-year OS of CUP patients with adenocarcinoma (n=1,389, median OS=1.83) was significantly worse when compared to metastatic adenocarcinoma of known primary (log-rank test p<0.0001). An identical result was obtained with CUP patients of undifferentiated histology (n=3,230). The 5-year OS of CUP patients with squamous cell carcinoma (n=247, median OS=18.5) did not differ significantly with those of other squamous cell carcinoma groups of known primary (log-rank test p>0.56). Conclusions: Although CUP patients as a whole have a poor prognosis compared to other metastatic patients of known primary, distinct subsets of CUP patients have similar prognosis. These data suggest that an intensive diagnostic approach for identification of the primary is not justified for all CUP patients.

Evaluating the hidden biology of cancer of unknown primary (CUP) in comparison to known metastatic disease.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12549-e12549
Author(s):  
Malek Bassam Hannouf ◽  
Salah Mahmud ◽  
Eric Winquist ◽  
Muriel Brackstone ◽  
Gregory S Zaric
Keyword(s):  
Tumour Size ◽  
Primary Tumour ◽  
Cancer Of Unknown Primary ◽  
Primary Site ◽  
Unknown Primary ◽  
Primary Cancer ◽  
Phenotypic Characteristics ◽  
Wilcoxon Rank Sum Test ◽  
Pathologic Features ◽  
Tumour Characteristics

e12549 Background: No consensus exists yet on whether CUP is a group of metastatic tumours with undetected primary sites or a unique clinicopathological entity with distinct genetic and phenotypic characteristics. We aimed to characterize the clinical and pathologic features of a cohort of CUP patients who had their latent primary site subsequently detected during their life or at autopsy in comparison to a cohort of patient presented with metastatic known primary cancers at initial diagnosis. Methods: We used historical snapshot files available in the Manitoba Cancer Registry (MCR) to identify all patients diagnosed with histologically or cytologically confirmed metastatic tumours in Manitoba during the period from January 1, 2002 to December 31, 2012. We linked all identified patients with their updated tumour-specific files available in the MCR for the purpose of identifying our two study cohorts. The first cohort included all patients who were initially diagnosed with CUP and who had their latent primary cancer identified and confirmed using either histology, cytology or autopsy at least 2 months after their initial CUP diagnosis. The second cohort included all patients initially diagnosed with a metastatic known primary cancer and whose cancer diagnosis did not change during lifetime or at autopsy. Information on patient and tumour characteristics was obtained from the MCR. Results: Out of 16,085 patients diagnosed with metastatic tumours, 2654 (%16.5) patients were initially diagnosed with CUP and 13,431 (84.5%) patients diagnosed with metastases of a known primary cancer. Out of the CUP group, 1033 (39%) patients had their latent primary site subsequently detected. Distribution of primary sites did not differ significantly between CUP patients who had their latent primary detected and patients diagnosed with metastases of a known primary cancer (p=0.44, Wilcoxon rank sum test). With the exception of tumour size, all other patient and tumour characteristics did not differ significantly between the two study cohorts across primary tumour sites. Conclusions: The clinical and pathologic features of CUP patient do not appear to be fundamentally different from those with metastatic known primary cancers.

The emerging role of trans-oral robotic surgery for the detection of the primary tumour site in patients with head-neck unknown primary cancers: A meta-analysis

2019 ◽  
Vol 46 (5) ◽  
pp. 663-671 ◽  
Author(s):  
Giuseppe Meccariello ◽  
Giovanni Cammaroto ◽  
Enyinnaya Ofo ◽  
Sebastiano Calpona ◽  
Elisabetta Parisi ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Meta Analysis ◽  
Primary Tumour ◽  
Unknown Primary ◽  
Tumour Site ◽  
Head Neck ◽  
Primary Tumour Site

Characterizing e-Inclusion Intermediary Actors in Europe

2014 ◽  
Vol 1 (4) ◽  
pp. 1-20
Author(s):  
Cristina Torrecillas ◽  
María Garrido ◽  
Gianluca Misuraca ◽  
Gabriel Rissola
Keyword(s):  
Information And Communication Technologies ◽  
Social Inclusion ◽  
Online Survey ◽  
Third Sector ◽  
Primary Data ◽  
Research Centre ◽  
Future Research ◽  
Joint Research ◽  
Preliminary Results

Digital and social inclusion intermediaries play a crucial role in providing digital literacy to excluded groups and in using Information and Communication Technologies (ICTs) to support social inclusion. However, information on the main characteristics of these actors is lacking. This paper presents the preliminary results of part of the MIREIA research conducted by the Institute for Prospective Technological Studies of the European Commission's Joint Research Centre, which aimed to characterise eInclusion intermediary actors in Europe and measure their socio-economic impact. This article explores the role of third sector organisations in the broader landscape of eInclusion intermediary actors. It first presents a conceptualization of the role and impacts of eInclusion intermediary actors, based on the results of a literature review and detailed 'locality mappings' conducted in three areas in Europe, in order to provide a definition of these actors. It then presents the methodology and main findings of an online survey designed to provide a 'map' of the eInclusion actors operating in Europe, answering the following questions: What are eInclusion actors? How can they be classified? Which services do they provide, to which targets groups?, and finally How do they operate and innovate? Findings show that the vast majority of eInclusion actors in the third sector are small organizations, in terms of staff numbers and budget, providing ICT services mainly to senior citizens, young adults and unemployed people. The results are consistent with the theoretical framework proposed and thus confirm that the configuration of the main characteristics of eInclusion intermediary actors is influenced by several factors including these actors' own intrinsic characteristics (mission, human and financial resources, etc.) and the external conditions (institutional environment, needs of the population where they operate, etc.). At the same time, these external factors and the different features of the intermediaries are linked and interrelated. These preliminary conclusions point to the fact that, despite the limitations inherent in the approach used, the findings presented in this paper can be considered relevant because: 1) they are the results of the first attempt in Europe to collect primary data from eInclusion intermediary actors and aim to create at least a baseline for future research; 2) the link between this activity and policy-making at EU level and the direct involvement of pan-European stakeholders and practitioners from the field will form the basis for further research and policy actions, informed by the results of the investigation; 3) the findings of the analysis provide useful insights and help shed light on the diversity and role of eInclusion intermediary actors and the contributions of their programmes to advancing social and economic inclusion in Europe. Further research is, however, required to systematise the findings and confirm the preliminary results with more in-depth investigation and analysis.

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