Survival in cancer of unknown primary site: population-based analysis by site and histology
- 24 November 2011
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 23 (7), 1854-1863
- https://doi.org/10.1093/annonc/mdr536
Abstract
Cancer of unknown primary (CUP) is diagnosed at a metastatic stage, conferring an unfavorable prognosis. The natural history of the disease is poorly understood, which complicates diagnosis, treatment and follow-up. Population-based survival data are lacking regarding location and histology of metastases. From the Swedish Cancer Registry, 18 911 CUP patients were identified between years 1987 and 2008. Survival was analyzed by Kaplan–Meier survival curves and Cox regression. Adenocarcinoma accounted for 70% of all extranodal cases with a 12-month survival of 17% and the median survival of 3 months. Adenocarcinoma was also the most common histology (33.4%) when metastases were limited to lymph nodes, with a 12-month survival of 41% and median survival of 8 months. For extranodal metastases, the extremes in survival were small intestinal cancer with poor prognosis and mediastinal cancer with favorable prognosis. For nodal metastases, patients affected in the head and neck, axillary and inguinal regions had the best prognosis and those with abdominal and intrapelvic metastases the worst prognosis. The present data underline the importance of histology and location of metastasis in assisting clinical decision making: hazard ratios differed by a factor of five among extranodal and nodal metastases.Keywords
Funding Information
- Deutsche Krebshilfe
- The Swedish Council for Working Life and Social Research
- ALF-fund of Region Skane
This publication has 25 references indexed in Scilit:
- Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of Oncology, 2011
- Power and limits of modern cancer diagnostics: cancer of unknown primaryAnnals of Oncology, 2011
- Malignant melanoma of unknown primary site. To make the long story short. A systematic review of the literatureCritical Reviews in Oncology/Hematology, 2011
- Subsequent cancers in patients diagnosed with cancer of unknown primary (CUP): etiological insights?Annals of Oncology, 2011
- Do all roads lead to Rome? Routes to metastasis developmentInternational Journal of Cancer, 2011
- Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of Oncology, 2010
- Cancer metastasis networks and the prediction of progression patternsBritish Journal of Cancer, 2009
- Cancer patients without a known primary: Incidence and survival trends in Sweden 1960–2007Acta Oncologica, 2009
- Carcinoma of Unknown Primary – an Orphan Disease?Breast Care, 2008
- Epidemiology of unknown primary tumours; incidence and population-based survival of 1285 patients in Southeast Netherlands, 1984–1992European Journal of Cancer, 2002