[Diagnostic protocol for unknown primary cancers. Review of 157 cases]

Area of Science:

• Oncology
• Medical Diagnostics
• Clinical Research

Context:

• Unknown Primary Cancer (UPC) diagnosis presents significant variability in clinical decision-making.
• Standardized diagnostic protocols, derived from scientific literature, offer a potential solution to reduce this variability.
• This study examines UPC characteristics in Asturias and assesses adherence to a theoretical standard diagnostic procedure.

Purpose:

• To describe the epidemiological characteristics of Unknown Primary Cancer (UPC) cases in Asturias.
• To evaluate the extent to which diagnostic decisions align with a scientifically established standard protocol.
• To quantify the variability and potential for improvement in UPC diagnosis.

Summary:

• A retrospective study of 157 UPC cases (mean age 67, 59% male) revealed adenocarcinoma (51%) as the most common histology and hepatomegaly (29%) as the frequent presentation.
• Primary tumor diagnosis was achieved in 22% of cases, with lung cancer being the most common (31%).
• Comparison with a recommended protocol indicated an average of 8 unnecessary analyses, 3 imaging studies, and 0.6 aggressive techniques per patient.

Impact:

• The findings highlight significant variability in diagnostic decision-making for Unknown Primary Cancer.
• Implementing a standardized diagnostic protocol is advised to minimize patient harm and reduce healthcare expenditures.
• Adoption of evidence-based protocols can lead to more efficient and effective cancer diagnosis and patient management.