Related Experiment Videos
Adenocarcinoma of unknown primary site
Seo Young Song1, Won Seog Kim, Hye Ran Lee
1Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Background:
Metastatic cancer of unknown primary site occupies 0.5-10% of all diagnosed cancer patients and includes various tumors with diverse responses to systemic chemotherapy. Adenocarcinoma of unknown primary site (ACUPS), the most common subtype, has no standard treatment, rarely responds to conventional treatment and has a poor survival rate.
Methods:
The retrospective study was performed to investigate the clinical characteristics and the treatment outcomes of ACUPS.
Results:
Eighty-one patients with ACUPS diagnosed at Samsung Medical Center from May 1995 to July 1999 were included. The median age was 58 years (range, 29-77). The common sites of metastases were the lymph node, liver, lung and bone in order. In 49 of 81 patients (60.5%), the dominant tumor location was below the diaphragm. The majority of patients (76 of 81) were initially treated with systemic chemotherapy including cisplatin. Responses were evaluable in 70 of 76. Eighteen of 70 patients (25.7%) responded to chemotherapy and complete remission was observed in 6 patients. The overall median survival of 81 patients was 5.6 months. The median survival of the responding patients was 18.3 months but the median survival of the nonresponding patients was 4.6 months (p < 0.01). In univariate and multivariate analysis, age, performance status and response to initial chemotherapy were significant prognostic factors for overall survival.
Conclusion:
We observed poor response to the treatment and survival rate in ACUPS, but complete remission and long-term survival were observed in a small number of patients.
Insights
Metastatic cancer of unknown primary site (ACUPS) shows poor treatment response and survival rates. However, a small subset of patients achieved complete remission and long-term survival with chemotherapy.
Area of Science:
- Oncology
- Medical Oncology
Background:
- Metastatic cancer of unknown primary site (ACUPS) represents a significant clinical challenge, accounting for 0.5-10% of cancer diagnoses.
- ACUPS, the most common subtype, lacks standard treatment protocols and exhibits limited response to conventional therapies, leading to poor prognoses.
Purpose of the Study:
- To investigate the clinical characteristics of ACUPS.
- To evaluate treatment outcomes and survival rates in patients with ACUPS.
Main Methods:
- Retrospective analysis of 81 ACUPS patients diagnosed between May 1995 and July 1999.
- Assessment of clinical data, treatment regimens (primarily cisplatin-based chemotherapy), response rates, and survival outcomes.
Main Results:
- The median age of patients was 58 years, with common metastatic sites including lymph nodes, liver, lung, and bone.
- Chemotherapy response was observed in 25.7% of evaluable patients (18 of 70), with 6 achieving complete remission.
- The overall median survival was 5.6 months, significantly longer in responders (18.3 months) versus non-responders (4.6 months).
Conclusions:
- ACUPS demonstrates a generally poor response to treatment and survival rates.
- Despite the overall grim outlook, a subset of patients can achieve complete remission and long-term survival.
- Age, performance status, and response to initial chemotherapy are significant prognostic factors for survival in ACUPS.