The management of patients with metastatic cancer from an unknown primary site

The authors outlined their management of patients with known or suspected metastatic cancer from an unknown primary site. Patients with disease in regional lymph nodes should receive thorough evaluation of sites that drain primarily to those nodes. If the primary site is not located, the node should be biopsied in a manner that allows node dissection if this proves to be indicated. A significant number of these patients will be cured or receive significant palliation. In patients with disseminated disease, an effort should be made to quickly determine whether the tumor is one for which specific treatment is available. There is nothing to be gained by conducting extensive evaluation to locate the primary site if the treatment will not be affected by this knowledge.