Carcinoma of unknown primary site. A prudent approach

The patient with carcinoma of unknown primary site deserves prompt and efficient evaluation in an effort to locate a primary tumor in a treatable location. Early collaboration between clinician and pathologist is essential. The needs of patient and family must be considered, and the hospital stay should not be extended by unnecessary diagnostic tests that have no purpose other than delineation of extent of disease. Specific chemotherapy regimens should be instituted if evaluation reveals a potentially responsive tumor. All patients should receive palliative therapy directed at relief of symptoms and pain and improved quality of life. Refinement of immunologic and cytochemical techniques for primary tumor site localization, along with advances in the therapy of colonic, pancreatic, lung, and ovarian carcinomas, should make the outlook for the patient with carcinoma with an occult primary site considerably brighter.