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Cáncer de sitio primario desconocido
Nicholas Pavlidis1, George Pentheroudakis
1Department of Medical Oncology, School of Medicine, University of Ioannina, Ioannina, Greece. npavlid@uoi.gr
Lancet (London, England)
|March 15, 2012
Resumen
El cáncer de sitio primario desconocido (CUP, por sus siglas en inglés) es un cáncer agresivo. La identificación del sitio primario ayuda en el tratamiento, con resultados distintos para subconjuntos pronósticos favorables y desfavorables.
Área de la Ciencia:
- Oncología Oncología.
- Investigación del cáncer Investigación del cáncer.
Sus antecedentes:
- El cáncer de sitio primario desconocido (CUP) constituye el 3-5% de los cánceres epiteliales.
- CUP se caracteriza por un comportamiento agresivo y metástasis temprana.
Objetivo del estudio:
- Revisar los enfoques de diagnóstico para la CUP.
- Discutir estrategias de tratamiento y resultados para diferentes subconjuntos de pronóstico de CUP.
Principales métodos:
- Revisión del examen histopatológico, la inmunohistoquímica y la evaluación radiológica.
- Discusión sobre el diagnóstico de microarrays de perfilado genético.
- Análisis de las respuestas al tratamiento y las tasas de supervivencia basadas en subconjuntos pronósticos.
Principales resultados:
- El adenocarcinoma metastásico es el subtipo CUP más común (80%).
- Existen subconjuntos de pronóstico favorables (20%) y desfavorables (80%) del pronóstico.
- Los subconjuntos favorables tratados con quimioterapia locorregional o a base de platino muestran resultados similares a las primarias conocidas.
- Los subconjuntos desfavorables tratados con quimioterapia empírica tienen respuestas y supervivencia pobres.
Conclusiones:
- El diagnóstico y el subconjunto precisos son cruciales para la gestión de la CUP.
- Los tratamientos dirigidos a subconjuntos favorables mejoran los resultados.
- Se necesita más investigación para optimizar el tratamiento para subconjuntos desfavorables de CUP.
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