Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;38(2):231-238.
doi: 10.1007/s10585-021-10073-3. Epub 2021 Jan 30.

Extensive diagnostic work-up for patients with carcinoma of unknown primary

L Meijer  1 , R H A Verhoeven  1   2 , I H J T de Hingh  3 , A J van de Wouw  4 , H W M van Laarhoven  5 , V E P P Lemmens  1   6 , C Loef  7
Affiliations

Extensive diagnostic work-up for patients with carcinoma of unknown primary

L Meijer et al. Clin Exp Metastasis. 2021 Apr.

Abstract

Patients with carcinoma of unknown primary (CUP) present with metastatic disease without an identified primary tumour. The unknown site of origin makes the diagnostic work-up and treatment challenging. Since little information is available regarding diagnostic work-up and treatment in daily practice, we collected and analysed these in a patient cohort with regard to the recommendations of the national CUP guideline. Data of 161 patients diagnosed with CUP in 2014 or 2015 were extracted from the Netherlands Cancer Registry (NCR) and supplemented with diagnostic work-up information from patient files and analysed. Patients underwent an average of five imaging studies during the diagnostic phase (range 1-17). From the tests as recommended in the national guideline on CUP, a chest X-ray was most commonly performed (73%), whereas a PET-CT was done in one out of four patients (24%). Biopsies were taken in 86% of the study population, with Cytokeratin 7 being the most frequently tested histopathological marker (73%). Less than half of patients received therapy (42%). CUP patients undergo extensive diagnostic work-up. The performance status did not influence the extent of the diagnostic work-up in CUP patients, but it was an important factor for receiving treatment.

Keywords: Diagnostics; Guideline; Oncology; Population-based; Unknown primary carcinoma.

PubMed Disclaimer

References

    1. Varadhachary GR (2007) Carcinoma of unknown primary origin. Gastrointest Cancer Res 1(6):229–235 - PubMed - PMC
    1. Bugat R et al (2003) Summary of the standards, options and recommendations for the management of patients with carcinoma of unknown primary site (2002). Br J Cancer 89(Suppl 1):S59–S66 - DOI
    1. Fizazi K et al (2015) Cancers of unknown primary site: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v133–v138 - DOI
    1. Pavlidis N, Pentheroudakis G (2012) Cancer of unknown primary site. Lancet 379(9824):1428–1435 - DOI
    1. Schroten-Loef C et al (2018) Unknown primary carcinoma in the Netherlands: decrease in incidence and survival times remain poor between 2000 and 2012. Eur J Cancer 101:77–86 - DOI

Publication types

LinkOut - more resources