A practical approach to liver metastasis from unknown primary cancer: What surgeons need to know

Swaid, Forat; Downs, Darrell; Rosemurgy, Alexander S.

doi:10.1016/j.cancergen.2016.08.004

Cited by 16 publications

(15 citation statements)

References 94 publications

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“…UU.) se diagnostican 30 000 nuevos casos (9). A medida que aumenta la edad, aumentan los casos con una edad media de presentación de 60-65 años (1).…”

Section: Metodologíaunclassified

“…El examen físico debe ser completo, se deben buscar masas o adenopatías, y debe incluir la exploración de los senos, piel, pelvis y recto (1,9). No obstante, la importancia de una historia clínica y un examen físico minucioso, de esta enfermedad en particular, con frecuencia no se realiza de esa manera.…”

Section: Enfoque Inicialunclassified

“…Aunque no se consideran estudiferente a los carcinomas; el segundo diferencia los tipos de carcinoma en adenocarcinoma, carcinoma escamocelular, neuroendocrino, tiroideo, renal, hepatocelular y germinal; y el tercero diferencia el tipo de adenocarcinoma, que es muy importante, ya que representa el 80% de los tumores metastásicos con primario desconocido (49). En el primer paso (Tabla 2) se diferencia el linfoma mediante cúmulo de diferenciación (CD) 45 o antígeno leucocitario común, ya que los linfomas pueden ser positivos para las CK (2); si es positivo para carcinoma, se continúa con el segundo paso (2,9,25 Otra forma de clasificar los tumores es según las CK 7 y 20, con las que se han creado 4 grupos de tumores (Tabla 5) que pueden sugerir un origen tumoral (9,50). Las CK no son completamente específicas, por lo que no deben ser usadas para invocar un sitio primario en la ausencia de un soporte morfológico o inmunohistoquímico (46).…”

Section: Perfil Molecularunclassified

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Cáncer metastásico con primario desconocido. Una revisión

Rodríguez

Regino

Grosso

2018

Rev. Colomb. Gastroenterol.

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ResumenEl tumor metastásico no siempre tiene un origen evidente, hasta en un tercio de los casos nunca se encuentra el tumor primario. Este artículo es una guía de los avances más recientes para mejorar el enfoque diagnóstico y el manejo del paciente con este tumor fatal y frecuente. El objetivo de este artículo, además de ser una guía, es ayudar a evitar errores comunes y graves. Uno de los errores más importantes es no tener en cuenta el papel fundamental de la confirmación histológica, pues esta puede evitar investigaciones innecesarias.En el artículo también se detallan los componentes de la evaluación estándar, la clasificación según su pronóstico y las indicaciones de la evaluación secundaria, que incluye las indicaciones de la endoscopia alta y baja, los marcadores tumorales, la tomografía por emisión de positrones (TEP), el papel que ocupa el perfil genético, la epigenética y el ácido desoxirribonucleico (ADN) viral. Adicionalmente, se indica el momento en que se debe detener la investigación. Recientemente, el tratamiento se ha modificado, lo que parece cambiar la historia de estos pacientes y de sus contrapartes con primario conocido. Palabras claveTumor metastásico, primario desconocido, cáncer. AbstractMetastatic tumors do not always have obvious origins: in one third of these cases, the primary tumor is never found. This article is a guide to the most recent advances in diagnostic approaches and patient management of these fatal and frequent tumors. An additional objective of this article is to help avoid common and serious errors. One of the most important errors is not taking the fundamental role of histological confirmation into account since it can avoid unnecessary investigations.The article also details the components of a standard evaluation, classification according to prognosis and indications for a secondary evaluation. These include indications for upper and lower endoscopy, tumor markers, positron emission tomography, and the roles of genetic profiling, epigenetics and viral DNA. It also indicates the moment at which an investigation should be stopped. Recently, treatment has changed, and these changes seems to have changed the history of these patients and their counterparts with known primary tumors.

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“…UU.) se diagnostican 30 000 nuevos casos (9). A medida que aumenta la edad, aumentan los casos con una edad media de presentación de 60-65 años (1).…”

Section: Metodologíaunclassified

Section: Enfoque Inicialunclassified

Section: Perfil Molecularunclassified

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Cáncer metastásico con primario desconocido. Una revisión

Rodríguez

Regino

Grosso

2018

Rev. Colomb. Gastroenterol.

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“…The liver is one of the most common sites for tumor metastases in different types of cancer, including colorectal cancer, lung carcinoma, ovarian cancer, melanoma, breast carcinoma and esophageal and urogenital tumors (1,2). This organ is a site of metastasis in 25% of metastatic cancers (3). In Western countries, metastases are the most common type of malignant neoplasms in the liver (3).…”

Section: Introductionmentioning

confidence: 99%

“…This organ is a site of metastasis in 25% of metastatic cancers (3). In Western countries, metastases are the most common type of malignant neoplasms in the liver (3). The analysis of the postoperative course in patients following resection of colorectal cancer reveals that liver metastases occur in 40-60% of patients (2).…”

Section: Introductionmentioning

confidence: 99%

Treatment of hepatic metastases with computed tomography‑guided interstitial brachytherapy

Kieszko¹,

Cisek²,

Kordzińska-Cisek

et al. 2018

Oncol Lett

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The aim of the present study was to evaluate the efficacy, safety and tolerability of local treatment of liver metastases of various types of cancer using brachytherapy with computed tomography (CT) imaging. Retrospective analysis of 61 patients with unresectable hepatic metastases treated with CT-guided interstitial high dose rate (HDR) brachytherapy of the liver between April 2014 and December 2016 was performed. Patients were treated with a single fractional dose of 15-25 Gy. Statistical analysis was performed on local relapse free survival (LRFS), progression free survival (PFS) and overall survival (OS) rates across the group. In the 6 and 12-month follow-up periods, the 6- and 12-month LRFS rates were 88.7 and 70.7%, PFS rates were 78.1 and 53.8% and the OS rates were 96.7 and 79.6%, respectively. In the Cox regression analysis, the 100% isodose was a statistically significant predictor of LRFS (P=0.01) and PFS (P=0.02), but it was not significant in OS (P=0.07). The 90% isodose was a statistically significant predictor of LRFS (P=0,03) but not significant in PFS (P=0.17) or OS (P=0.25). In all patients, no serious complications were observed. Overall, 30% of patients experienced pain at the injection site, and 50% exhibited nausea or vomiting. In 2 patients, minor subcapsular bleeding occurred without clinical significance, and 1 patient was diagnosed with a pneumothorax that was not clinically significant. Brachytherapy HDR with CT imaging is an effective and safe method of local treatment of liver metastases. The effectiveness of the treatment is probably dose-dependent, and increases with increasing dosage.

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Common bile duct metastasis from recurrent adenocarcinoma of lung: A case report

Yeo

Chien

Tsai

et al. 2020

Adv in Digestive Medicine

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Obstructive jaundice caused by metastasis of lung cancer to distal common bile duct (CBD) is extremely rare. Here, we report a 70-year-old man presented with progressive jaundice and generalized weakness for 1 month. He had a medical history of stage IIB (pT2N1M0) lung adenocarcinoma, for which he had undergone surgical treatment and subsequent adjuvant chemotherapy 3 years ago. Endoscopic retrograde cholangiopancreatography (ERCP) rev

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A practical approach to liver metastasis from unknown primary cancer: What surgeons need to know

Cited by 16 publications

References 94 publications

Cáncer metastásico con primario desconocido. Una revisión

Cáncer metastásico con primario desconocido. Una revisión

Treatment of hepatic metastases with computed tomography‑guided interstitial brachytherapy

Common bile duct metastasis from recurrent adenocarcinoma of lung: A case report

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