Cancer patients without a known primary: Incidence and survival trends in Sweden 1960–2007

Randén, Margareta; Rutqvist, Lars‐Erik; Johansson, Hemming

doi:10.1080/02841860902862503

Cited by 55 publications

(62 citation statements)

References 12 publications

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Section: Discussionmentioning

confidence: 96%

“…Our CUP cohort is smaller than those of large, European-based population studies of CUP with sample sizes ranging from 18 911 to 57 638 [9,11,14]. however, our work encompassed a six-year period, whereas these studies included 21 [9] to 47 [11] years of observations. as a consequence, our study did not include CUP cases from the 1990s, a period that is suggested to have been the peak of CUP incidence from European cancer registries [11,14].…”

Section: Discussionmentioning

confidence: 96%

“…We describe patient characteristics and examine overall survival using subgroups defined by histology and metastatic site. Similar studies have been conducted in Europe, but we are not aware of any published data on CUP survival in Canada [9][10][11][12].…”

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confidence: 80%

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Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

et al. 2015

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background. Cancer of unknown primary origin (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Our objective was to identify incident cases of CUP in Ontario, Canada, and determine the influence of histology and sites of metastases on overall survival (OS). Material and methods. We used the Ontario Cancer Registry (OCR) and the Same-Day Surgery and Discharge Abstract Database (SDS/DAD) to identify patients diagnosed with CUP in Ontario between 1 January 2000, and 31 December 2005. Patient diagnostic information, including histology and survival data, was obtained from the OCR. We cross-validated CUP diagnosis and obtained additional information about metastasis through data linkage with the SDS/DAD database. OS was assessed using Cox regression models adjusting for histology and sites of metastases. results. We identified 3564 patients diagnosed with CUP. Patients without histologically confirmed disease (n  1821) had a one-year OS of 10.9%, whereas patients with confirmed histology (n  1743) had a one-year OS of 15.6%. The most common metastatic sites were in the respiratory or digestive systems (n  1603), and the most common histology was adenocarcinoma (n  939). Three-year survival rates were 3.5%, 5.3%, 41.6% and 3.6% among adenocarcinoma, unspecified carcinoma, squamous cell carcinoma and undifferentiated histology, respectively. Three-year survival rates were 40%, 2.4%, 8.0% and 4.6% among patients with metastases localised to lymph nodes, the respiratory or digestive systems, other specified sites, and unspecified sites, respectively. conclusion. CUP patients in Ontario have a poor prognosis. Some subgroups may have better survival rates, such as patients with metastases localised to lymph nodes and patients with squamous cell histology.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

et al. 2015

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“…According to studies in Europe, 2,5,6) CUP accounts for 3% to 5% of all cancers, although the reported incidence of CUP extends to a wide range because of the difficulty in defining CUP. A study analyzing 26641 CUP patients demonstrated that 9633 patients (36.2%), in total, were diagnosed with lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

A Case of Femoral Arterial Bleeding by an Unknown Origin Metastatic Groin Lymph Nodes Carcinoma

Nakamura

Oda

Yasunaga

et al. 2016

Annals of Vascular Diseases

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We report a case of femoral arterial bleeding complicated with hemorrhagic shock caused by bacterial infection attributed to an inguinal lymph node metastasis of carcinoma of unknown primary. Because of severe preoperative condition, a venous patch plasty of ruptured artery, and omentopexy for the groin was performed as a less invasive surgery. But the recurrence of bleeding was occurred postoperatively. A staged operation, hemostasis with a venous patch plasty at a first stage, and an extra-anatomical bypass soon after improvement of shock condition in a second stage, can be one of surgical procedures to save the lives and salvage limbs. Keywords: femoral arterial bleeding, groin lymph nodes, groin infectionIn this paper, we report a case of femoral arterial bleeding caused by bacterial infection attributed to an inguinal lymph node metastasis of a CUP in an elderly patient. Case ReportA 79-year-old man was emergently transferred to our hospital for treatment of pulsatile massive bleeding from the eroded ulceration in the left groin with hemorrhagic shock. He noticed swelling of the lymph nodes in the left groin 15 months previously, and then the patient was diagnosed with metastatic carcinoma of the lymph nodes, which was pathologically classified as squamous cell carcinoma (SCC), after biopsy of the affected lymph node. Despite of close examinations using extensive diagnostic procedures, which included measurement of tumor markers, ultrasonography, computed tomography (CT), magnetic resonance imaging, gastrointestinal endoscopy, and combined 18 F-fluorinefluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT), the primary origin was not identified. FDG-PET showed high levels of FDG uptake in the left groin but significant FDG uptake was not detected in any other site such as the abdomen, the genitals and the lower extremities (Fig. 1). Based on these findings, a diagnosis of CUP with inguinal lymph node metastasis was made, and radical inguinal lymphadenectomy was judged to be difficult. Then, the patient underwent radiation therapy, but it was not effective to suppress expansion of the metastatic lymph node carcinoma. During the following 7 months, the expanded metastatic lymph node carcinoma eroded the skin with occurrence of ulceration, infection, and femoral vessel involvement. A small amount of bleeding from the ulceration repeatedly occurred during the last 4 months. CT performed one month previously revealed the large, irregular and poorly bordered mass extended from left pelvic region to the left groin with necrosis of its central part with involvement of the iliac and femoral arteries and a fistula to the skin ( Fig. 2A). Thrombosis of the left femoral and iliac veins and cancerous invasion to the pelvis were also demonstrated on CT (Figs. 2B, 2C). On admission, the patient was in circulatory collapse

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“…Although the exact etiology of CUP is poorly understood, CUP is thought to either represent: (i) a concurrent but undetected primary cancer, or (ii) a spontaneously regressed primary cancer that was either misdiagnosed, ignored, or went unnoticed. The incidence of CUP has declined, mainly due to the evolution of new detection methods and diagnostic modalities to identify the primary site [5,6].…”

Section: Discussionmentioning

confidence: 99%

Metastatic transitional cell carcinoma to the inguinal lymph nodes from an unknown primary: A case report

Almaimani¹

2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comMetastatic transitional cell carcinoma to the inguinal lymph nodes from an unknown primary: A case report Ghassan Almaimani ABSTRACT Introduction: The carcinoma of unknown primary (CUP) is uncommon in the inguinal region, accounting for 1-3% of all CUPs. The diagnostic workup for CUP includes histopathological examination, imaging and, more recently, molecular testing. Nevertheless, the primary site frequently remains unknown. Case Report: Herein, we report a case of 78-year-old male who was referred for evaluation of a painless swelling in the right inguinal region. Histopathological examination of the biopsy and resection specimens revealed transitional cell carcinoma (TCC) but no primary site was identified despite thorough clinical and radiological evaluation. Conclusion: This is the first reported case of pure TCC of the inguinal lymph nodes presenting as a CUP. This may have occurred either from an unidentifiable primary lesion or the primary may have since regressed. Although there are no clear guidelines for the management of such patients, treatment must be multimodal and might include surgical resection and perhaps postoperative adjuvant radiotherapy to achieve optimal outcomes. Investigation with PET would have been useful in this case.

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Cancer patients without a known primary: Incidence and survival trends in Sweden 1960–2007

Cited by 55 publications

References 12 publications

Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

A Case of Femoral Arterial Bleeding by an Unknown Origin Metastatic Groin Lymph Nodes Carcinoma

Metastatic transitional cell carcinoma to the inguinal lymph nodes from an unknown primary: A case report

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