Carcinoma of unknown primary with a colon-cancer profile—changing paradigm and emerging definitions

Varadhachary, Gauri R.; Raber, Martin N.; Matamoros, Aurelio; Abbruzzese, James L.

doi:10.1016/s1470-2045(08)70151-7

Cited by 119 publications

(60 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The sites of metastasis were fairly typical in 29 (90%) patients, and the IHC staining patterns of the biopsy specimens were frequently supportive of colorectal carcinoma. The IHC staining patterns are also helpful in recognizing this subset of CUP patients and typical IHC staining patterns may be useful in planning therapy, as has been previously reported by Varadhachary et al [19] A minority of the patients reported here did not have typical IHC staining patterns for colorectal carcinoma, and the molecular assays provided a presumptive diagnosis in these patients.…”

Section: Discussionsupporting

confidence: 71%

Carcinoma of Unknown Primary Site: Outcomes in Patients with a Colorectal Molecular Profile Treated with Site Specific Chemotherapy

Greco¹,

Lennington²,

Spigel³

et al. 2012

JCT

View full text Add to dashboard Cite

Purpose: Accurate identification of carcinoma of unknown primary site (CUP) patients with colorectal sites of origin may improve outcomes by directing colorectal chemotherapy rather than empiric chemotherapy. Clinical features, standard pathologic evaluation, treatment response, and survival of CUP patients whose tumors had colorectal genetic signatures were examined. Patients and Methods: We prospectively tested paraffin-embedded biopsies from 213 CUP patients using mRNA-based RT-PCR assays, and identified patients with colorectal genetic signatures. Results: Assays were successful in 185 specimens (87%); 32 (17%) had colorectal genetic signatures. All 32 patients had carcinoma; colonoscopy was normal in 30 patients studied; 29 patients (90%) had typical metastatic sites; 17 (53%) had consistent IHC profiles (CK20+, CDX2+). Twenty-nine patients (90%) received first-and/or second-line colorectal chemotherapy regimens (response rates of 69% and 54%, respectively). Median, 2-and 4-year survivals for all 32 patients were 21 months, 42%, and 35%, respectively. Conclusion: The majority of CUP patients with colorectal molecular profile diagnoses responded to site-specific chemotherapy; median survival was similar to patients with known advanced colorectal carcinoma and superior to expected survival of CUP patients receiving empiric chemotherapy. Molecular profile assays can identify CUP patients with colorectal carcinoma; colorectal chemotherapy appears to improve outcomes.

show abstract

Section: Discussionsupporting

confidence: 71%

Carcinoma of Unknown Primary Site: Outcomes in Patients with a Colorectal Molecular Profile Treated with Site Specific Chemotherapy

Greco¹,

Lennington²,

Spigel³

et al. 2012

JCT

View full text Add to dashboard Cite

show abstract

“…Histologically, adenocarcinoma (40 -50%) and poorly differentiated carcinoma including poorly differentiated adenocarcinoma (30 -40%) account for the vast majority of cases. In recent years comparable clinical behaviour of both groups was demonstrated and 'treatable' subsets were identified: resectable disease, squamous or poorly differentiated carcinoma in upper cervical nodes, women with axillary nodes (suggestive of occult breast cancer), women with peritoneal carcinomatosis (suggestive of occult ovarian cancer), young men with features of extragonadal germ cell cancer (young age, poorly differentiated carcinoma, midline presentation, multiple pulmonary nodules), neuroendocrine carcinoma, and possibly colon-cancer-type carcinoma (Varadhachary et al, 2008). Unfortunately, these subsets represent only 5 -10% of cases (Pavlidis and Fizazi, 2005).…”

mentioning

confidence: 99%

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

et al. 2008

View full text Add to dashboard Cite

Platinum/taxane combinations are widely used in patients with carcinoma of unknown primary (CUP), yielding response rates of 30% and median overall survival of 9 -11 months in selected patients. Yet these combinations have not been subject to a randomised trial to overcome selection bias, a major problem in CUP. We randomised 92 patients to either paclitaxel/carboplatin (arm A) or the non-platinum non-taxane regimen gemcitabine/vinorelbine (arm B). The primary endpoint was rate of practicability as defined: application of X2 cycles of therapy (1) with a maximal delay of 1 week (2) and survival of X8 months (3). Practicability was shown in 52.4% (95% CI 36 -68%) in arm A and in 42.2% (95% CI 28 -58%) in arm B, respectively. The median overall survival, 1-year survival -rate and response rate of patients treated in arm A was 11.0 months, 38, and 23.8%, arm B 7.0 months, 29, and 20%. In conclusion, the paclitaxel/carboplatin regimen showed clinically meaningful activity in this randomised trial (Clinical trial registration number 219, 'Deutsches KrebsStudienRegister', German Cancer Society.)

show abstract

“…A thorough histopathological evaluation is always needed to guide the clinician to the most likely primary tumor site or sites, to give reason to further specific examinations, for example endoscopy, and to deliver important information about the tumor that may have influence on the prognosis and possibly the choice of therapy and improvement of clinical outcome (Varadhachary et al, 2008).…”

Section: Resultsmentioning

confidence: 99%

Comparative Histopathological Characterization of Prostate Cancer in Saudi Patients by Conventional and 2005 ISUP Modified Gleason Systems

Suhaibani

Kizilbash²,

Beladi³

2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: The aim of this study was to compare the characterization of prostate cancer using the conventional and 2005 ISUP modified Gleason systems. Materials and Methods: The study employed samples from 40 prostate cancer patients with resection, biopsy and RP materials. The majority of cases (95%) comprised adenocarcinoma of the prostate with a modified combined Gleason score of 7 in 20 of the cases (50%). Results: Upgrading of Gleason scores to a score of 7 occurred in more than 45% of the cases. Conclusion: The study successfully showed that by the use of the 2005 ISUP modified Gleason system, score 6 cancers decreased from 25% to 17.5% of cases, whereas score 7 cancers increased from 45% to 50%.

show abstract

Carcinoma of unknown primary with a colon-cancer profile—changing paradigm and emerging definitions

Cited by 119 publications

References 14 publications

Carcinoma of Unknown Primary Site: Outcomes in Patients with a Colorectal Molecular Profile Treated with Site Specific Chemotherapy

Carcinoma of Unknown Primary Site: Outcomes in Patients with a Colorectal Molecular Profile Treated with Site Specific Chemotherapy

Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

Comparative Histopathological Characterization of Prostate Cancer in Saudi Patients by Conventional and 2005 ISUP Modified Gleason Systems

Contact Info

Product

Resources

About