Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients.

Abbruzzese, James L.; Abbruzzese, Marie C.; Hess, Kenneth R.; Raber, Martin N.; Lenzi, Renato; Frost, Philip

doi:10.1200/jco.1994.12.6.1272

Cited by 319 publications

(202 citation statements)

References 22 publications

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“…Considering the influence of gender, Abbruzesse et al (1994) found that women lived longer, while Snyder et al (1979) found no difference in survival between men and women. Our finding that survival time is shorter in patients with more metastases is a common finding in UPT patients (Abbruzzese et al, 1994). The influence of therapy is nil in several studies Greco and Hainsworth, 1993); in our study, patients receiving any kind of therapy lived longer, although it should be remarked that the number was small (n 5 9) and that they were not treated according to one standard protocol.…”

Section: Survival Analysis In Upt Patientscontrasting

confidence: 47%

“…However, we should bear in mind that these results are based on a relatively small number of patients. Earlier studies did not find any influence of age on survival of UPT patients either (Snyder et al, 1979;Abbruzzese et al, 1994). Considering the influence of gender, Abbruzesse et al (1994) found that women lived longer, while Snyder et al (1979) found no difference in survival between men and women.…”

Section: Survival Analysis In Upt Patientsmentioning

confidence: 97%

“…This restriction was based on the fact that the microvasculature of different organs is phenotypically distinct (Fidler and Ellis, 1994) and the micro-environment influences the expression of angiogenic factors (such as basic fibroblast growth factor) by tumor cells (Singh et al, 1994). Furthermore, the liver is a common site of metastases of UPT (Abbruzzese et al, 1994;Nystrom et al, 1977) and liver biopsy is frequently performed. Adenocarcinoma is the most frequent histologic diagnosis in UPT (60%) (Abbruzzese et al, 1994;Hainsworth and Greco, 1993) and therefore we confined ourselves to this tumor type.…”

Section: Patientsmentioning

confidence: 99%

“…Furthermore, the liver is a common site of metastases of UPT (Abbruzzese et al, 1994;Nystrom et al, 1977) and liver biopsy is frequently performed. Adenocarcinoma is the most frequent histologic diagnosis in UPT (60%) (Abbruzzese et al, 1994;Hainsworth and Greco, 1993) and therefore we confined ourselves to this tumor type. All patients were diagnosed and treated in the University Hospital Maastricht (AZM).…”

Section: Patientsmentioning

confidence: 99%

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Microvessel density in unknown primary tumors

Hillen¹,

Hak²,

Joosten-Achjanie³

et al. 1997

Int. J. Cancer

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Section: Survival Analysis In Upt Patientscontrasting

confidence: 47%

Section: Survival Analysis In Upt Patientsmentioning

confidence: 97%

Section: Patientsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Microvessel density in unknown primary tumors

Hillen¹,

Hak²,

Joosten-Achjanie³

et al. 1997

Int. J. Cancer

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“…These lengths and rates of survival are similar to those observed for patients with chemotherapy-treated metastatic lung, pancreatic, and gastric carcinomas, among others. 7 In a review of Ͼ600 patients with CUP who were evaluated for treatment at The University of Texas M. D. Anderson Cancer Center (M. D. Anderson; a tertiary referral center) from 1987 to 1992, 8 the median survival was 11 months, 90% of patients received anticancer treatment, and 49.2% of patients received chemotherapy.…”

mentioning

confidence: 99%

The influence of comorbidities, age, and performance status on the prognosis and treatment of patients with metastatic carcinomas of unknown primary site

Sève

Sawyer

Hanson

et al. 2006

Cancer

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BACKGROUNDThe authors investigated how comorbidities, age, and performance status were related to the choice of chemotherapy and to the prognosis of patients with carcinomas of unknown primary site (CUP).METHODSPatients in Northern Alberta who were diagnosed with CUP during 2000 to 2003 were included (n = 389 patients). Survival was compared by age at diagnosis (ages <65 years, 65‐74 years, and >75 years), comorbidity score (Adult Comorbidity Evaluation‐27 [ACE‐27] scores of 0‐1 and >2), performance status (PS), and other explanatory variables, such as gender, histology, and site and number of metastases.RESULTSThe median age was 68 years, and the median overall survival was 12 weeks. An ACE‐27 overall comorbidity score >2 was found in 34% of patients, and a PS >2 was observed in 50% of patients. Multivariate analysis showed that patients who had a PS ≥2 and a high overall ACE‐27 score had a worse prognosis. The impact of comorbidities on survival was limited to patients with low PS. Patients who were not evaluated at a cancer center were older, had a worse functional status, and had more moderate or severe comorbidities. Among the 257 patients who were evaluated at a cancer center, 108 patients received chemotherapy, and 121 patients had a good PS (0‐1). Age was the only independent variable that was related to the likelihood of not receiving chemotherapy among patients who had a good PS. The median overall survival of the 121 patients who had a good PS was 317 days, and overall survival was not associated significantly with chemotherapy. A logistic regression analysis that included all patients who were evaluated at a cancer center identified young age, good PS, lymph node/pleural involvement, and few comorbidities as variables that were associated independently with receiving chemotherapy.CONCLUSIONSPatients with CUP who were not evaluated at a cancer center were older, had a worse functional status, and had more moderate or severe comorbidities; this referral bias largely explained the differences between data from registries and from tertiary centers. Moderate and severe comorbidities impacted survival in patients with who had a PS ≥2. An age‐related decline was observed in the percentage of adults with good PS who received chemotherapy. The current results suggested that older patients with CUP were under treated and that factors other than PS were involved in the decision to use chemotherapy for the treatment of patients with CUP. Cancer 2006. © 2006 American Cancer Society.

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