Cancer of unknown primary origin natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
- Early clinical features include fatigue, weight-loss, and loss of appetite.
- Cancers of unknown primary origin are characterized by their aggressiveness, early dissemination, and unpredictable metastasis.
- Upon presentation, around 60% of patients with cancer of unknown primary have two or more affected sites.[1]
- The most common sites of metastasis in cancer of unknown origin are lymph nodes, lungs, liver, bones, and pleura.[2]
- If left untreated, the majority of patients with cancer of unknown primary origin may progress to develop multiple organ failure, heart failure, and death.
- Common complications of cancer of unknown primary origin, may include: hypercalcemia, adrenal insufficiency, and inappropriate antidiuretic syndrome, hematologic disorders, and malignant effusions.
- Prognosis is generally poor, and the average survival time of patients with cancer of unknown primary origin is approximately 6-12 months after diagnosis.[3][4]
- Sites of metastasis and prognosis differ with the types of CUPs:[5][6][7][8]
Type | Common sites of metastasis | Characteristics | 5-year survival rates |
---|---|---|---|
Adenocarcinoma | Liver, lungs, bones, axillary lymph nodes, and peritnoneum | Most common type of CUP | 5% |
Squamous cell carcinoma | Cervical lymph nodes | More common in males | 30% |
Neuroendocrine carcinoma | Bone marrow, bone lesions, lymph nodes, and lungs | Predominating type in children | 17% |
Undifferntiated | Lungs and lymph nodes | Rapid tumor growth | 13-16% |
References
- ↑
- ↑ Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M; et al. (1988). "Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients". Arch Intern Med. 148 (9): 2035–9. PMID 3046543.
- ↑ Nelson KA, Walsh D, Abdullah O, McDonnell F, Homsi J, Komurcu S, LeGrand SB, Zhukovsky DS (2000). "Common complications of advanced cancer". Semin. Oncol. 27 (1): 34–44. PMID 10697020.
- ↑ Altman E, Cadman E (1986). "An analysis of 1539 patients with cancer of unknown primary site". Cancer. 57 (1): 120–4. PMID 3940611.
- ↑
- ↑ Hainsworth JD, Dial TW, Greco FA (1988). "Curative combination chemotherapy for patients with advanced poorly differentiated carcinoma of unknown primary site". Am J Clin Oncol. 11 (2): 138–45. PMID 2451881.
- ↑ Nguyen C, Shenouda G, Black MJ, Vuong T, Donath D, Yassa M (1994). "Metastatic squamous cell carcinoma to cervical lymph nodes from unknown primary mucosal sites". Head Neck. 16 (1): 58–63. PMID 8125789.
- ↑ Kuttesch JF, Parham DM, Kaste SC, Rao BN, Douglass EC, Pratt CB (1995). "Embryonal malignancies of unknown primary origin in children". Cancer. 75 (1): 115–21. PMID 7804965.