title: Managing carcinomas of unknown primary site.
abstract: Patients with carcinoma of unknown primary site are heterogeneous with respect to tumor biology, clinical characteristics, and response to therapy. These patients should no longer be considered uniformly "untreatable"; careful evaluation can identify treatable subsets. The initial light microscopic findings should be used to categorize patients into one of three groups: Well-differentiated adenocarcinoma, poorly differentiated carcinoma (or adenocarcinoma), and squamous carcinoma. Subsequent evaluation and treatment differ for these three groups. Poorly differentiated carcinomas are often responsive to cisplatin-based chemotherapy; effective systemic treatments are also available for some subsets of patients with adenocarcinoma. Surgery and/or radiotherapy is often beneficial for patients with squamous carcinoma, especially those who have isolated cervical lymphadenopathy.
authors.affiliation: Division of Oncology, Vanderbilt University, School of Medicine.
authors.forename: J D
authors.initials: JD
authors.lastname: Hainsworth
authors.forename: F A
authors.initials: FA
authors.lastname: Greco
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000628:therapy