Adenocarcinoma of unknown primary site.
BACKGROUND
Metastatic cancer of unknown primary site occupies 0.5-10% of all diagnosed cancer patients and includes various tumors with diverse responses to systemic chemotherapy. Adenocarcinoma of unknown primary site (ACUPS), the most common subtype, has no standard treatment, rarely responds to conventional treatment and has a poor survival rate.


METHODS
The retrospective study was performed to investigate the clinical characteristics and the treatment outcomes of ACUPS.


RESULTS
Eighty-one patients with ACUPS diagnosed at Samsung Medical Center from May 1995 to July 1999 were included. The median age was 58 years (range, 29-77). The common sites of metastases were the lymph node, liver, lung and bone in order. In 49 of 81 patients (60.5%), the dominant tumor location was below the diaphragm. The majority of patients (76 of 81) were initially treated with systemic chemotherapy including cisplatin. Responses were evaluable in 70 of 76. Eighteen of 70 patients (25.7%) responded to chemotherapy and complete remission was observed in 6 patients. The overall median survival of 81 patients was 5.6 months. The median survival of the responding patients was 18.3 months but the median survival of the nonresponding patients was 4.6 months (p < 0.01). In univariate and multivariate analysis, age, performance status and response to initial chemotherapy were significant prognostic factors for overall survival.


CONCLUSIONS
We observed poor response to the treatment and survival rate in ACUPS, but complete remission and long-term survival were observed in a small number of patients.
Song
Seo Young
SY
Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Kim
Won Seog
WS
Lee
Hye Ran
HR
Jung
Hyun Sik
HS
Oh
Sung Yong
SY
Kim
Ji Hyang
JH
Kim
Kihyun
K
Nam
Eun Mi
EM
Oh
Young Ryun
YR
Jung
Chul Won
CW
Yoon
Sung Soo
SS
Im
Young Hyuck
YH
Lee
Hong Ghi
HG
Kang
Won Ki
WK
Park
Chan Hyung
CH
Park
Keunchil
K
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome