title: Adenocarcinoma of unknown primary site.
abstract: 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.
authors.affiliation: Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Song
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Lee
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Jung
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Ji Hyang
authors.initials: JH
authors.lastname: Kim
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Nam
authors.forename: Young Ryun
authors.initials: YR
authors.lastname: Oh
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Young Hyuck
authors.initials: YH
authors.lastname: Im
authors.forename: Hong Ghi
authors.initials: HG
authors.lastname: Lee
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Kang
authors.forename: Chan Hyung
authors.initials: CH
authors.lastname: Park
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
mesh_terms: 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