title: Single-center management of 136 patients with cancer of unknown primary site (CUP syndrome) over a period of 10 years.
abstract: BACKGROUND
  Cancer of unknown primary site (CUP syndrome) is a particular challenge in oncology which occurs in about 5-10% of cancer patients. Here, we investigated clinicopathological and prognostic factors in patients with CUP syndrome in a retrospective analysis.
  
  
  METHODS
  136 patients with CUP syndrome who were treated in our Department of Oncology and Hematology were analyzed over a period of 10 years. Clinical and histopathological characteristics, response to chemotherapy, survival and prognostic factors were investigated in a retrospective analysis.
  
  
  RESULTS
  83 of the patients (61%) received first-line chemotherapy, which induced an overall response rate of 19%. Altogether 37 different chemotherapy regimens were used. Median overall survival of all patients was 7.9 months. In multivariate Cox regression analysis, gender, Karnofsky performance status, treatment modality and extent of disease were identified as independent prognostic factors.
  
  
  CONCLUSIONS
  Our analysis showed a poor prognosis for patients with CUP syndrome. The response rate to chemotherapy was low with no significant benefit for any of the investigated cytotoxic agents. Newer diagnostic and therapeutical approaches might contribute to an improvement of prognosis, and their value is currently investigated in prospective studies.
authors.affiliation: Klinik für Onkologie, Hämatologie und Knochenmarktransplantation mit Sektion Pneumologie, Hubertus Wald Tumorzentrum - Universitäres Cancer Center Hamburg, Hamburg, Germany. i.thoem@uke.uni-hamburg.de
authors.forename: Ina
authors.initials: I
authors.lastname: Thöm
authors.forename: Claudia
authors.initials: C
authors.lastname: Rogers
authors.forename: Birte
authors.initials: B
authors.lastname: Andritzky
authors.forename: Isabell
authors.initials: I
authors.lastname: Witzel
authors.forename: Gunter
authors.initials: G
authors.lastname: Schuch
authors.forename: Dieter Kurt
authors.initials: DK
authors.lastname: Hossfeld
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: Eckart
authors.initials: E
authors.lastname: Laack
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult