title: Evaluation of prognostic factors and the role of chemotherapy in unfavorable carcinoma of unknown primary site: a 10-year cohort study.
abstract: BACKGROUND
  Carcinoma of unknown primary site (CUP) has a poor prognosis and the prognostic factors in these patients are not well established. Furthermore, there are no selection criteria for patients who should benefit from chemotherapy.
  
  
  METHODS
  The medical records of 179 CUP patients who were treated at Taipei Veterans General Hospital from 2000 to 2009 were reviewed. Factors associated with survival were determined by Kaplan-Meier analysis. Differences between the groups with and without palliative chemotherapy were analyzed.
  
  
  RESULTS
  Univariate analysis revealed multiple prognostic factors, including performance status, lung metastasis, number of metastatic organs, serum albumin, corrected serum calcium, lactate dehydrogenase (LDH), sodium, and cholesterol levels, palliative chemotherapy, and white blood cell and lymphocyte counts. Multivariate analysis showed that performance status < 2, serum albumin level ≥ 3.5 g/dl, corrected serum calcium level < 10.7 mg/dl, single metastatic organ, and palliative chemotherapy were independent factors of better prognosis. Patients with better performance status, higher serum albumin, and lower serum LDH levels had significantly greater benefit from palliative chemotherapy.
  
  
  CONCLUSIONS
  Certain patients with unfavorable CUP will have better survival. Identification of patients with unfavorable CUP who could benefit from palliative chemotherapy warrants future prospective studies.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Kuo-Wei
authors.initials: KW
authors.lastname: Chen
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Hsueh-Ju
authors.initials: HJ
authors.lastname: Lu
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.forename: Jin-Hwang
authors.initials: JH
authors.lastname: Liu
authors.forename: Tzeon-Jye
authors.initials: TJ
authors.lastname: Chiou
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
authors.forename: Wei-Shu
authors.initials: WS
authors.lastname: Wang
authors.forename: Ta-Chung
authors.initials: TC
authors.lastname: Chao
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Peter Mu-Hsin
authors.initials: PM
authors.lastname: Chang
authors.forename: Muh-Hwa
authors.initials: MH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002277:Carcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D010166:Palliative Care; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D007770:L-Lactate Dehydrogenase