Evaluation of prognosis for carcinoma of unknown origin in elderly patients.
OBJECTIVE
Carcinoma of unknown origin has a poor outcome and usually occurs in elderly patients. In this article, we analyzed the prognostic factors in elderly patients with cancer of unknown primary site (CUP) for treatment considerations.


METHODS
Patients >70 years old with histologically proven carcinoma were retrospectively reviewed. The prognostic factors were analyzed with univariate and multivariate Cox regression.


RESULTS
We included 63 patients aged 70-79 years and 51 patients ≥80 years old. The results of multivariate Cox regression in the 70-79 years age group revealed white blood cell count ≤10(4)/ml [p = 0.033; hazard ratio (HR) 2.51, range 1.079-5.840] and albumin ≥3.5 g/dl (p = 0.007; HR 3.38, range 1.398-8.177) as independent factors. In the group of patients ≥80 years old, Eastern Cooperative Oncology Group performance status <1 (p = 0.020), white blood cell count ≤10(4)/ml (p = 0.001), albumin ≥3.5 g/dl (p = 0.006), lactate dehydrogenase (LDH) ≤250 U/l (p = 0.002) and non-chest metastasis (p = 0.043) were significantly better with univariate analysis. Multivariate Cox regression revealed albumin ≥3.5 g/dl (p = 0.007; HR 3.28, range 1.389-7.745) and LDH ≤250 U/l (p = 0.045; HR 3.18, range 1.026-9.848) as independent factors.


CONCLUSIONS
For elderly patients with CUP, the serum albumin level seems to be a consistently independent prognostic factor. In patients >80 years old, serum LDH plays an important role in prognosis. This study is helpful in predicting the outcome and management for this group of patients.
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Hsueh-Ju
HJ
Lu
Kuo-Wei
KW
Chen
Cheng-Hwai
CH
Tzeng
Jin-Hwang
JH
Liu
Tzeon-Jye
TJ
Chiou
Chueh-Chuan
CC
Yen
Ta-Chung
TC
Chao
Hao-Wei
HW
Teng
Ming-Huang
MH
Chen
Chun-Yu
CY
Liu
Wei-Shu
WS
Wang
Peter Mu-Hsin
PM
Chang
Muh-Hwa
MH
Yang
D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009382:Neoplasms, Unknown Primary / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate
D012709:Serum Albumin; D007770:L-Lactate Dehydrogenase