title: [Long-term survival after surgical resection of a cancer of unknown primary site-a case report].
abstract: We report a case of long-term survival after combination chemotherapy and surgical resection of a cancer of unknown primary site[ CUPs]. A septuagenarian female was identified as having high blood levels of carcinoembryonic antigen (CEA) during follow-up monitoring of asthma. Endoscopy and imaging studies including computed tomography (CT) and positron emission tomography (PET)-CT revealed a malignant lymph node adjacent to the abdominal aorta; however, no other lesion was detected. Therefore, we performed CT-guided biopsy and diagnosed the lesion to be a lymph node metastasis of poorly differentiated adenocarcinoma. As we considered this as a systemic disease, the patient received 2 courses of combination chemotherapy with 5-fluorouracil( 5-FU)/cisplatin( CDDP) and achieved a partial response (PR). Later, the patient received S-1 therapy as second-line chemotherapy and S-1/irinotecan( CPT-11) as third-line chemotherapy in an outpatient clinic. However, the tumor continued to grow, and therefore, we decided to perform surgical resection. Histopathological examination of the resected specimen yielded a diagnosis of metastatic adenocarcinoma of the lymph node. The patient has been well without any signs of recurrence for more than 9 years since surgery. As CUPs is generally associated with poor prognosis, this case raises the possibility that combination therapy might improve convalescence.
authors.affiliation: Dept. of Surgery, Kinki Central Hospital.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tsukao
authors.forename: Jeong Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Kenji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hyuga
authors.forename: Teruhiro
authors.initials: T
authors.lastname: Chono
authors.forename: Risa
authors.initials: R
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Takemoto
authors.forename: Ko
authors.initials: K
authors.lastname: Takachi
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Nishioka
authors.forename: Taro
authors.initials: T
authors.lastname: Aoki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Uemura
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy / Q000601:surgery*; D010094:Oxonic Acid / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D002166:Camptothecin