title: Unknown primary adenocarcinomas: a single-center experience.
abstract: This study aimed to elucidate the clinical and prognostic characteristics of a homogeneous group of patients with cancer of unknown primary (CUP). Between 1999 and 2014, CUP was diagnosed in 159 (1.3%) of 11,742 cancer patients at Trakya University Hospital (Edirne, Turkey). Ninety-seven (61%) of the 159 patients were retrospectively reviewed. Among these, 61 (62.8%) patients with adenocarcinoma were included in this study. The most frequently predicted primary tumor site was the lung (37.7%), and 59% of the patients were smokers. There was a significant relationship between smoking and the lung as a potential primary cancer site (p = 0.042). The most frequent site of metastasis was the liver (60.7%). The median number of metastases per patient was two, but patients with liver metastases had a median of five metastases. The overall median survival time was 7 months. Median survival was significantly longer in patients with a predicted primary site than in patients without the predicted site (7 vs. 6 months, respectively; p = 0.038). When the patients with predicted ovarian and peritoneal tumors were excluded from the comparison, the statistical p value was still close to significant (p = 0.07). Multivariate analysis revealed that smoking, liver metastasis, serum alkaline phosphatase ≥92 U/L, and progression in response to chemotherapy were independent predictors of a poor prognosis. The present study identified several independent prognostic factors in patients with unknown primary adenocarcinomas who received chemotherapy. Smoking, the presence of liver metastasis, and response to chemotherapy were independent risk factors for both progression-free and overall survival.
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey. sernazuzunoglu@gmail.com.
authors.forename: Sernaz
authors.initials: S
authors.lastname: Uzunoglu
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.forename: Hilmi
authors.initials: H
authors.lastname: Kodaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cinkaya
authors.forename: Esma
authors.initials: E
authors.lastname: Turkmen
authors.forename: Ilhan
authors.initials: I
authors.lastname: Hacibekiroglu
authors.forename: Ali
authors.initials: A
authors.lastname: Sari
authors.forename: Alaattin
authors.initials: A
authors.lastname: Ozen
authors.forename: Ufuk
authors.initials: U
authors.lastname: Usta
authors.forename: Irfan
authors.initials: I
authors.lastname: Cicin
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016019:Survival Analysis
chemical_list: D000469:Alkaline Phosphatase