How to Diagnose and Treat a Cancer of Unknown Primary Site.
Almost one in every three patients with advanced tumors have distant metastasis at the time of clinical diagnosis. In most cases, the primary tumor site is identified immediately, within a few days. But for some patients, the primary lesion cannot be found after the initial clinical assessment. These cases are called cancers of unknown primary origin (CUPs), a clinical diagnosis very difficult to manage by physicians due to the absence of a standard-of-care for the initial therapeutic regimen, as well as due to the impossibility to include these cases in randomized clinical trials. A cancer of unknown primary site is often associated with a poor prognosis as patients are usually treated with a non-selective empirical therapy. In the current paper, we summarize both the diagnostic challenges for patients with a cancer of unknown primary site as well as the current available therapeutic options, with emphasis on the management of this unique disease entity.
Department of Hematology,Research Center for Functional Genomics and Translational Medicine,Iuliu Hatieganu University of Medicine and Pharmacy;Department of Hematology,Ion Chiricuta Oncology Institute; Cluj-Napoca, Romania. ciprian.tomuleasa@umfcluj.ro.
Ciprian
C
Tomuleasa
Department pf Surgery,Iuliu Hatieganu University of Medicine and Pharmacy; Department of Surgery, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj Napoca, Romania.
Florin
F
Zaharie
Department pf Surgery,Iuliu Hatieganu University of Medicine and Pharmacy;Departemnt of Surgery, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Mihai-Stefan
MS
Muresan
Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Laura
L
Pop
Department of Radiotherapy/Oncology,Iuliu Hatieganu University of Medicine and Pharmacy;Department of Radiotherapy, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Zsolt
Z
Fekete
Department of Hematology, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Delia
D
Dima
Department of Hematology,Iuliu Hatieganu University of Medicine and Pharmacy; Department of Hematology, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Ioana
I
Frinc
Departments of Hematology, Ion Chiricuta Oncology Institute;Department of Genetics,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Adrian
A
Trifa
Department of Animal Facility; Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Cristian
C
Berce
Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Ancuta
A
Jurj
Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Ioana
I
Berindan-Neagoe
Department of Hematology,Iuliu Hatieganu University of Medicine and Pharmacy; Department of Hematology, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.
Mihnea
M
Zdrenghea
D014408:Biomarkers, Tumor / Q000378:metabolism; D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods; D009362:Neoplasm Metastasis; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis
D014408:Biomarkers, Tumor