TY - JOUR
T1 - Extensive diagnostic work-up for patients with carcinoma of unknown primary
AU - Meijer, L.
AU - Verhoeven, R. H. A.
AU - de Hingh, I. H. J. T.
AU - van de Wouw, A. J.
AU - van Laarhoven, H. W. M.
AU - Lemmens, V. E. P. P.
AU - Loef, C.
N1 - Funding Information: The authors would like to thank the registration clerks at The Netherlands comprehensive cancer organisation for data collection. We also want to thank the national association of Crematoria for the financial contribution from the Viallant fund for this research. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Patients with carcinoma of unknown primary (CUP) present with metastatic disease without an identified primary tumour. The unknown site of origin makes the diagnostic work-up and treatment challenging. Since little information is available regarding diagnostic work-up and treatment in daily practice, we collected and analysed these in a patient cohort with regard to the recommendations of the national CUP guideline. Data of 161 patients diagnosed with CUP in 2014 or 2015 were extracted from the Netherlands Cancer Registry (NCR) and supplemented with diagnostic work-up information from patient files and analysed. Patients underwent an average of five imaging studies during the diagnostic phase (range 1–17). From the tests as recommended in the national guideline on CUP, a chest X-ray was most commonly performed (73%), whereas a PET-CT was done in one out of four patients (24%). Biopsies were taken in 86% of the study population, with Cytokeratin 7 being the most frequently tested histopathological marker (73%). Less than half of patients received therapy (42%). CUP patients undergo extensive diagnostic work-up. The performance status did not influence the extent of the diagnostic work-up in CUP patients, but it was an important factor for receiving treatment.
AB - Patients with carcinoma of unknown primary (CUP) present with metastatic disease without an identified primary tumour. The unknown site of origin makes the diagnostic work-up and treatment challenging. Since little information is available regarding diagnostic work-up and treatment in daily practice, we collected and analysed these in a patient cohort with regard to the recommendations of the national CUP guideline. Data of 161 patients diagnosed with CUP in 2014 or 2015 were extracted from the Netherlands Cancer Registry (NCR) and supplemented with diagnostic work-up information from patient files and analysed. Patients underwent an average of five imaging studies during the diagnostic phase (range 1–17). From the tests as recommended in the national guideline on CUP, a chest X-ray was most commonly performed (73%), whereas a PET-CT was done in one out of four patients (24%). Biopsies were taken in 86% of the study population, with Cytokeratin 7 being the most frequently tested histopathological marker (73%). Less than half of patients received therapy (42%). CUP patients undergo extensive diagnostic work-up. The performance status did not influence the extent of the diagnostic work-up in CUP patients, but it was an important factor for receiving treatment.
KW - Diagnostics
KW - Guideline
KW - Oncology
KW - Population-based
KW - Unknown primary carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85100035757&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10585-021-10073-3
DO - https://doi.org/10.1007/s10585-021-10073-3
M3 - Article
C2 - 33515369
SN - 0262-0898
VL - 38
SP - 231
EP - 238
JO - Clinical and Experimental Metastasis
JF - Clinical and Experimental Metastasis
IS - 2
ER -