Abstract
BACKGROUND:
Cancer
of unknown primary (CUP) is a fatal cancer for which incidence trends
have changed but detailed survival trends remain unexplored. These could
point out successful diagnostic and therapeutic approaches. We
investigate survival trends in CUP according to histology, locations of
metastases and site-specific causes of death.
RESULTS:
Survival for patients with
CUP increased over the study period (HR=0.91 [95% confidence interval
(CI): 0.78-0.84], p<0.001 for trend). Adenocarcinoma was the only
histology associated with increased survival (0.78 [0.74-0.82],
p<0.001 for trend). Survival was improved most clearly for CUP of the
pelvis (0.55 [0.36-0.83]), peritoneum (0.58 [0.53-0.65]) and nervous
system (0.46 [0.29-0.72]). Survival improved substantially in patients
with ovarian (0.57 [0.46-0.70]), peritoneal (0.39 [0.24-0.65]) and
biliary system cancers (0.67 [0.52-0.87]). Kaplan-Meier curves showed
significant survival gains for all CUP and adenocarcinoma patients
(p<0.001).
CONCLUSIONS:
Over time, survival for
patients with CUP increased for adenocarcinoma and for CUP of the
pelvis, peritoneum and nervous system. Survival trends in CUP may be
related to (1) similar trends in other common metastatic tumours,
particularly pancreatic and hepatobiliary cancers, which are common
'hidden' primaries for CUP, (2) earlier detection and (3) advances in
the management of metastatic cancers. The improvement in survival at
specific locations suggests true therapeutic gains.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.