Cancer of unknown primary origin medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Cancer of unknown primary origin}} | {{Cancer of unknown primary origin}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}; {{RAK}} | ||
==Overview== | ==Overview== | ||
There is no treatment for cancer of unknown primary origin; the mainstay of [[therapy]] is supportive care. Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined [[Clinical|clinicopathologic]] subsets. | |||
==Medical Therapy== | ==Medical Therapy== | ||
*There is no [[Therapy|treatment]] for cancer of unknown primary origin; the mainstay of therapy is supportive care.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref> | |||
*The treatment for cancer of unknown primary origin will depend on several factors, such as [[metastatic]] origin, [[biopsy]] findings, [[Age|patients age]], and [[performance status]]. | |||
*There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref> | *Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined [[Clinical|clinicopathologic]] subsets.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref> | ||
*The treatment for cancer of unknown primary origin will depend on several factors, such as [[metastatic]] origin, [[biopsy]] findings, patients age, and performance status. | *The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin according to the European Society of Medical Oncology:<ref name="pmid26314775">{{cite journal| author=Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G et al.| title=Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2015 | volume= 26 Suppl 5 | issue= | pages= v133-8 | pmid=26314775 | doi=10.1093/annonc/mdv305 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314775 }} </ref> | ||
*Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis | |||
*The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin. | |||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |''' Treatment for cancer of unknown primary origin'''<br> | ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |''' Treatment for cancer of unknown primary origin'''<br> | ||
<SMALL> Adapted from the European Society of Medical Oncology<ref name=" | <SMALL> Adapted from the European Society of Medical Oncology<ref name="pmid26314775">{{cite journal| author=Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G et al.| title=Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2015 | volume= 26 Suppl 5 | issue= | pages= v133-8 | pmid=26314775 | doi=10.1093/annonc/mdv305 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314775 }} </ref></SMALL> | ||
|- | |- | ||
| style="background:#DCDCDC;" align="center" | '''Sub-type''' | | style="background:#DCDCDC;" align="center" | '''Sub-type''' | ||
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|- | |- | ||
| | | | ||
Poorly differentiated [[ | Poorly differentiated [[Neuroendocrine tumors|neuroendocrine carcinomas]] of an unknown primary | ||
| | | | ||
Platinum | [[Platinum]] + [[etoposide]] combination [[chemotherapy]] | ||
|- | |- | ||
| | | | ||
[[ | Well-differentiated [[Neuroendocrine tumors|neuroendocrine tumour]] of unknown primary | ||
| | | | ||
[[Somatostatin]] analogues, [[streptozocin]] + [[5-fluorouracil]], [[sunitinib]], [[everolimus]] | |||
|- | |- | ||
| | | | ||
[[Peritoneal]] adenocarcinomatosis of a serous papillary histological type in females | |||
| | | | ||
Optimal [[Surgery|surgical]] debulking followed by [[platinum]]–taxane-based chemotherapy | |||
|- | |- | ||
| | | | ||
[[ | Isolated [[axillary]] nodal [[metastases]] in [[Female|females]] | ||
| | | | ||
[[Axillary]] nodal [[dissection]], [[mastectomy]] or [[breast]] irradiation and adjuvant chemohormonotherapy | |||
|- | |- | ||
| | | | ||
[[Squamous cell carcinoma]] involving non-supraclavicular cervical [[lymph nodes]] | |||
| | | | ||
Neck dissection and/or irradiation of bilateral neck and head–neck axis. For advanced stages induction [[chemotherapy]] with [[platinum]]-based combination or chemoradiation | |||
|- | |||
| | |||
CUP with a [[colorectal]] [[immunohistochemistry]] (CK20+ CDX2+ CK7−) or molecular profile | |||
| | |||
Systemic treatment used for [[colorectal cancer]] | |||
|- | |||
| | |||
Single [[metastatic]] deposit from unknown primary | |||
| | |||
Resection and/or [[radiotherapy]] ± [[systemic therapy]] | |||
|- | |||
| | |||
[[Men]] with blastic [[bone metastases]] or [[immunohistochemistry]]/serum [[PSA]] expression | |||
| | |||
[[Androgen deprivation therapy]] ± [[radiotherapy]] | |||
|} | |} | ||
==References== | ==References== | ||
Latest revision as of 13:18, 21 October 2019
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Cancer of unknown primary origin Microchapters |
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Differentiating Cancer of Unknown Primary Origin from other Diseases |
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Cancer of unknown primary origin medical therapy On the Web |
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Risk calculators and risk factors for Cancer of unknown primary origin medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Roukoz A. Karam, M.D.[2]
Overview
There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care. Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined clinicopathologic subsets.
Medical Therapy
- There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care.[1]
- The treatment for cancer of unknown primary origin will depend on several factors, such as metastatic origin, biopsy findings, patients age, and performance status.
- Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined clinicopathologic subsets.[1]
- The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin according to the European Society of Medical Oncology:[2]
| Treatment for cancer of unknown primary origin Adapted from the European Society of Medical Oncology[2] | |
|---|---|
| Sub-type | Proposed treatment |
|
Poorly differentiated neuroendocrine carcinomas of an unknown primary |
Platinum + etoposide combination chemotherapy |
|
Well-differentiated neuroendocrine tumour of unknown primary |
Somatostatin analogues, streptozocin + 5-fluorouracil, sunitinib, everolimus |
|
Peritoneal adenocarcinomatosis of a serous papillary histological type in females |
Optimal surgical debulking followed by platinum–taxane-based chemotherapy |
|
Isolated axillary nodal metastases in females |
Axillary nodal dissection, mastectomy or breast irradiation and adjuvant chemohormonotherapy |
|
Squamous cell carcinoma involving non-supraclavicular cervical lymph nodes |
Neck dissection and/or irradiation of bilateral neck and head–neck axis. For advanced stages induction chemotherapy with platinum-based combination or chemoradiation |
|
CUP with a colorectal immunohistochemistry (CK20+ CDX2+ CK7−) or molecular profile |
Systemic treatment used for colorectal cancer |
|
Single metastatic deposit from unknown primary |
Resection and/or radiotherapy ± systemic therapy |
|
Men with blastic bone metastases or immunohistochemistry/serum PSA expression |
|
References
- ↑ 1.0 1.1 Briasoulis E, Tolis C, Bergh J, Pavlidis N (2005). "ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP)". Ann. Oncol. 16 Suppl 1: i75–6. doi:10.1093/annonc/mdi804. PMID 15888766.
- ↑ 2.0 2.1 Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G; et al. (2015). "Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 26 Suppl 5: v133–8. doi:10.1093/annonc/mdv305. PMID 26314775.