Extensive diagnostic work-up for patients with carcinoma of unknown primary

Adult Aged, 80 and over Male Adolescent EMC OR-01 Infant, Newborn Radboud University Medical Center Infant Middle Aged Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences 3. Good health Young Adult 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Child, Preschool Humans Neoplasms, Unknown Primary Female Child Aged
DOI: 10.1007/s10585-021-10073-3 Publication Date: 2021-01-30T05:02:35Z
ABSTRACT
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.
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