Baev V, Koppers-Lalic D, Costa-Silva B. Liquid Biopsy: Current Status and Future Perspectives. Cancers (Basel). 2023 Jun 15. 15 (12):404-408. [QxMD MEDLINE Link]. [Full Text].
Yentz S, Bhave M, Cobain E, Baker L. Cancer of Unknown Primary. De Vita VT Jr, Lawrence TS, Rosenberg SA, eds. De Vita, Hellman, and Rosenberg's Cancer: Principles and Practice. 12th Ed. Philadelphia PA: Wolters Kluwer Health; 2022. 1856-63.
Rassy E, Assi T, Pavlidis N. Exploring the biological hallmarks of cancer of unknown primary: where do we stand today?. Br J Cancer. 2020 Apr. 122 (8):1124-1132. [QxMD MEDLINE Link]. [Full Text].
Olivier T, Fernandez E, Labidi-Galy I, Dietrich PY, Rodriguez-Bravo V, Baciarello G, et al. Redefining cancer of unknown primary: Is precision medicine really shifting the paradigm?. Cancer Treat Rev. 2021 Jun. 97:102204. [QxMD MEDLINE Link]. [Full Text].
Bochtler T, Krämer A. Does Cancer of Unknown Primary (CUP) Truly Exist as a Distinct Cancer Entity?. Front Oncol. 2019. 9:402. [QxMD MEDLINE Link]. [Full Text].
Cancer Facts & Figures 2023. American Cancer Society. Available at https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf. Accessed: July 28, 2023.
Hess KR, Abbruzzese MC, Lenzi R, et al. Classification and regression tree analysis of 1000 consecutive patients with unknown primary carcinoma. Clin Cancer Res. 1999 Nov. 5(11):3403-10. [QxMD MEDLINE Link].
Copeland EM, McBride CM. Axillary metastases from unknown primary sites. Ann Surg. 1973 Jul. 178(1):25-7. [QxMD MEDLINE Link].
Merson M, Andreola S, Galimberti V, et al. Breast carcinoma presenting as axillary metastases without evidence of a primary tumor. Cancer. 1992 Jul 15. 70(2):504-8. [QxMD MEDLINE Link].
Davidson BJ, Spiro RH, Patel S, et al. Cervical metastases of occult origin: the impact of combined modality therapy. Am J Surg. 1994 Nov. 168(5):395-9. [QxMD MEDLINE Link].
[Guideline] Krämer A, Bochtler T, Pauli C, Baciarello G, Delorme S, Hemminki K, et al. Cancer of unknown primary: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Mar. 34 (3):228-246. [QxMD MEDLINE Link]. [Full Text].
Levine MN, Drummond MF, Labelle RJ. Cost-effectiveness in the diagnosis and treatment of carcinoma of unknown primary origin. CMAJ. 1985 Nov 15. 133(10):977-87. [QxMD MEDLINE Link].
Maisey MN, Ellam SV. Investigating the adenocarcinoma of unknown origin (ACUP): a cost benefit analysis. Rev Epidemiol Sante Publique. 1984. 32(1):57-61. [QxMD MEDLINE Link].
Schapira DV, Jarrett AR. The need to consider survival, outcome, and expense when evaluating and treating patients with unknown primary carcinoma. Arch Intern Med. 1995 Oct 23. 155(19):2050-4. [QxMD MEDLINE Link].
Kole AC, Nieweg OE, Pruim J, et al. Detection of unknown occult primary tumors using positron emission tomography. Cancer. 1998 Mar 15. 82(6):1160-6. [QxMD MEDLINE Link].
Mukherjee S, Fischbein NJ, Baugnon KL, Policeni BA, Raghavan P. Contemporary Imaging and Reporting Strategies for Head and Neck Cancer: MRI, FDG PET/MRI, NI-RADS, and Carcinoma of Unknown Primary-AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2023 Feb. 220 (2):160-172. [QxMD MEDLINE Link].
Coassin M, Ebrahimi KB, O'Brien JM, Stewart JM. Optical coherence tomography for retinal metastasis with unknown primary tumor. Ophthalmic Surg Lasers Imaging. 2011 Dec 8. 42:e110-3. [QxMD MEDLINE Link].
Molina R, Bosch X, Auge JM, Filella X, Escudero JM, Molina V, et al. Utility of serum tumor markers as an aid in the differential diagnosis of patients with clinical suspicion of cancer and in patients with cancer of unknown primary site. Tumour Biol. 2011 Dec 9. [QxMD MEDLINE Link].
Hainsworth JD, Rubin MS, Spigel DR, Boccia RV, Raby S, Quinn R, et al. Molecular Gene Expression Profiling to Predict the Tissue of Origin and Direct Site-Specific Therapy in Patients With Carcinoma of Unknown Primary Site: A Prospective Trial of the Sarah Cannon Research Institute. J Clin Oncol. 2012 Oct 1. [QxMD MEDLINE Link].
[Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Occult Primary (Cancer of Unknown Primary [CUP]). NCCN. Available at https://www.nccn.org/professionals/physician_gls/pdf/occult.pdf. Version 1.2022 — September 2, 2021; Accessed: February 25, 2022.
Meleth S, Whitehead N, Swinson T, Lux L. Technology assessment on genetic testing or molecular pathology testing of cancers with unknown primary site to determine origin. Technology Assessment Report. RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ). February 20, 2013. Available at https://www.cms.gov/Medicare/Coverage/DeterminationProcess/downloads/id90TA.pdf.
Hainsworth JD, Rubin MS, Spigel DR, Boccia RV, Raby S, Quinn R, et al. Molecular gene expression profiling to predict the tissue of origin and direct site-specific therapy in patients with carcinoma of unknown primary site: a prospective trial of the Sarah Cannon research institute. J Clin Oncol. 2013 Jan 10. 31 (2):217-23. [QxMD MEDLINE Link]. [Full Text].
Hayashi H, Kurata T, Takiguchi Y, Arai M, Takeda K, Akiyoshi K, et al. Randomized Phase II Trial Comparing Site-Specific Treatment Based on Gene Expression Profiling With Carboplatin and Pacl*taxel for Patients With Cancer of Unknown Primary Site. J Clin Oncol. 2019 Mar 1. 37 (7):570-579. [QxMD MEDLINE Link].
Ariza A, Balañá C, Concha Á, Hitt R, Homet B, Matilla A, et al. Update on the diagnosis of cancer of unknown primary (CUP) origin. Clin Transl Oncol. 2011 Jul. 13(7):434-41. [QxMD MEDLINE Link].
Battifora H. Recent progress in the immunohistochemistry of solid tumors. Semin Diagn Pathol. 1984 Nov. 1(4):251-71. [QxMD MEDLINE Link].
Motzer RJ, Rodriguez E, Reuter VE, et al. Molecular and cytogenetic studies in the diagnosis of patients with poorly differentiated carcinomas of unknown primary site. J Clin Oncol. 1995 Jan. 13(1):274-82. [QxMD MEDLINE Link].
Feinmesser R, Miyazaki I, Cheung R, et a;. Diagnosis of nasopharyngeal carcinoma by DNA amplification of tissue obtained by fine-needle aspiration. N Engl J Med. 1992 Jan 2. 326(1):17-21. [QxMD MEDLINE Link].
Bosl GJ, Ilson DH, Rodriguez E, et al. Clinical relevance of the i(12p) marker chromosome in germ cell tumors. J Natl Cancer Inst. 1994 Mar 2. 86(5):349-55. [QxMD MEDLINE Link].
Sandberg AA, Meloni AM, Suijkerbuijk RF. Reviews of chromosome studies in urological tumors. III. Cytogenetics and genes in testicular tumors. J Urol. 1996 May. 155(5):1531-56. [QxMD MEDLINE Link].
Garrow GC, Greco FA, Hainsworth JD. Poorly differentiated neuroendocrine carcinoma of unknown primary tumor site. Semin Oncol. 1993 Jun. 20(3):287-91. [QxMD MEDLINE Link].
Altree-Tacha D, Tyrrell J, Haas T. CDH17 Is a More Sensitive Marker for Gastric Adenocarcinoma Than CK20 and CDX2. Arch Pathol Lab Med. 2017 Jan. 141 (1):144-150. [QxMD MEDLINE Link].
[Guideline] Losa F, Soler G, Casado A, Estival A, Fernández I, Giménez S, et al. SEOM clinical guideline on unknown primary cancer (2017). Clin Transl Oncol. 2018 Jan. 20 (1):89-96. [QxMD MEDLINE Link]. [Full Text].
Hainsworth JD, Greco FA. Treatment of patients with cancer of an unknown primary site. N Engl J Med. 1993 Jul 22. 329(4):257-63. [QxMD MEDLINE Link].
Pavlidis N, Briasoulis E, Hainsworth J, et al. Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer. 2003 Sep. 39(14):1990-2005. [QxMD MEDLINE Link].
Moertel CG, Reitemeier RJ, Schutt AJ, et al. Treatment of the patient with adenocarcinoma of unknown origin. Cancer. 1972 Dec. 30(6):1469-72. [QxMD MEDLINE Link].
Righi PD, Sofferman RA. Screening unilateral tonsillectomy in the unknown primary. Laryngoscope. 1995 May. 105(5 Pt 1):548-50. [QxMD MEDLINE Link].
Guarischi A, Keane TJ, Elhakim T. Metastatic inguinal nodes from an unknown primary neoplasm. A review of 56 cases. Cancer. 1987 Feb 1. 59(3):572-7. [QxMD MEDLINE Link].
Mistry RC, Qureshi SS, Talole SD, et al. Cervical lymph node metastases of squamous cell carcinoma from an unknown primary: Outcomes and patterns of failure. Indian J Cancer. 2008 Apr-Jun. 45(2):54-8. [QxMD MEDLINE Link].
Guarischi A, Keane TJ, Elhakim T. Metastatic inguinal nodes from an unknown primary neoplasm. A review of 56 cases. Cancer. 1987 Feb 1. 59 (3):572-7. [QxMD MEDLINE Link].
Pentheroudakis G, Briasoulis E, Kalofonos HP, Fountzilas G, Economopoulos T, Samelis G, et al. Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncol. 2008. 47 (6):1148-55. [QxMD MEDLINE Link].
Hainsworth JD, Spigel DR, Farley C, et al. Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol. 2007 May 1. 25(13):1747-52. [QxMD MEDLINE Link].
Hainsworth JD, Spigel DR, Thompson DS, Murphy PB, Lane CM, Waterhouse DM, et al. Pacl*taxel/carboplatin plus bevacizumab/erlotinib in the first-line treatment of patients with carcinoma of unknown primary site. Oncologist. 2009 Dec. 14 (12):1189-97. [QxMD MEDLINE Link].
FAQs
What is the clinical presentation of metastasis? ›
Bone pain: Pain associated with bone metastasis is a frequent symptom. It is typically gradual in onset and described as a dull, boring pain that is worse at night. Nerve root or spinal cord compression: Bone metastases causing nerve root compression can present as radicular pain different from mechanical pain.
What is metastatic cancer with unknown primary site workup? ›Lab studies for metastatic cancer with an unknown primary site should include the following: Complete blood cell count (iron deficiency anemia may point toward an occult gastrointestinal malignancy leading to chronic blood loss) Urinalysis (microscopic hematuria may be a sign of occult genitourinary malignancy)
What is the primary clinical manifestation of metastatic bone cancer? ›The most common symptom of bone metastases, and usually the first to happen, is pain in the bone. Bone pain can come and go, or it can be constant. It is often worse at night. The pain may be only in one area or it may spread throughout the body.
What does metastatic cancer of unknown primary mean? ›Carcinoma of unknown primary (CUP) is a rare disease in which malignant (cancer) cells are found in the body but the place the cancer began is not known. Cancer can form in any tissue of the body. The primary cancer (the cancer that first formed) can spread to other parts of the body. This process is called metastasis.
What features are suggestive of metastasis? ›Some common signs of metastatic cancer include: pain and fractures, when cancer has spread to the bone. headache, seizures, or dizziness, when cancer has spread to the brain. shortness of breath, when cancer has spread to the lung.
What are the 5 stages of metastasis? ›Metastasis is a multi-step process encompassing the (i) local infiltration of tumor cells into the adjacent tissue, (ii) transendothelial migration of cancer cells into vessels known as intravasation, (iii) survival in the circulatory system, (iv) extravasation and (v) subsequent proliferation in competent organs ...
How do you detect cancer of unknown primary? ›Approach to diagnosing a cancer of unknown primary
Imaging tests such as x-rays, ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging) scans. Endoscopy exams to look at organs through a lighted tube placed into a body opening such as the mouth, nose, or anus. Blood tests.
Lymph nodes are one of the most common places for cancer to spread. The liver, lungs, and bones are also common sites of metastasis. Certain types of cancer are more likely to spread to certain organs.
How long can you live with metastatic cancer without treatment? ›Stage 4 cancer usually has spread to multiple places in the body, meaning you can live only a few weeks or a few months. In rare cases, some people may survive for several months or even a year with stage 4 cancer, with or without treatment.
What is the life expectancy of someone with metastatic bone disease? ›Most patients with metastatic bone disease survive for 6-48 months. In general, patients with breast and prostate carcinoma live longer than those with lung carcinoma. Patients with renal cell or thyroid carcinoma have a variable life expectancy.
What is the most common primary cancer to metastasize to bone? ›
Almost all cancers can spread to the bone, but cancers that often spread there include breast, lung, prostate, kidney, melanoma, ovarian, and thyroid. The spine is the most common site for bone metastases.
How long can you live with metastatic cancer of unknown primary? ›When all types of CUP are included, the average survival time is about 9 to 12 months after diagnosis.
Is cancer of unknown primary always stage 4? ›Treatment for cancer of unknown primary
However, CUP cannot be given a stage because the primary cancer is not known and the cancer has already spread to other parts of the body when it is found.
Outlook / Prognosis
Because carcinoma of unknown primary (CUP) is not the primary cancer and has already spread when it was found, the potential to cure the cancer is less likely than finding a primary cancer early. Survival rates vary from person to person, ranging from months to several years.
(meh-TAS-tuh-sis) The spread of cancer cells from the place where they first formed to another part of the body. In metastasis, cancer cells break away from the original (primary) tumor, travel through the blood or lymph system, and form a new tumor in other organs or tissues of the body.
What are the symptoms of metastasis? ›- Bloating, swollen belly, decreased appetite, getting full quickly or jaundice (common in liver metastases).
- Bone pain or fractures (common in bone metastases).
- Dizziness, headaches and seizures (common in brain metastases).
Nonetheless, this review identifies four distinguishing features that are required: motility and invasion, ability to modulate the secondary site or local microenvironments, plasticity, and ability to colonize secondary tissues.
What is the clinical presentation of metastasis to the brain? ›Signs and symptoms of brain metastases include: Headache, sometimes with vomiting or nausea. Mental changes, such as increasing memory problems. Seizures.