Liver metastases from cancer of unknown primary (CUPL): A retrospective analysis of presentation, management and prognosis in 49 patients and systematic review of the literature. Cancer treatment reviews [Cancer Treat Rev] Journal article | | Title | Liver metastases from cancer of unknown primary (CUPL): A retrospective analysis of presentation, management and prognosis in 49 patients and systematic review of the literature. | | Author(s) | Lazaridis G, Pentheroudakis G, Fountzilas G, Pavlidis N | | Institution | Department of Medical Oncology, Ioannina University Hospital, Niarxou Avenue, 45500 Ioannina, Greece; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece. | | Source | Cancer Treat Rev 2008 Jun 25. | | Abstract | AIM: Patients with liver metastases from cancer of unknown primary (CUPL) have a dismal prognosis. We retrospectively analysed their management and outcome and performed a systematic review of CUPL series published in the literature.
PATIENTS AND METHODS: Electronic data from 49 CUPL patients referred to Hellenic Cooperative Oncology Group (HeCOG) centers were retrospectively studied for characteristics of clinical presentation, diagnostic workup, management, outcome and prognostic factors. A systematic literature review was undertaken in PubMed and EmBase databases.
RESULTS: All our patients (males: 31, females: 18; median age: 65) underwent a computed tomography scan (CT) of the abdomen, 71% a thoracic CT, 53% gastroscopy and 47% colonoscopy. The commonest histologic subtypes encountered were adenocarcinoma (N=34) or undifferentiated carcinoma (N=12). The liver was the only metastatic site in 38% of patients, while it was accompanied with other metastatic sites in 62% (the commonest: lung, bone and lymph nodes). Forty-seven patients received first-line chemotherapy (42 platinum based) and 16 second-line. An objective response was observed in six patients (12%), median survival being 10 months (95% CI, 7-13). In univariate analysis, good performance status and normal baseline serum CEA levels were correlated with superior survival, while in multivariate analysis only age<55 (HR 0.16, p=0.02) and the absence of extrahepatic disease (HR 0.21, p=0.007) predicted for a better outcome. Published data from four relevant series (total patients=662) parallel our findings.
CONCLUSIONS: Patients with liver metastases from CUP are resistant to conventional types of treatment and carry a poor prognosis. Understanding the molecular biology of CUP is essential for the development of new, targeted effective therapies. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18584969 |
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