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

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dc.contributor.authorLazaridis, G.en
dc.contributor.authorPentheroudakis, G.en
dc.contributor.authorFountzilas, G.en
dc.contributor.authorPavlidis, N.en
dc.date.accessioned2015-11-24T19:06:41Z
dc.date.available2015-11-24T19:06:41Z
dc.identifier.issn1532-1967-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/20367
dc.rightsDefault Licence-
dc.subjectAdenocarcinoma/drug therapy/pathology/*secondaryen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAnalysis of Varianceen
dc.subjectAntineoplastic Combined Chemotherapy Protocols/*administration & dosageen
dc.subjectBiopsy, Needleen
dc.subjectCarcinoma/drug therapy/pathology/*secondaryen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectImmunohistochemistryen
dc.subjectLiver Neoplasms/drug therapy/*secondaryen
dc.subjectLogistic Modelsen
dc.subjectLymph Nodes/pathologyen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMultivariate Analysisen
dc.subjectNeoplasm Stagingen
dc.subjectNeoplasms, Unknown Primary/drug therapy/*pathologyen
dc.subjectProbabilityen
dc.subjectPrognosisen
dc.subjectProportional Hazards Modelsen
dc.subjectRetrospective Studiesen
dc.subjectRisk Assessmenten
dc.subjectSurvival Analysisen
dc.subjectTomography, X-Ray Computeden
dc.titleLiver metastases from cancer of unknown primary (CUPL): a retrospective analysis of presentation, management and prognosis in 49 patients and systematic review of the literatureen
heal.abstractAIM: 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1016/j.ctrv.2008.05.005-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/18584969-
heal.identifier.secondaryhttp://ac.els-cdn.com/S0305737208001874/1-s2.0-S0305737208001874-main.pdf?_tid=d717ef7eff37e45df5455e236e7dc813&acdnat=1333954250_ff72ef34704faea11c8497999cd4f735-
heal.journalNameCancer Treat Reven
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2008-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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