Unknown primary adenocarcinomas: a single-center experience

Sernaz Uzunoglu; Bulent Erdogan; Hilmi Kodaz; Ahmet Cinkaya; Esma Turkmen; Ilhan Hacibekiroglu; Ali Sari; Alaattin Ozen; Ufuk Usta; Irfan Cicin

doi:10.17305/bjbms.2016.1495

Authors

Sernaz Uzunoglu Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Bulent Erdogan Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Hilmi Kodaz Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Ahmet Cinkaya Department of Radiation Oncology, Faculty of Medicine, Kutahya Dumlupınar University, Kutahya, Turkey
Esma Turkmen Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Ilhan Hacibekiroglu Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Ali Sari Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Alaattin Ozen Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Ufuk Usta Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
Irfan Cicin Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

DOI:

https://doi.org/10.17305/bjbms.2016.1495

Keywords:

adenocarcinoma, neoplasm metastasis, prognosis

Abstract

This study aimed to elucidate the clinical and prognostic characteristics of a homogeneous group of patients with cancer of unknown primary (CUP). Between 1999 and 2014, CUP was diagnosed in 159 (1.3%) of 11,742 cancer patients at Trakya University Hospital (Edirne, Turkey). Ninety-seven (61%) of the 159 patients were retrospectively reviewed. Among these, 61 (62.8%) patients with adenocarcinoma were included in this study. The most frequently predicted primary tumor site was the lung (37.7%), and 59% of the patients were smokers. There was a significant relationship between smoking and the lung as a potential primary cancer site (p = 0.042). The most frequent site of metastasis was the liver (60.7%). The median number of metastases per patient was two, but patients with liver metastases had a median of five metastases. The overall median survival time was 7 months. Median survival was significantly longer in patients with a predicted primary site than in patients without the predicted site (7 vs. 6 months, respectively; p = 0.038). When the patients with predicted ovarian and peritoneal tumors were excluded from the comparison, the statistical p value was still close to significant (p = 0.07). Multivariate analysis revealed that smoking, liver metastasis, serum alkaline phosphatase ≥92 U/L, and progression in response to chemotherapy were independent predictors of a poor prognosis. The present study identified several independent prognostic factors in patients with unknown primary adenocarcinomas who received chemotherapy. Smoking, the presence of liver metastasis, and response to chemotherapy were independent risk factors for both progression-free and overall survival.

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Author Biographies

Sernaz Uzunoglu, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Bulent Erdogan, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Hilmi Kodaz, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Ahmet Cinkaya, Department of Radiation Oncology, Faculty of Medicine, Kutahya Dumlupınar University, Kutahya, Turkey

Department of Radiation Oncology
Esma Turkmen, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Ilhan Hacibekiroglu, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Ali Sari, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology
Alaattin Ozen, Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Radiation Oncology
Ufuk Usta, Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Pathology
Irfan Cicin, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

Department of Medical Oncology

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