Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities

Urban, Damien; Rao, Aparna D.; Bressel, Mathias; Lawrence, Yaacov Richard; Mileshkin, Linda

doi:10.1038/bjc.2013.386

Cited by 73 publications

(86 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Application of a more restrictive definition of CUP results in a considerably lower estimate of incidence under 0.3 % [81][82][83][84][85]. The proportion of CUP in oral metastases varied between the studies.…”

Section: Carcinoma Of Unknown Primarymentioning

confidence: 95%

Metastatic Tumors to the Jaws and Mouth

Hirshberg

Berger

Allon

et al. 2014

Head and Neck Pathol

162

171

View full text Add to dashboard Cite

Metastatic dissemination to the oral cavity is rare and is usually the evidence of a wide spread disease with an average survival rate of 7 months. In almost a quarter of the cases, oral metastasis was found to be the first indication of an occult malignancy at a distant site. Metastatic lesions can be found anywhere in the oral cavity, however, the jawbones with the molar area is the most frequently involved site. In the oral soft tissues, the gingiva is the most common site, suggesting the possible role of inflammation in the attraction of metastatic deposits. The most common primary malignancies presenting oral metastases were the lung, kidney, liver, and prostate for men, and breast, female genital organs, kidney, and colorectum for women. Most patients with jawbone metastasis complain of swelling, pain, and paresthesia. An exophytic lesion is the most common clinical presentation of metastatic lesions in the oral soft tissues. Early lesions, mainly those located in the gingiva, may resemble a hyperplastic or reactive lesion. Once a lesion is recognized as metastasis, the primary tumor site should be identified following clinical, radiological and histopathological investigations. If standardized diagnostic workup fails to detect the site of origin, then the term carcinoma of unknown primary is applied. Personalized medicine tools such as tissue-oforigin assays should be applied, either by immunohistochemical testing or by molecular-profiling methods as these may lead to a more favorable outcome.

show abstract

Section: Carcinoma Of Unknown Primarymentioning

confidence: 95%

Metastatic Tumors to the Jaws and Mouth

Hirshberg

Berger

Allon

et al. 2014

Head and Neck Pathol

162

171

View full text Add to dashboard Cite

show abstract

“…An American study found that a higher proportion of CUP was diagnosed in the elderly, females, black people and residents of less affluent or less educated counties [23]. A recent study of Scottish Cancer Registry data from 1961-2010 found that during 2001-2010, age-standardised rates of CUP were higher in the most compared with the least deprived quintile of the population [24].…”

Section: What Is Already Known On This Topic?mentioning

confidence: 99%

Cancer of Unknown Primary: a Cancer Registry Study of Factors Affecting Access to Diagnosis

et al. 2017

View full text Add to dashboard Cite

The registry classified 7,428 patients as C80, 8,849 as C77-79, and 10,804 as C20. Compared to C20, the number of cases of C80 showed a statistically significant increasing trend with 3 increasing travel time to primary care. Risk also increased strongly with age, and deprivation.Results for C77-C79 were similar to those for C80, except that the travel time to primary care showed no effect. Considering all CUP alone, histological diagnosis significantly declined with travel time to the nearest hospital. There was no association with sex and the likelihood of histological diagnosis, but a marked decline with age, a downward trend with deprivation, and an increase when the nearest hospital was a cancer centre. These findings facilitate the understanding of factors associated with the group of patients that includes those with the least effective access to cancer services.

show abstract

“…It is also possible that, for some members of this group, CUP diagnosis was used by the registry as a temporary diagnosis but was never updated, so that the final record shows unconfirmed histology. Two recent population registry studies reported CUP with no histological evidence to comprise 30.3% and 58.4% of CUP cases [15,24]. While this does not prove the accuracy of the CUP diagnosis, it does show these patients represent a significant and clinically visible subset of the CUP population.…”

Section: Discussionmentioning

confidence: 92%

Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

et al. 2015

View full text Add to dashboard Cite

background. Cancer of unknown primary origin (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Our objective was to identify incident cases of CUP in Ontario, Canada, and determine the influence of histology and sites of metastases on overall survival (OS). Material and methods. We used the Ontario Cancer Registry (OCR) and the Same-Day Surgery and Discharge Abstract Database (SDS/DAD) to identify patients diagnosed with CUP in Ontario between 1 January 2000, and 31 December 2005. Patient diagnostic information, including histology and survival data, was obtained from the OCR. We cross-validated CUP diagnosis and obtained additional information about metastasis through data linkage with the SDS/DAD database. OS was assessed using Cox regression models adjusting for histology and sites of metastases. results. We identified 3564 patients diagnosed with CUP. Patients without histologically confirmed disease (n  1821) had a one-year OS of 10.9%, whereas patients with confirmed histology (n  1743) had a one-year OS of 15.6%. The most common metastatic sites were in the respiratory or digestive systems (n  1603), and the most common histology was adenocarcinoma (n  939). Three-year survival rates were 3.5%, 5.3%, 41.6% and 3.6% among adenocarcinoma, unspecified carcinoma, squamous cell carcinoma and undifferentiated histology, respectively. Three-year survival rates were 40%, 2.4%, 8.0% and 4.6% among patients with metastases localised to lymph nodes, the respiratory or digestive systems, other specified sites, and unspecified sites, respectively. conclusion. CUP patients in Ontario have a poor prognosis. Some subgroups may have better survival rates, such as patients with metastases localised to lymph nodes and patients with squamous cell histology.

show abstract

Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities

Cited by 73 publications

References 30 publications

Metastatic Tumors to the Jaws and Mouth

Metastatic Tumors to the Jaws and Mouth

Cancer of Unknown Primary: a Cancer Registry Study of Factors Affecting Access to Diagnosis

Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada

Contact Info

Product

Resources

About