Carcinoma of Unknown Primary: Features and Outcomes of Patients Managed in a Large Uk Centre

Integration of a patient-centred MUO/CUP service within a new acute oncology service: challenges and rewards

“…Contemporary studies have published dismal survival rates in CUP patients, although our data (Fig 1b) and published reports demonstrate that favourable sub-groups can do significantly better. 4,11,12 The majority in the retrospective group and 100% of patients in the prospective group were offered palliative care (16.67% did not need it or refused in the prospective group). Yet, we note that hospice placements in both groups were overall quite low as compared with reports published by English peers; this may be reflective of some uniqueness in cultural differences and social values specific to Northern Ireland that can influence patient choice and carer support.…”

“…Prognostic stratification into favourable (approximately 20%) and unfavourable (approximately 80%) sub-groups take into account multiple parameters like age, performance score (PS), tumour differentiation, morphology, sites and number of metastases, as well as biomarkers like lactate dehydrogenase (LDH) and albumin. [2][3][4][5] Confirmed carcinoma of unknown primary (cCUP; primary tumour origin unknown despite exhaustive investigations) usually have aggressive chemotherapy/radiotherapy resistant biology and, consequently, poor clinical outcomes with reported median survival being 4-12 months. 2,3,6 Seminal reports published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD; and the National Chemotherapy Advisory Group (NCAG; 2009) were critical in identifying fragmented pathways for acutely unwell cancer patients with poor patient experience.…”