Hussien, N., Elsayed, Z., Ibrahim, D., Eltabakh, F. (2022). Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt. Research in Oncology, 18(2), 69-75. doi: 10.21608/resoncol.2022.92845.1151
Nervana M. Hussien; Zeinab Elsayed; Dina R. Ibrahim; Fatma M. Eltabakh. "Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt". Research in Oncology, 18, 2, 2022, 69-75. doi: 10.21608/resoncol.2022.92845.1151
Hussien, N., Elsayed, Z., Ibrahim, D., Eltabakh, F. (2022). 'Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt', Research in Oncology, 18(2), pp. 69-75. doi: 10.21608/resoncol.2022.92845.1151
Hussien, N., Elsayed, Z., Ibrahim, D., Eltabakh, F. Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt. Research in Oncology, 2022; 18(2): 69-75. doi: 10.21608/resoncol.2022.92845.1151
Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt
1Department of Clinical Oncology, Faculty of Medicine, Helwan University, Cairo, Egypt
2Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Identification of prognostic factors in patients with cancer of unknown primary (CUP) is important to optimize their management. Aim: To study the clinicopathological characteristics of patients with CUP and to identify factors that influence their survival. Methods: A retrospective review of the medical records of 102 patients who presented with CUP in two Egyptian cancer care facilities during six years from 2012 to 2017 inclusive. Results: The median age of patients was 61 years (range: 40-96) and 63% were males. Well-/moderately-differentiated adenocarcinoma was the most common histopathological diagnosis (60%) followed by poorly-differentiated carcinoma (25%). The common sites of metastases were the liver (56%), lymph nodes (56%), lungs (44%), and bones (38%). The initial treatment plan was single modality treatment in 43% of patients, combined modality in 16%, and best supportive care in 41%. The 6-month time-to-progression (TTP) and overall survival (OS) rates were 52.7% and 56.1%, respectively. Eastern Cooperative Oncology Group (ECOG) performance status >1, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter TTP. Age ≥65 years, ECOG performance status >1, comorbidities, >1 metastatic site, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, best supportive care / single modality treatment plan and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter OS. Conclusions: Many factors may affect the prognosis of CUP patients, e.g., old age, poor performance status, and low serum albumin. Further studies including a larger sample size are needed to develop predictive models based on these factors in patients with CUP.
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