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KMID : 0616619990050010149
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Journal of Soonchunhyang Medical College
1999 Volume.5 No. 1 p.149 ~ p.156
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Survival Rate and Prognostic Factors of Malignancy of Unknown Origin
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Abstract
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Purpose : Patients with cancer of unknown primary site represent 5% to 10% of all cancer patients. This study was to evaluate survival and prognostic factors of patients with malignancy of unknown origin.
Materials and Methods : A retrospective analysis was done for one hundred and two patients with malignancy of unknown origin who were treated from January 1989 to December 1998. There were 52 male and 50 female patients. Age of patients ranged from 20 to 94 years (mean 58 years). Clinical presentation depended on the site of metastases. In cases of multiple metastatic sites, we selected the first apparent metastasis or the symptomatic one for which the patient was first seen. The three most frequent initial metastatic sites were peritoneum, lymph node, and liver. Median follow up period was 4 months(0-100 months) and survival rate measured form the time of diagnosis.
Results : The two years survival rate was 13.6% with a median survival time of 4 months. The factors associated with the overall survival rate were the tumor marker CEA(p=0.0061), smoking history(p=0.0039), and histologic type(squamous cell carcinoma versus non-squamous cell carcinoma, p=0.0295). Marginal statistical difference was found according to performance status. No statistical differences were found according to sex, weight loss, initial metastatic site and numbers, primary lesion site, and treatment modality.
Conclusion : Squamous cell carcinoma was associated with survival rate. In squamous cell carcinoma of unknown origin with good prognostic factor, especially cervical lymph node metastasis, we suggest an approach of extensive initial workup for staging and aggressive treatment.
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KEYWORD
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