Seeber S, Strumberg D
Innere Klinik und Poliklinik (Tumorforschung), Westdeutsches Tumorzentrum, Universitätsklinikum, Essen, Germany.
Urologe A. 2006 May;45(5):614-9. doi: 10.1007/s00120-006-1054-2.
Carcinoma of unknown primary is common, accounting for 2-6% of all cancer patients. The primary site is found in less than 25% of patients before death and frequently goes undiscovered at postmortem examination. At the time point of first diagnosis of CUP syndrome, usually more than 80% of the patients present a disseminated situation. Prognosis depends on the involved site and is unaffected by whether or not the primary site is ever found. For patients presenting with metastasis to peripheral lymph nodes, node dissection may be curative. In patients with small cell malignancies, peritoneal carcinomatosis (in women), poorly differentiated carcinomas involving external lymph nodes, mediastinum, or retroperitoneum, but without metastases to viscera or bone, objective long-term responses are possible with combination chemotherapy. For all other patients, toxic therapies are recommended only for patients with good functional status, for palliation of symptoms when they develop, and for continuous support of the quality of life.
原发灶不明的癌很常见,占所有癌症患者的2% - 6%。在不到25%的患者死亡前能找到原发部位,且在尸检时常常仍未被发现。在首次诊断CUP综合征时,通常超过80%的患者已处于播散状态。预后取决于受累部位,且不受原发部位是否被发现的影响。对于出现外周淋巴结转移的患者,淋巴结清扫可能治愈。对于小细胞恶性肿瘤患者、腹膜种植转移(女性)、累及外部淋巴结、纵隔或腹膜后但未发生内脏或骨转移的低分化癌患者,联合化疗可能产生客观的长期缓解。对于所有其他患者,仅建议对功能状态良好的患者采用毒性治疗,用于缓解出现的症状以及持续维持生活质量。