Fernández Cotarelo M J, Guerra Vales J M
Servicio de Medicina Interna, Hospital de Móstoles, Móstoles, Madrid, Spain.
Rev Clin Esp. 2009 Oct;209(9):439-43. doi: 10.1016/s0014-2565(09)72517-2.
The term cancer of unknown primary site includes metastatic tumours with different histology and behaviour. Although most of them have a poor short-term prognosis, some patients can benefit from a treatment and will achieve a longer survival. The treatable cases are: metastases of squamous carcinoma in cervical or inguinal adenopathies, metastases of adenocarcinoma in axilar adenopathies in women, malignant ascites due to adenocarcinoma in women, osteoblastic bone metastases in men with elevated serum prostatic specific antigen levels, poorly differentiated tumours with features of a germinal extragonadal tumour, poorly differentiated neuroendocrine carcinomas and patients with a single metastasis. Chemotherapy must be considered in the rest of patients, although the optimum regimen is not well established yet.
原发部位不明的癌症这一术语包括具有不同组织学和行为的转移性肿瘤。尽管其中大多数患者短期预后较差，但一些患者可从治疗中获益并获得更长的生存期。可治疗的病例包括：宫颈或腹股沟淋巴结肿大中的鳞状细胞癌转移、女性腋窝淋巴结肿大中的腺癌转移、女性因腺癌导致的恶性腹水、血清前列腺特异性抗原水平升高的男性的成骨性骨转移、具有生殖腺外生殖细胞瘤特征的低分化肿瘤、低分化神经内分泌癌以及仅有一处转移的患者。对于其他患者必须考虑化疗，尽管最佳方案尚未完全确立。
