Cizmarevic Bogdan, Lanisnik Bostjan, Dinevski Dejan
University Clinical Center Maribor, ENT Department, Maribor, Slovenia.
Coll Antropol. 2012 Nov;36 Suppl 2:27-32.
The first aim of the study was to determine the survival rate of the patients with Carcinoma of the Unknown Primary (CUP) in relation to lymph node status and eventual later identification of the primary tumor. To second one was to investigate the impact of PET-CT on identification of the primary tumor. We studied 97 patients sent to our University Medical Center with diagnosis of metastasis of unknown primary tumor between 1.1.1997 and 1.9.2009. All patients had panendoscopy and some had PET-CT at later period. All susceptible patients had a surgery and postoperative radiation therapy. After the completed their treatment they were followed up at ENT department. With preoperative examinations we discovered 48 primary tumors. Only in one case of 13 the PET-CT detected the primary tumor not confirmed with other examination methods. After the treatment we found primary tumors in 10 patients. In 39 patients we didn't discover any primary tumor. The 2-year overall survival for 10 patients with found tumor was 80.0%, the 2-year overall survival for the 39 patients without discovered tumor was 73.8%. The 2-year disease-specific survival for 10 patients with found tumor was 90.0%, the 2-year disease-specific survival for 39 patients without discovered tumor was 81.6%. The 2-year overall survival for high neck level lymph node metastasis group (N = 36) was 80.1%, the 2-year overall survival for low neck level lymph node group (N = 13) was 61.5%. PET-CT method was not particularly useful in detecting primary tumors in patients with metastasis with unknown primary. Patients with high neck level lymph node metastasis had statistically significant better survival.
该研究的首要目的是确定未知原发癌（CUP）患者的生存率与淋巴结状态以及原发肿瘤最终后续确诊之间的关系。第二个目的是研究PET-CT对原发肿瘤确诊的影响。我们研究了1997年1月1日至2009年9月1日期间被送至我校医学中心、诊断为未知原发肿瘤转移的97例患者。所有患者均接受了全内镜检查，部分患者在之后还接受了PET-CT检查。所有符合条件的患者均接受了手术及术后放射治疗。完成治疗后，他们在耳鼻喉科接受随访。通过术前检查，我们发现了48例原发肿瘤。在13例患者中，只有1例PET-CT检测到的原发肿瘤未得到其他检查方法的证实。治疗后，我们又发现了10例原发肿瘤。在39例患者中，我们未发现任何原发肿瘤。10例发现肿瘤患者的2年总生存率为80.0%，39例未发现肿瘤患者的2年总生存率为73.8%。10例发现肿瘤患者的2年疾病特异性生存率为90.0%，39例未发现肿瘤患者的2年疾病特异性生存率为81.6%。高颈部淋巴结转移组（N = 36）的2年总生存率为80.1%，低颈部淋巴结组（N = 13）的2年总生存率为61.5%。PET-CT方法在检测未知原发转移患者的原发肿瘤方面并非特别有用。高颈部淋巴结转移患者的生存率在统计学上有显著提高。
