Yamane Sakiko, Katada Chikatoshi, Tanabe Satoshi, Azuma Mizutomo, Ishido Kenji, Yano Takafumi, Wada Takuya, Watanabe Akinori, Kawanishi Natsuko, Furue Yasuaki, Kondo Yuki, Komori Shouko, Ishiyama Hiromichi, Hayakawa Kazushige, Koizumi Wasaburo
Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan.
J Transl Int Med. 2017 Mar 31;5(1):58-63. doi: 10.1515/jtim-2017-0006. eCollection 2017 Mar.
To evaluate the clinical outcomes in patients with cancer of an unknown primary site (CUP), who were treated by gastrointestinal oncologists.
We retrospectively studied 29 patients with CUP who were presented at the Department of Gastroenterology, Kitasato University Hospital from October 2005 to October 2013, and were treated by the gastrointestinal oncologists. The patients were divided into two groups, namely chemotherapy group and symptomatic therapy group, and the clinical characteristics and survival times were compared. The clinical course was studied according to the histologic type (adenocarcinoma or non-adenocarcinoma), prognostic subset (favorable or unfavorable), and the presence or absence of chemotherapy.
The chemotherapy group comprised 19 patients, and the symptomatic therapy group comprised 10 patients. The median survival time was 11 months in the chemotherapy group and 3 months in the symptomatic therapy group. Twenty-two patients had adenocarcinoma, and 7 had non-adenocarcinoma. Of the 22 patients with adenocarcinoma, 2 belonged to the favorable prognostic subset and received chemotherapy. One of these patients died of cancer at 47 months, and the other was alive and disease free at 58 months. Among the 20 patients with adenocarcinoma in the unfavorable prognostic subset, 16 received chemotherapy and had a median survival of 16 months. Seven (44%) of these patients survived for at least 21 months, and 3 patients who could receive 3 or more regimens survived for at least 46 months.
It might be appropriate for gastrointestinal oncologists to treat CUP on the basis of clinical experience, depending on the situation.
评估由胃肠肿瘤学家治疗的原发部位不明癌症（CUP）患者的临床结局。
我们回顾性研究了2005年10月至2013年10月在北里大学医院胃肠病科就诊并由胃肠肿瘤学家治疗的29例CUP患者。将患者分为两组，即化疗组和对症治疗组，并比较其临床特征和生存时间。根据组织学类型（腺癌或非腺癌）、预后亚组（良好或不良）以及是否接受化疗来研究临床病程。
化疗组有19例患者，对症治疗组有10例患者。化疗组的中位生存时间为11个月，对症治疗组为3个月。22例患者为腺癌，7例为非腺癌。在22例腺癌患者中，2例属于预后良好亚组并接受了化疗。其中1例患者在47个月时死于癌症，另1例在58个月时存活且无疾病。在预后不良亚组的20例腺癌患者中，16例接受了化疗，中位生存期为16个月。其中7例（44%）患者存活至少21个月，3例能够接受3种或更多方案治疗的患者存活至少46个月。
胃肠肿瘤学家根据具体情况凭借临床经验治疗CUP可能是合适的。
