Greco F A, Vaughn W K, Hainsworth J D
Ann Intern Med. 1986 Apr;104(4):547-53. doi: 10.7326/0003-4819-104-4-547.
We describe the clinical characteristics and prognostic features of 71 patients with advanced poorly differentiated carcinoma of unknown primary site. These patients had at least one component of the extragonadal germ cell cancer syndrome that we have previously described. Of 68 patients who received therapy, 62 were given intensive cisplatin-based combination chemotherapy that is used for treatment of germinal neoplasms. Fifteen patients (22%) had complete responses, and 9 patients (13%) have remained free of tumor after a minimum follow-up of 36 months (range, 36 to 67 months). Tumor in the mediastinum, retroperitoneum, and lymph nodes was associated with a favorable outcome of treatment when compared with tumor in other locations (p = 0.0016, Cox regression analysis). Although the histogenesis of tumors in many of these patients remains unclear, we believe the tumors most likely originate from germ cells. Patients with advanced poorly differentiated carcinoma should be considered for treatment with cisplatin-based combination chemotherapy, particularly if tumors occur predominantly in the mediastinum, retroperitoneum, or lymph nodes.
我们描述了71例晚期原发部位不明的低分化癌患者的临床特征和预后特征。这些患者至少具有我们之前描述过的性腺外生殖细胞癌综合征的一种成分。在接受治疗的68例患者中，62例接受了用于治疗生殖细胞瘤的以顺铂为基础的强化联合化疗。15例患者（22%）获得完全缓解，9例患者（13%）在至少36个月（范围为36至67个月）的随访后仍无肿瘤。与其他部位的肿瘤相比，纵隔、腹膜后和淋巴结的肿瘤治疗结果较好（p = 0.0016，Cox回归分析）。尽管这些患者中许多肿瘤的组织发生仍不清楚，但我们认为这些肿瘤很可能起源于生殖细胞。晚期低分化癌患者应考虑接受以顺铂为基础的联合化疗，特别是如果肿瘤主要发生在纵隔、腹膜后或淋巴结。
