Ma Minting, Guo Bin, Duan Qiuli, Jiao Pengqing, Bi Junfang, Wei Suju, Wang Junyan, Zhang Fan, Xu Yu, Zhang Panpan, He Ming, Jin Jing
Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.
Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.
Oncol Lett. 2025 Feb 13;29(4):185. doi: 10.3892/ol.2025.14929. eCollection 2025 Apr.
Cancer of unknown primary (CUP) is a diagnosis that the primary lesion cannot be confirmed by a series of imaging, endoscopic and pathological examinations. The present study aimed to assess the clinical characteristics and survival outcomes of patients with CUP. The present retrospective observational study included patients diagnosed with malignancies confirmed as CUP using histopathology at the Oncology Department of the Fourth Hospital of Hebei Medical University (Shijiazhuang, China) from January 2009 to January 2021. Clinical and pathological data, genetic testing results, treatment modalities and median overall survival (OS) were analyzed. A total of 107 patients were included, with a mean age of 56.59 years. The median follow-up period was 48.8 months. Adenocarcinoma was the most common pathological type (38.3%), followed by squamous cell carcinoma (31.8%) and neuroendocrine carcinoma (16.8%). The median OS was 28.4 months, with 1-, 2-, 3- and 4-year OS rates of 68.2, 54.1, 48.4 and 42.3%, respectively. Imaging revealed that 31 patients (29%) had visceral metastases, and these patients had a significantly shorter median OS compared with those without visceral metastases (8.9 vs. 69 months; P=0.001). Patients who received local treatment (n=31; 29%) had significantly longer survival times than those who did not (69 vs. 17.9 months; P=0.009). Of the 107 patients, 101 (94.4%) received systemic treatment. The median OS times for different treatment groups were as follows: Chemotherapy alone, 28.4 months; chemotherapy combined with immune checkpoint inhibitors, anti-angiogenic agents or targeted therapy, not reached; no chemotherapy, 8.0 months; and untreated, 9.4 months, with significant differences observed among the groups (P=0.008). The survival outcomes of patients with CUP varied based on the presence of visceral metastasis and the treatment modalities employed. Systemic treatments, particularly those incorporating targeted therapy, appear to have the potential to improve prognosis.
原发灶不明的癌症（CUP）是一种通过一系列影像学、内镜及病理检查仍无法确诊原发病灶的诊断。本研究旨在评估CUP患者的临床特征及生存结局。本项回顾性观察性研究纳入了2009年1月至2021年1月在河北医科大学第四医院（中国石家庄）肿瘤科经组织病理学确诊为CUP的恶性肿瘤患者。分析了临床和病理数据、基因检测结果、治疗方式及中位总生存期（OS）。共纳入107例患者，平均年龄56.59岁。中位随访期为48.8个月。腺癌是最常见的病理类型（38.3%），其次是鳞状细胞癌（31.8%）和神经内分泌癌（16.8%）。中位OS为28.4个月，1年、2年、3年和4年OS率分别为68.2%、54.1%、48.4%和42.3%。影像学检查显示，31例患者（29%）有内脏转移，这些患者的中位OS明显短于无内脏转移的患者（8.9个月对69个月；P=0.001）。接受局部治疗的患者（n=31；29%）的生存时间明显长于未接受局部治疗的患者（69个月对17.9个月；P=0.009）。107例患者中，101例（94.4%）接受了全身治疗。不同治疗组的中位OS时间如下：单纯化疗，28.4个月；化疗联合免疫检查点抑制剂、抗血管生成药物或靶向治疗，未达到；未化疗，8.0个月；未治疗，9.4个月，各组间差异有统计学意义（P=0.008）。CUP患者的生存结局因内脏转移情况及所采用的治疗方式而异。全身治疗，尤其是那些包含靶向治疗的方案，似乎有改善预后的潜力。
