Lembersky B C, Thomas L C
Division of Medical Oncology, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Med Clin North Am. 1996 Jan;80(1):153-71. doi: 10.1016/s0025-7125(05)70433-8.
Despite the fact that effective therapy does not currently exist for the majority of patients presenting with metastases of unknown primary site, the last decade has witnessed significant advances in the approach to this heterogeneous disease. The use of modern pathologic techniques that frequently provide better diagnostic precision and the recognition of specific subgroups with a favorable prognosis and responsiveness to treatment has improved the outcome for some patients. Currently the diagnostic strategy should emphasize the rapid identification of patients likely to benefit from available therapy, whereas clinical research should focus on the development of more effective treatments for those patients with unresponsive tumors. In the future, continued improvements in the molecular characterization of these tumors will likely enhance understanding of the metastatic process, allow for more specific definitions of cell lineage, and provide insights for better therapy.
尽管目前对于大多数出现原发部位不明转移瘤的患者尚无有效的治疗方法，但在过去十年中，针对这种异质性疾病的治疗方法取得了显著进展。现代病理技术的应用常常能提供更高的诊断准确性，并且对具有良好预后和对治疗有反应的特定亚组的认识，改善了部分患者的治疗结果。目前，诊断策略应着重于快速识别可能从现有治疗中获益的患者，而临床研究则应聚焦于为那些肿瘤无反应的患者开发更有效的治疗方法。未来，这些肿瘤分子特征的持续改善可能会加深对转移过程的理解，实现对细胞谱系更精确的定义，并为更好的治疗提供思路。
