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1. Todoroki T, Murata S, Nakagawa Y, Ohkohchi N, Morishita Y: A long-term survivor of repeated inguinal nodes recurrence of papillary serous adenocarcinoma of CUP: case report. Int Semin Surg Oncol; 2006;3:22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A long-term survivor of repeated inguinal nodes recurrence of papillary serous adenocarcinoma of CUP: case report.
  • BACKGROUND: Tumor spread beyond the peritoneal cavity in cases of papillary serous adenocarcinoma of the unknown primary (CUP) is a rare late event and carries a poor prognosis.
  • Pathological examination revealed the tumors to be metastases of a papillary serous adenocarcinoma with a psammoma body of CUP.
  • Four and a half years after the primary resection, the CA125 level increased again and newly developed asymptomatic metastases were found in the right deep inguinal nodes and extirpated at that time.

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  • (PMID = 16930493.001).
  • [ISSN] 1477-7800
  • [Journal-full-title] International seminars in surgical oncology : ISSO
  • [ISO-abbreviation] Int Semin Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1574334
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2. Speel EJ, van de Wouw AJ, Claessen SM, Haesevoets A, Hopman AH, van der Wurff AA, Osieka R, Buettner R, Hillen HF, Ramaekers FC: Molecular evidence for a clonal relationship between multiple lesions in patients with unknown primary adenocarcinoma. Int J Cancer; 2008 Sep 15;123(6):1292-300

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Molecular evidence for a clonal relationship between multiple lesions in patients with unknown primary adenocarcinoma.
  • Unknown primary adenocarcinoma (UPA) comprises a group of heterogeneous cancers of great clinical and biological interest.
  • UPA presents as metastatic disease without a detectable primary site after medical workup.
  • A molecular resemblance would argue for an early clonal outgrowth of tumor cells from the primary lesion, a mutual feature observed within this group of neoplasms.
  • The molecular data indicated that the multiple lesions in the 14 UPA patients, including the primary tumors, are clonally related.
  • In agreement with the theory of tumor progression, some metastatic lesions showed additional genetic alterations besides the characteristics that were shared with the primary tumor.
  • Our data provide molecular evidence for a clonal relationship between multiple metastases and the primary tumor within individual UPA patients, independent of the anatomical origin of the cancer.
  • [MeSH-major] Adenocarcinoma / genetics. Neoplasm Metastasis / genetics. Neoplasms, Unknown Primary / genetics

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  • [Copyright] Copyright 2008 Wiley-Liss, Inc.
  • (PMID = 18561313.001).
  • [ISSN] 1097-0215
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD44; 0 / CD44v6 antigen
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3. Buc E, Lesurtel M, Belghiti J: Is preoperative histological diagnosis necessary before referral to major surgery for cholangiocarcinoma? HPB (Oxford); 2008;10(2):98-105

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  • Provided that between 8% and 43% of bile duct strictures are not ECC, the lesions mimicking ECC that should be ruled out are gallbladder cancer, Mirizzi syndrome, primary sclerosing cholangitis (PSC), autoimmune pancreatitis and portal biliopathy.
  • The lack of the primary site, a relatively large tumour size and ancillary findings such as bile duct dilatation may provide a clue to the diagnosis.
  • In the event of adenocarcinoma from unknown primary, surgery is an effective treatment even if prognosis is poor.

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  • (PMID = 18773064.001).
  • [ISSN] 1365-182X
  • [Journal-full-title] HPB : the official journal of the International Hepato Pancreato Biliary Association
  • [ISO-abbreviation] HPB (Oxford)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2504385
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4. Hainsworth JD, Spigel DR, Thompson DS, Murphy PB, Lane CM, Waterhouse DM, Naot Y, Greco FA: Paclitaxel/carboplatin plus bevacizumab/erlotinib in the first-line treatment of patients with carcinoma of unknown primary site. Oncologist; 2009 Dec;14(12):1189-97
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  • [Title] Paclitaxel/carboplatin plus bevacizumab/erlotinib in the first-line treatment of patients with carcinoma of unknown primary site.
  • INTRODUCTION: This phase II trial evaluated the efficacy and toxicity of the combination of paclitaxel, carboplatin, bevacizumab, and erlotinib in the first-line treatment of patients with carcinoma of unknown primary site (CUP).
  • METHODS: Patients with previously untreated CUP (adenocarcinoma, poorly differentiated carcinoma, poorly differentiated squamous carcinoma) without clinical or pathologic characteristics of a well-defined treatable subset were eligible.
  • CONCLUSIONS: Empiric treatment with paclitaxel, carboplatin, bevacizumab, and erlotinib is effective and well tolerated as first-line treatment for patients with CUP.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Unknown Primary / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adult. Aged. Aged, 80 and over. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal / adverse effects. Antibodies, Monoclonal, Humanized. Bevacizumab. Carboplatin / administration & dosage. Carboplatin / adverse effects. Carcinoma / drug therapy. Carcinoma, Squamous Cell / drug therapy. Disease-Free Survival. Erlotinib Hydrochloride. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Quinazolines / administration & dosage. Quinazolines / adverse effects. Survival Rate. Young Adult

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  • (PMID = 19965914.001).
  • [ISSN] 1549-490X
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Quinazolines; 2S9ZZM9Q9V / Bevacizumab; BG3F62OND5 / Carboplatin; DA87705X9K / Erlotinib Hydrochloride; P88XT4IS4D / Paclitaxel
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5. Bordel Gómez MT, Used Aznar MM: [Cutaneous metastases from adenocarcinoma of unknown primary site]. Actas Dermosifiliogr; 2006 Dec;97(10):662-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Cutaneous metastases from adenocarcinoma of unknown primary site].
  • [Transliterated title] Metástasis cutáneas de adenocarcinoma de origen primario desconocido.
  • Metastatic cancer of unknown primary site appears in 5-10% of oncologic patients.
  • The primary tumor is usually discovered at autopsy and only in 27% of patients alive.
  • Metastases from cancer of unknown primary site may be located in the skin and subcutaneous tissue and it is the dermatologist the first in evaluating these patients.
  • We present a case of cutanoeus metastases from moderately-differentiated adenocarcinoma of unknown primary site.
  • The primary tumor could not be identified in spite of the imaging and endoscopic studies performed.
  • Based on these studies we excluded a colorectal or prostatic origin and considered a pancreatic adencarcinoma as the possible primary tumor.
  • Even though a minority of these patients will have a curable disease, the appropriate use of pathological diagnosis and selected imaging studies for an optimal management of patients with a tumor of unknown primary site should not be ignored.
  • [MeSH-major] Adenocarcinoma / secondary. Neoplasms, Unknown Primary. Skin Neoplasms / secondary

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  • (PMID = 17173831.001).
  • [ISSN] 0001-7310
  • [Journal-full-title] Actas dermo-sifiliográficas
  • [ISO-abbreviation] Actas Dermosifiliogr
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 17
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6. Gulec SA, Mesoloras G, Dezarn WA, McNeillie P, Kennedy AS: Safety and efficacy of Y-90 microsphere treatment in patients with primary and metastatic liver cancer: the tumor selectivity of the treatment as a function of tumor to liver flow ratio. J Transl Med; 2007;5:15
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  • [Title] Safety and efficacy of Y-90 microsphere treatment in patients with primary and metastatic liver cancer: the tumor selectivity of the treatment as a function of tumor to liver flow ratio.
  • BACKGROUND: Treatment records and follow-up data on 40 patients with primary and metastatic liver malignancies who underwent a single whole-liver treatment with Y-90 resin microspheres (SIR-Spheres Sirtex Medical, Lake Forest, IL) were retrospectively reviewed.
  • RESULTS: Of the 40 patients, 5 had hepatocellular cancer (HCC), and 35 had metastatic liver tumors (15 colorectal cancer, 10 neuroendocrine tumors, 4 breast cancer, 2 lung cancer, 1 ovarian cancer, 1 endometrial cancer, and 2 unknown primary adenocarcinoma).

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  • (PMID = 17359531.001).
  • [ISSN] 1479-5876
  • [Journal-full-title] Journal of translational medicine
  • [ISO-abbreviation] J Transl Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Toll-Like Receptors; 0 / Yttrium Radioisotopes; 58784XQC3Y / Yttrium
  • [Other-IDs] NLM/ PMC1845138
  • [General-notes] NLM/ Original DateCompleted: 20070802
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7. Greco FA: Therapy of adenocarcinoma of unknown primary: are we making progress? J Natl Compr Canc Netw; 2008 Nov;6(10):1061-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapy of adenocarcinoma of unknown primary: are we making progress?
  • Therapy for patients with unknown primary carcinoma is evolving and requires a detailed understanding of the various clinicopathologic subsets with more favorable prognoses.
  • The survival of patients with several metastatic adenocarcinomas of known primary sites, including colon/rectum, lung, and pancreas, has been improved by the administration of chemotherapy alone or combined with biologic targeted drugs (bevacizumab, erlotinib).
  • Approximately 60% of the patients with unknown primary adenocarcinoma have clinically occult primary sites of colon/rectum, lung, and pancreas.
  • Many of these patients will also benefit from therapeutic regimens now proven to be useful for patients with these known primary sites.
  • All available data make a convincing argument that progress is being made for the commonly seen patients with adenocarcinoma of unknown primary site, and is likely to continue as understanding of these and other neoplasms further evolves.
  • [MeSH-major] Adenocarcinoma / therapy. Neoplasms, Unknown Primary / therapy

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  • (PMID = 19176201.001).
  • [ISSN] 1540-1405
  • [Journal-full-title] Journal of the National Comprehensive Cancer Network : JNCCN
  • [ISO-abbreviation] J Natl Compr Canc Netw
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 48
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8. Nieto Y, Shpall EJ, Bearman SI, McSweeney PA, Cagnoni PJ, Matthes S, Gustafson D, Long M, Barón AE, Jones RB: Phase I and pharmacokinetic study of docetaxel combined with melphalan and carboplatin, with autologous hematopoietic progenitor cell support, in patients with advanced refractory malignancies. Biol Blood Marrow Transplant; 2005 Apr;11(4):297-306
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  • Fifty-nine patients with advanced refractory malignancy (32 breast cancer, 10 non-Hodgkin lymphoma, 6 germ cell tumors, 4 Hodgkin disease, 4 ovarian cancer, 2 sarcoma, and 1 unknown primary adenocarcinoma) with a median of 3 prior chemotherapy regimens and a median of 3 organs involved were enrolled.

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  • (PMID = 15812395.001).
  • [ISSN] 1083-8791
  • [Journal-full-title] Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • [ISO-abbreviation] Biol. Blood Marrow Transplant.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; BG3F62OND5 / Carboplatin; Q41OR9510P / Melphalan
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9. Spurgeon JM, Cotlar AM: Cytoreductive surgery in the management of malignant ascites from adenocarcinoma of unknown primary (ACUP). Curr Surg; 2005 Sep-Oct;62(5):500-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cytoreductive surgery in the management of malignant ascites from adenocarcinoma of unknown primary (ACUP).
  • A case report is presented of a 62-year-old man with adenocarcinoma of unknown primary (ACUP) who was admitted with massive ascites from intraperitoneal carcinomatosis secondary to a gastrointestinal tract malignancy.
  • [MeSH-major] Adenocarcinoma / therapy. Chemotherapy, Cancer, Regional Perfusion / methods. Neoplasm Invasiveness / pathology. Neoplasms, Unknown Primary / pathology. Palliative Care. Peritoneal Neoplasms / therapy

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  • (PMID = 16125606.001).
  • [ISSN] 0149-7944
  • [Journal-full-title] Current surgery
  • [ISO-abbreviation] Curr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
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10. Shibata K, Kametani T, Takase M, Chatani K, Masuda S: [A case of adenocarcinoma of unknown primary site successfully treated with gemcitabine monotherapy]. Gan To Kagaku Ryoho; 2006 Oct;33(10):1489-92
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  • [Title] [A case of adenocarcinoma of unknown primary site successfully treated with gemcitabine monotherapy].
  • A 68-year-old female diagnosed with adenocarcinoma of unknown primary site (ACUP) by biopsy of supraclavicular lymph node was admitted to our department because of progressive dyspnea with cough.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antimetabolites, Antineoplastic / administration & dosage. Deoxycytidine / analogs & derivatives. Lung Neoplasms / secondary. Neoplasms, Unknown Primary / drug therapy

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  • (PMID = 17033244.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Antimetabolites, Antineoplastic; 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / DU-PAN-2 antigen, human; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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11. Elert A, Forst F, Ihling C, Schneider A: [Cyst, endometriosis, borderline tumor, CUP : diagnostic stations of a supposedly simple renal cyst]. Urologe A; 2010 Dec;49(12):1522-4, 1526
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Cyst, endometriosis, borderline tumor, CUP : diagnostic stations of a supposedly simple renal cyst].
  • [Transliterated title] Zyste, Endometriose, Borderlinetumor, CUP : Diagnostische Stationen einer vermeintlichen simplen Nierenzyste.
  • We report the case of a female patient in whom the diagnosis of a supposedly simple symptomatic renal cyst changed over endometriosis and borderline malignancy to a CUP.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / secondary. Endometriosis / diagnosis. Kidney Diseases, Cystic / diagnosis. Kidney Neoplasms / diagnosis. Kidney Neoplasms / secondary. Neoplasms, Unknown Primary / diagnosis

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  • [Cites] Urologe A. 2002 May;41(3):263-6 [12132276.001]
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  • (PMID = 20949255.001).
  • [ISSN] 1433-0563
  • [Journal-full-title] Der Urologe. Ausg. A
  • [ISO-abbreviation] Urologe A
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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12. El-Rayes BF, Shields AF, Zalupski M, Heilbrun LK, Jain V, Terry D, Ferris AM, Philip PA: A phase II study of carboplatin and paclitaxel in adenocarcinoma of unknown primary. Am J Clin Oncol; 2005 Apr;28(2):152-6
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  • [Title] A phase II study of carboplatin and paclitaxel in adenocarcinoma of unknown primary.
  • BACKGROUND: Cisplatin-based combination chemotherapy is commonly used in the treatment of carcinoma of unknown primary site.
  • This study was conducted to evaluate the efficacy and toxicity of combination carboplatin and paclitaxel in patients with adenocarcinoma of unknown primary site (ACUP).
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Unknown Primary / drug therapy

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  • (PMID = 15803009.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-22453
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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13. Power D, Lagunes DR: Adenocarcinoma of unknown primary in a 20-year-old African American male. Clin Genitourin Cancer; 2009 Aug;7(2):E45-8
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  • [Title] Adenocarcinoma of unknown primary in a 20-year-old African American male.
  • Lung biopsy revealed poorly differentiated adenocarcinoma positive for cytokeratin 7.
  • By exclusion, it appeared that the patient had a carcinoma of unknown primary.
  • [MeSH-major] Adenocarcinoma / diagnosis. Kidney Medulla / pathology. Kidney Neoplasms / diagnosis. Neoplasms, Unknown Primary / diagnosis

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  • (PMID = 19692325.001).
  • [ISSN] 1938-0682
  • [Journal-full-title] Clinical genitourinary cancer
  • [ISO-abbreviation] Clin Genitourin Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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14. Iglseder S: [Palliative chemotherapy and CUP-syndrome: medical intentions versus patients' attitudes in decision making]. Wien Med Wochenschr; 2006 May;156(9-10):283-7
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  • [Title] [Palliative chemotherapy and CUP-syndrome: medical intentions versus patients' attitudes in decision making].
  • [Transliterated title] Palliative Chemotherapie bei CUP: Arztliche Intentionen versus Patientenhaltung in der Entscheidungsfindung--ein Fallbeispiel.
  • The following case report is about a 55 year old male patient with CUP-syndrome.
  • In tumors of unknown primary site regimens with different combinations of Platin, Taxol, Etoposide, Irinotecan and Gemcitabine showed responses up to 46% and a survival benefit with an overall median survival up to 12 months and even long term survival.
  • [MeSH-major] Adenocarcinoma, Scirrhous / drug therapy. Adenocarcinoma, Scirrhous / secondary. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Decision Making. Intention. Neoplasms, Unknown Primary / drug therapy. Palliative Care / psychology. Patient Participation. Pelvic Neoplasms / drug therapy. Pelvic Neoplasms / secondary. Physician-Patient Relations

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  • (PMID = 16830247.001).
  • [ISSN] 0043-5341
  • [Journal-full-title] Wiener medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Wien Med Wochenschr
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Analgesics, Opioid
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15. Hu M, Yu J, Liu N, Kong L, Zhang P: The role of whole body <sup>18</sup>F-FDG PET/CT scan in patients with carcinoma of unknown primary. J Clin Oncol; 2009 May 20;27(15_suppl):e22051

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of whole body <sup>18</sup>F-FDG PET/CT scan in patients with carcinoma of unknown primary.
  • : e22051 Background: Carcinoma of unknown primary (CUP) is a heterogeneous group of tumors and usually follows an aggressive biological and clinical behavior.
  • Difficult challenges in oncology which the identification of the primary tumor and a complete disease staging could offer a more rational and efficient treatment in order to improve the survival time.
  • Our aim was to evaluate the role of <sup>18</sup>F-FDG PET/CT scan with two aspects: detection of the primary site, and estimation of tumor biological behavior which essential for the development of new, individual and targeted effective therapies.
  • METHODS: One hundred and seventeen patients presenting with histologically confirmed metastatic carcinoma (76 lymph nodes, 41 visceral biopsy proven) of unknown primary site were included in this retrospective study.
  • The evaluations as follows had not revealed a primary site: detailed medical history, full physical and laboratory examinations, and diagnostic imaging methods.
  • RESULTS: In 42 (35.90%) patients, a primary tumor site which was confirmed by follow-up or surgery was showed by PET/CT.
  • In 15 (12.82%) patients, the primary tumor site was suggested by PET/CT but not confirmed.
  • In 60 (51.28%) patients, the primary tumor site was not localized modifying the stage of disease.
  • Between the adenocarcinoma and squamous cell carcinoma groups, no significant difference in SUVmax was found ( t=1.191, p = 0.244).
  • A significantly higher SUVmax was found among patients with poorly or undifferentiated carcinoma compared with patients with well to moderately ( t=4.013, p<0.01) differentiation; In 42 patients with a confirmed primary tumor site, the SUVmax of Metastatic tumours have a closely relationship correlate with those of primary tumours, ( r=0.738, p<0.01).
  • Furthermore, a significantly higher SUVmax was found among metastases compared with primary tumors ( t=3.470, p<0.01).
  • CONCLUSIONS: Our data strongly support <sup>18</sup>F-FDG PET/ CT imagings not only provide new insights in the diagnosis and staging of patients with CUP, but also evaluate biologic characters of tissue.

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  • (PMID = 27963233.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Hainsworth JD, Lane C, Spigel DR, Shipley D, Waterhouse D, Bury M, Greco FA: Randomized phase III comparison of paclitaxel/carboplatin/etoposide versus gemcitabine/irinotecan, both followed by gefitinib, in patients (pts) with carcinoma of unknown primary site (CUP). J Clin Oncol; 2009 May 20;27(15_suppl):4631

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Randomized phase III comparison of paclitaxel/carboplatin/etoposide versus gemcitabine/irinotecan, both followed by gefitinib, in patients (pts) with carcinoma of unknown primary site (CUP).
  • : 4631 Background: Empiric chemotherapy for pts with CUP has resulted in modest survival improvements.
  • METHODS: Previously untreated pts with CUP (adenocarcinoma, poorly differentiated adenocarcinoma, poorly differentiated carcinoma, poorly differentiated squamous carcinoma) were eligible.
  • The primary endpoint was the 2-year survival rate.
  • CONCLUSIONS: The PCE and GI regimens had comparable efficacy in the treatment of CUP, while the GI regimen was better tolerated.
  • Better treatments are needed for pts with CUP.

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  • (PMID = 27964228.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Dimitroulas T, Settas L: Paget's disease of the vulva in a patient with scleroderma and underlying adenocarcinoma: case report. Eur J Gynaecol Oncol; 2009;30(4):458-9
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  • [Title] Paget's disease of the vulva in a patient with scleroderma and underlying adenocarcinoma: case report.
  • The patient underwent radical vulvectomy, but 18 months later died due to adenocarcinoma of unknown primary origin.
  • [MeSH-major] Adenocarcinoma / pathology. Neoplasms, Multiple Primary. Neoplasms, Unknown Primary. Paget Disease, Extramammary / complications. Scleroderma, Systemic / complications. Vulvar Neoplasms / complications

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  • (PMID = 19761147.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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18. Sarbia M, Fritze F, Geddert H, von Weyhern C, Rosenberg R, Gellert K: Differentiation between pancreaticobiliary and upper gastrointestinal adenocarcinomas: is analysis of cytokeratin 17 expression helpful? Am J Clin Pathol; 2007 Aug;128(2):255-9
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  • Metastatic adenocarcinoma of unknown primary site, eg, to lymph nodes, liver, or lung, may originate from many organs.
  • A high prevalence of cytokeratin (CK)17 expression in pancreaticobiliary adenocarcinoma was reported, and preliminary data indicate infrequent or missing expression in gastric adenocarcinoma.
  • CK17 expression was as follows: pancreatic, 88%; bile duct, 59%; esophageal, 30%; distal gastric, 28%; gastric cardiac, 27%; and colorectal adenocarcinoma, 6%.
  • These differences were statistically significant for all tumor types except in comparisons of esophageal, cardiac, and distal gastric adenocarcinoma.
  • However, in individual cases of adenocarcinoma of unknown primary site, CK17 results alone are insufficient to differentiate the analyzed tumor entities.
  • [MeSH-major] Adenocarcinoma / chemistry. Bile Duct Neoplasms / chemistry. Gastrointestinal Neoplasms / chemistry. Keratin-17 / analysis. Pancreatic Neoplasms / chemistry

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  • (PMID = 17638659.001).
  • [ISSN] 0002-9173
  • [Journal-full-title] American journal of clinical pathology
  • [ISO-abbreviation] Am. J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Martin SK, Agarwal G, Lynch GR: Subcutaneous fat necrosis as the presenting feature of a pancreatic carcinoma: the challenge of differentiating endocrine and acinar pancreatic neoplasms. Pancreas; 2009 Mar;38(2):219-22
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  • Previous pathological evaluation of the patient's liver biopsy led to an initial diagnosis of adenocarcinoma of unknown primary site.

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  • (PMID = 19238022.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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20. Sorgho-Lougue LC, Luciani A, Kobeiter H, Zelek L, Malhaire C, Deux JF, Brun B, Piedbois P, Rahmouni A: Adenocarcinomas of unknown primary (ACUP) of the mediastinum mimicking lymphoma: CT findings at diagnosis and follow-up. Eur J Radiol; 2006 Jul;59(1):42-8
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  • [Title] Adenocarcinomas of unknown primary (ACUP) of the mediastinum mimicking lymphoma: CT findings at diagnosis and follow-up.
  • OBJECTIVE: To describe the computed tomography (CT) features at diagnosis and after treatment of adenocarcinoma of unknown primary (ACUP) mimicking lymphoma of the mediastinum.
  • [MeSH-major] Adenocarcinoma / radiography. Adenocarcinoma / secondary. Mediastinal Neoplasms / radiography. Mediastinal Neoplasms / secondary. Neoplasms, Unknown Primary / radiography. Tomography, Spiral Computed

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  • (PMID = 16504446.001).
  • [ISSN] 0720-048X
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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21. Strickland-Marmol LB, Khoor A, Livingston SK, Rojiani A: Utility of tissue-specific transcription factors thyroid transcription factor 1 and Cdx2 in determining the primary site of metastatic adenocarcinomas to the brain. Arch Pathol Lab Med; 2007 Nov;131(11):1686-90
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  • [Title] Utility of tissue-specific transcription factors thyroid transcription factor 1 and Cdx2 in determining the primary site of metastatic adenocarcinomas to the brain.
  • CONTEXT: Brain metastases of adenocarcinoma of unknown primary pose a diagnostic dilemma to the surgical pathologist.
  • Although the most common source in these cases is the lung, determining a primary source is difficult on routinely stained slides.
  • Lee Moffitt Cancer Center and Research Institute, Tampa, Fla, and retrieved 38 consecutive cases of metastatic adenocarcinoma (22 pulmonary, 10 breast, 6 gastrointestinal [2 esophagus/gastroesophageal junction, 4 colorectal]) to the brain with confirmation of the primary site by chart review and histologic evaluation.
  • CONCLUSIONS: Cdx2 is a specific and valuable tool for the surgical pathologist when faced with the common problem of metastatic adenocarcinoma of unknown primary.
  • In conjunction with TTF-1, cytokeratin 7, and cytokeratin 20, Cdx2 can accurately differentiate the most common sources of metastatic adenocarcinoma to the brain.
  • [MeSH-major] Adenocarcinoma / secondary. Brain Neoplasms / secondary. DNA-Binding Proteins / metabolism. Homeodomain Proteins / metabolism. Neoplasms, Unknown Primary / diagnosis. Neoplasms, Unknown Primary / metabolism

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  • (PMID = 17979487.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CDX2 protein, human; 0 / DNA-Binding Proteins; 0 / Homeodomain Proteins; 0 / Keratin-20; 0 / Keratin-7; 0 / TTF1 protein, human
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22. Cohen SJ, Engstrom PF, Lewis NL, Langer CJ, McLaughlin S, Beard M, Weiner LM, Meropol NJ: Phase I study of capecitabine and oxaliplatin in combination with the proteasome inhibitor bortezomib in patients with advanced solid tumors. Am J Clin Oncol; 2008 Feb;31(1):1-5
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  • Three objective tumor responses were noted (squamous cell of anus, adenocarcinoma of unknown primary, adenocarcinoma of rectum).

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  • (PMID = 18376220.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA006927
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Boronic Acids; 0 / Organoplatinum Compounds; 0 / Pyrazines; 04ZR38536J / oxaliplatin; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; 69G8BD63PP / Bortezomib; U3P01618RT / Fluorouracil
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23. Levy MJ, Clain JE, Clayton A, Halling KC, Kipp BR, Rajan E, Roberts LR, Root RM, Sebo TJ, Topazian MD, Wang KK, Wiersema MJ, Gores GJ: Preliminary experience comparing routine cytology results with the composite results of digital image analysis and fluorescence in situ hybridization in patients undergoing EUS-guided FNA. Gastrointest Endosc; 2007 Sep;66(3):483-90
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  • RESULTS: Malignancy was diagnosed in 30 of 42 patients, including esophageal squamous cell carcinoma, esophageal adenocarcinoma, gastric adenocarcinoma, pancreatic adenocarcinoma, pancreatic mucinous cystic neoplasia, intraductal papillary mucinous neoplasia, metastatic forearm sarcoma, small cell and non-small cell lung cancer, thyroid carcinoma, malignant GI stromal tumor, melanoma, adenocarcinoma of unknown primary, and lymphoma.


24. Afify A, Lynne LC, Howell L: Correlation of cytologic examination with ELISA assays for hyaluronan and soluble CD44v6 levels in evaluation of effusions. Diagn Cytopathol; 2007 Feb;35(2):105-10
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  • Malignant effusions included 18 cases of metastatic adenocarcinomas (9 ovarian, 3 breast, 3 pulmonary, 3 adenocarcinoma of unknown primary) and 2 cases of lymphomas.

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  • (PMID = 17230576.001).
  • [ISSN] 8755-1039
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD44; 0 / Biomarkers, Tumor; 0 / CD44v6 antigen; 0 / Glycoproteins; 9004-61-9 / Hyaluronic Acid
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25. Kato S, Yasuda K, Nishino Y, Ohori H, Takahashi M, Takahashi S, Yamaura G, Ohtsuka K, Kakudo Y, Chiba N, Shimodaira H, Sakayori M, Kato S, Suzuki T, Murakawa Y, Gamoh M, Shibata H, Yoshioka T, Ishioka C: [Clinical characteristics of cancer of unknown primary (CUP)--a summary of 22 cases]. Gan To Kagaku Ryoho; 2007 Aug;34(8):1227-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical characteristics of cancer of unknown primary (CUP)--a summary of 22 cases].
  • Cancer of unknown primary site (CUP) is not a rare entity and accounts for 3-5% of all malignant neoplasias.
  • CUP shows much histological and therapeutic heterogeneity.
  • Histologically, half of CUPs are adenocarcinoma and the rest are undifferentiated carcinomas.
  • We analyzed the clinical and therapeutic characteristics 22 cases of CUP patients.
  • Most CUP patients are found from lymph node swelling.
  • Because of its variety, individualized therapy may be ideal for CUP.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymph Nodes / pathology. Neoplasms, Unknown Primary / drug therapy. Neoplasms, Unknown Primary / mortality
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adult. Aged. Aged, 80 and over. Bone Neoplasms / secondary. Carboplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Etoposide / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Metastasis. Male. Middle Aged. Paclitaxel / administration & dosage. Prognosis. Survival Rate

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  • (PMID = 17687203.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; U3P01618RT / Fluorouracil
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26. Shield PW, Koivurinne K: The value of calretinin and cytokeratin 5/6 as markers for mesothelioma in cell block preparations of serous effusions. Cytopathology; 2008 Aug;19(4):218-23
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  • OBJECTIVE: To determine the value of calretinin and cytokeratin (CK) 5/6 in discriminating mesothelioma from adenocarcinoma in serous effusion specimens.
  • The adenocarcinomas included metastatic carcinomas from the breast (12), lung (19), stomach (3), colon (1), pancreas (2), ovary (6) endometrium (1) and 23 histologically confirmed metastases from unknown primary sites.
  • Only 3% (2/67) of adenocarcinomas were positive for calretinin, one being a lung adenocarcinoma and the other an adenocarcinoma of unknown primary site in an ascitic fluid.
  • Six (9%) adenocarcinomas were positive, including metastases from the lung (1), breast (1), ovary (2) and unknown primary site (2).
  • Four of the six adenocarcinoma cases positive for CK5/6 were in ascitic fluids.
  • Only one adenocarcinoma case, (which was from unknown primary site in an ascitic fluid sample), was positive for both markers.
  • The two markers make a useful addition to EMA and the panel of adenocarcinoma markers routinely applied to effusion specimens.

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  • (PMID = 17916095.001).
  • [ISSN] 1365-2303
  • [Journal-full-title] Cytopathology : official journal of the British Society for Clinical Cytology
  • [ISO-abbreviation] Cytopathology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CALB2 protein, human; 0 / Calbindin 2; 0 / Keratin-5; 0 / Keratin-6; 0 / S100 Calcium Binding Protein G
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27. Koizumi T, Nakaya N, Okamura C, Sato Y, Shimazu T, Nagase S, Niikura H, Kuriyama S, Tase T, Ito K, Tsubono Y, Okamura K, Yaegashi N, Tsuji I: Case-control study of coffee consumption and the risk of endometrial endometrioid adenocarcinoma. Eur J Cancer Prev; 2008 Aug;17(4):358-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Case-control study of coffee consumption and the risk of endometrial endometrioid adenocarcinoma.
  • This study examined the association between coffee consumption and the risk of endometrial endometrioid adenocarcinoma (EEA) in Japan by a case-control design.
  • The multivariate-adjusted OR of EEA for individuals in the highest tertile of coffee consumption (2 to 3 cups or more/day) was 0.4 [95% confidence interval (CI), 0.2-0.9], and that of cases in the intermediate tertile (5 to 6 times/week-1 cup/day) was 0.6 (95% CI, 0.3-1.2), relative to the individuals in the lowest tertile of coffee consumption (3 to 4 times or less/week) (P for trend=0.014).

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  • (PMID = 18562962.001).
  • [ISSN] 1473-5709
  • [Journal-full-title] European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
  • [ISO-abbreviation] Eur. J. Cancer Prev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Coffee
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28. Kakuta Y, Nakaya N, Nagase S, Fujita M, Koizumi T, Okamura C, Niikura H, Ohmori K, Kuriyama S, Tase T, Ito K, Minami Y, Yaegashi N, Tsuji I: Case-control study of green tea consumption and the risk of endometrial endometrioid adenocarcinoma. Cancer Causes Control; 2009 Jul;20(5):617-24
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  • [Title] Case-control study of green tea consumption and the risk of endometrial endometrioid adenocarcinoma.
  • OBJECTIVE: To investigate the association between green tea consumption and the risk of endometrial cancer restricted to endometrial endometrioid adenocarcinoma (EEA) using a case-control design in Japan.
  • The multivariate-adjusted OR of EEA was 0.77 (95% CI: 0.37-1.58) for those in the second quartile of green tea consumption (5-6 cups/week-1 cup/day), 0.61 (0.30-1.23) in the third quartile (2-3 cups/day), and 0.33 (0.15-0.75) in the highest quartile (> or = 4 cups/day), as referenced with those in the lowest quartile (< or = 4 cups/week; p for trend = 0.007).

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  • (PMID = 19067194.001).
  • [ISSN] 1573-7225
  • [Journal-full-title] Cancer causes & control : CCC
  • [ISO-abbreviation] Cancer Causes Control
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Tea
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29. Adachi Y, Nakamura H, Nitta S: [Mediastinal lymph node adenocarcinoma with unknown primary site; report of a case]. Kyobu Geka; 2006 Jul;59(7):597-601

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  • [Title] [Mediastinal lymph node adenocarcinoma with unknown primary site; report of a case].
  • In the histological diagnosis, there were no malignant finding in the right lung, and mediastinal lymph nodes showed poorly differentiated adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / pathology. Lymph Node Excision. Lymph Nodes / pathology. Neoplasms, Unknown Primary

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  • (PMID = 16856539.001).
  • [ISSN] 0021-5252
  • [Journal-full-title] Kyobu geka. The Japanese journal of thoracic surgery
  • [ISO-abbreviation] Kyobu Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Carcinoembryonic Antigen
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30. Eickhoff A, Spiethoff A, Hartmann D, Jakobs R, Weickert U, Schilling D, Eickhoff JC, Bohrer MH, Riemann JF: [Space-occupying lesions in the liver: incidence of adenocarcinoma metastases of unknown primary site]. Dtsch Med Wochenschr; 2007 Feb 23;132(8):369-74
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  • [Title] [Space-occupying lesions in the liver: incidence of adenocarcinoma metastases of unknown primary site].
  • BACKGROUND AND OBJECTIVE: The diagnostic approach to newly detected space-occupying lesions in the liver can be difficult and a histogenetic classification of the primary tumor is impossible in some cases.
  • Such cases of metastatic disease without a detectable primary tumor are classified as cancer of unknown primary site (CUP).
  • It was the main aim of this study to analyze the true incidence of adenocarcinoma metastases of the liver with an unknown primary cancer after application of a standardized protocol of clinical and immunhistochemical diagnostic tests and a long-term follow-up.
  • Primary tumors of the liver were found in 21 cases and non-hepatocellular tumors (metastases) were documented in 106 patients, 82 of the latter (77%) had metastases of an adenocarcinoma.
  • The further diagnostic approach was based on histochemistry, immunhistochemistry and imaging techniques, making possible a full diagnosis of primary tumor in a further 59 (72%) cases.
  • Thus the incidence of an adenocarcinoma of the liver of unknown primary site was 23 of 127 cases (18%).
  • [MeSH-major] Adenocarcinoma / secondary. Liver Neoplasms / secondary. Neoplasms, Unknown Primary / diagnosis

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  • (PMID = 17299675.001).
  • [ISSN] 0012-0472
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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31. Rivas E, Sanchez-Herrero J, Alonso M, Alvarez MJ, Teijeira S, Ballestín C, Tardio A, Navarro C: Miliary brain metastases presenting as rapidly progressive dementia. Neuropathology; 2005 Jun;25(2):153-8
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  • Neuropathological examination revealed an extensive miliary metastatic dissemination from an unknown primary adenocarcinoma.

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  • (PMID = 15875909.001).
  • [ISSN] 0919-6544
  • [Journal-full-title] Neuropathology : official journal of the Japanese Society of Neuropathology
  • [ISO-abbreviation] Neuropathology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
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32. Pawar A, Schlader E, Mac-Thiong JM, Maurais G, Dion D, Bédard D: Rare metastatic adenocarcinoma to the spine infiltrating three adjacent foramen in lumbar vertebrae. Orthopedics; 2010 Dec;33(12):928

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  • [Title] Rare metastatic adenocarcinoma to the spine infiltrating three adjacent foramen in lumbar vertebrae.
  • Computed tomography-guided biopsy confirmed the diagnosis of metastatic adenocarcinoma.
  • However, the primary site could not be found despite several investigations.
  • It is usually thought that the primary tumor spreads to the spine through the valveless Batson's plexus or by direct arterial seeding into vertebral bodies.
  • A paravertebral primary tumor such as a lymphoma, a primary tumor from the lungs, or a renal cell carcinoma can potentially infiltrate the vertebral bodies and enter the spinal canal through the neural foramen.
  • But a large retroperitoneal metastatic mass from an unknown primary adenocarcinoma is a rare condition.
  • Thus, the pathogenesis of metastatic adenocarcinomas, particularly when the primary site is unknown, is not completely understood and can give a varied radiological presentation.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma / surgery. Lumbar Vertebrae / pathology. Lumbar Vertebrae / surgery. Spinal Neoplasms / pathology. Spinal Neoplasms / secondary

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  • [Copyright] Copyright 2010, SLACK Incorporated.
  • (PMID = 21162500.001).
  • [ISSN] 1938-2367
  • [Journal-full-title] Orthopedics
  • [ISO-abbreviation] Orthopedics
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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33. Gutiérrez Macías A, Lizarralde Palacios E, Merino Múgica JM, Cabeza García S, Martínez Odriozola P, Miguel de la Villa F: [Bilateral chylothorax in a case of metastatic adenocarcinoma of unknown primary]. An Med Interna; 2006 Apr;23(4):176-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Bilateral chylothorax in a case of metastatic adenocarcinoma of unknown primary].
  • [Transliterated title] Quilotórax bilateral en un caso de adenocarcinoma metastásico de primario desconocido.
  • Necropsy showed widespread metastatic adenocarcinoma of unknown primary.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / secondary. Chylothorax / etiology. Neoplasms, Unknown Primary / diagnosis

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  • (PMID = 16796411.001).
  • [ISSN] 0212-7199
  • [Journal-full-title] Anales de medicina interna (Madrid, Spain : 1984)
  • [ISO-abbreviation] An Med Interna
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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34. Stakia P, Lagos P, Gourgiotis S, Tzilalis VD, Aloizos S, Salemis NS: Large mass affecting retroperitoneal great vessels: a rare presentation of a cancer of unknown primary with diagnostic dilemma and challenged surgical intervention. J Gastrointest Cancer; 2009;40(1-2):55-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Large mass affecting retroperitoneal great vessels: a rare presentation of a cancer of unknown primary with diagnostic dilemma and challenged surgical intervention.
  • INTRODUCTION: Cancers of unknown primary site (CUPs) consist of a clinical entity which accounts for 3-5% of all solid tumor patients.
  • They are metastatic solid tumors whose fundamental characteristic is the absence of identifiable site of the primary tumor.
  • A complete resection of the mass was performed while the histological examination revealed a solitary retroperitoneal lymph node categorized as metastatic adenocarcinoma of unknown primary site.
  • CONCLUSION: It is essential to assess the high incidence of patients with cancer who present with CUP.
  • [MeSH-major] Adenocarcinoma / secondary. Blood Vessels / pathology. Neoplasms, Unknown Primary / pathology. Retroperitoneal Neoplasms / secondary

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  • (PMID = 19513858.001).
  • [ISSN] 1941-6636
  • [Journal-full-title] Journal of gastrointestinal cancer
  • [ISO-abbreviation] J Gastrointest Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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35. DeMartini W, Lehman C: A review of current evidence-based clinical applications for breast magnetic resonance imaging. Top Magn Reson Imaging; 2008 Jun;19(3):143-50
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  • Specifically, MRI has been shown to be advantageous for cancer assessment for screening patients at high risk, evaluating patients with a new breast cancer diagnosis, monitoring patients undergoing neoadjuvant chemotherapy, and evaluating patients with metastatic axillary adenocarcinoma and unknown primary site.

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  • (PMID = 18941394.001).
  • [ISSN] 1536-1004
  • [Journal-full-title] Topics in magnetic resonance imaging : TMRI
  • [ISO-abbreviation] Top Magn Reson Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] United States
  • [Number-of-references] 73
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36. DeMartini W, Lehman C, Partridge S: Breast MRI for cancer detection and characterization: a review of evidence-based clinical applications. Acad Radiol; 2008 Apr;15(4):408-16
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  • RESULTS: Breast MRI has been shown in multiple studies to be advantageous for screening patients at high risk, evaluating patients with a new breast cancer diagnosis, monitoring treatment response in patients undergoing neoadjuvant chemotherapy and evaluating patients with metastatic axillary adenocarcinoma and unknown primary site.

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  • (PMID = 18342764.001).
  • [ISSN] 1076-6332
  • [Journal-full-title] Academic radiology
  • [ISO-abbreviation] Acad Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 72
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37. Faivre S, Delbaldo C, Vera K, Robert C, Lozahic S, Lassau N, Bello C, Deprimo S, Brega N, Massimini G, Armand JP, Scigalla P, Raymond E: Safety, pharmacokinetic, and antitumor activity of SU11248, a novel oral multitarget tyrosine kinase inhibitor, in patients with cancer. J Clin Oncol; 2006 Jan 1;24(1):25-35
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  • Six objective responses were observed in three renal cell carcinomas, one neuroendocrine tumor, one stromal tumor, and one unknown primary adenocarcinoma patient.


38. Pentheroudakis G, Briasoulis E, Kalofonos HP, Fountzilas G, Economopoulos T, Samelis G, Koutras A, Karina M, Xiros N, Samantas E, Bamias A, Pavlidis N, Hellenic Cooperative Oncology Group: Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncol; 2008;47(6):1148-55
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  • [Title] Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study.
  • We sought to optimise the regimen as a suitable outpatient palliative treatment for cancer of unknown primary (CUP).
  • PATIENTS AND METHODS: Eligible CUP patients with adenocarcinoma or poorly differentiated carcinoma, performance status of 0-2, adequate organ function and assessable disease were treated with docetaxel 75 mg/m(2) and carboplatin at an area under the concentration time-curve (AUC) of 5, both as 30-minute intravenous infusions, every three weeks.
  • CONCLUSIONS: One-hour docetaxel/carboplatin is a convenient, safe and effective outpatient palliative treatment for CUP patients, providing meaningful survival prolongation only in favourable-risk patients.
  • Insights in the molecular biology of CUP are needed for the development of targeted therapeutic manipulations of malignant resistance and progression.
  • [MeSH-major] Adenocarcinoma / drug therapy. Ambulatory Care. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Neoplasms, Unknown Primary / drug therapy. Outpatients. Palliative Care / methods

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  • (PMID = 18607872.001).
  • [ISSN] 1651-226X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; BG3F62OND5 / Carboplatin
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39. Wang ZP, Liu YT, Yang J: [Classification and regression tree analysis of 154 patients with cancer of unknown primary]. Zhonghua Zhong Liu Za Zhi; 2010 Sep;32(9):690-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Classification and regression tree analysis of 154 patients with cancer of unknown primary].
  • OBJECTIVE: To explore the prognostic factors and their impact on survival of patients with cancer of unknown primary (CUP).
  • METHODS: The clinical and follow up data of 154 CUP patients referred to the Cancer Hospital & Institute, Chinese Academy of Medical Sciences from January 1, 2003 to December 31, 2007 were analyzed.
  • RESULTS: The median survival for 154 eligible consecutive CUP patients was 18.2 months, and the 5-year survival rate was 1.3%.
  • The median survival of the 5 subsets ranged from 5.5 months (younger than 34 years old subgroup) to 61.8 months for patients at age of 34 to 60, with one or two organ sites involved, and non-adenocarcinoma histology subsets.
  • [MeSH-major] Adenocarcinoma / secondary. Bone Neoplasms / secondary. Neoplasms, Unknown Primary / classification

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  • (PMID = 21122385.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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40. Yakushiji S, Ando M, Yonemori K, Kohno T, Shimizu C, Katsumata N, Fujiwara Y: Cancer of unknown primary site: review of consecutive cases at the National Cancer Center Hospital of Japan. Int J Clin Oncol; 2006 Dec;11(6):421-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cancer of unknown primary site: review of consecutive cases at the National Cancer Center Hospital of Japan.
  • BACKGROUND: Cancer of unknown primary (CUP) is not a rare clinical entity, accounting for 3%-5% of all solid malignancies.
  • METHODS: We retrospectively reviewed 86 (38 male/48 female) patients with a diagnosis of CUP (exclusive of female patients with adenocarcinoma involving the axillary lymph nodes alone and patients with squamous cell carcinoma of the cervical lymph nodes) who were referred to the National Cancer Center Hospital between April 1996 and October 2002.
  • The histological diagnosis was adenocarcinoma in 61 patients (71%), poorly differentiated carcinoma in 18 patients (21%), and squamous cell carcinoma in 4 patients (5%).
  • Twenty-three female patients had peritoneal carcinomatosis of adenocarcinoma.
  • Sixty-one of the 86 patients (71%) were categorized as a subgroup of CUP without a specific therapy, and 55 of these 61 patients (90%) received platinum-containing regimens.
  • CONCLUSION: In this series, the survival of the patients in the CUP subgroup without a specific therapy did not seem worse than that in previous reports.
  • Empirical chemotherapy with platinum-containing regimens may benefit some CUP patients in a subgroup without a specific chemotherapy.
  • [MeSH-major] Adenocarcinoma / secondary. Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary / pathology

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  • (PMID = 17180509.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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41. Lazaridis G, Pentheroudakis G, Fountzilas G, Pavlidis N: Liver metastases from cancer of unknown primary (CUPL): a retrospective analysis of presentation, management and prognosis in 49 patients and systematic review of the literature. Cancer Treat Rev; 2008 Dec;34(8):693-700
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Liver metastases from cancer of unknown primary (CUPL): a retrospective analysis of presentation, management and prognosis in 49 patients and systematic review of the literature.
  • AIM: Patients with liver metastases from cancer of unknown primary (CUPL) have a dismal prognosis.
  • The commonest histologic subtypes encountered were adenocarcinoma (N=34) or undifferentiated carcinoma (N=12).
  • CONCLUSIONS: Patients with liver metastases from CUP are resistant to conventional types of treatment and carry a poor prognosis.
  • Understanding the molecular biology of CUP is essential for the development of new, targeted effective therapies.
  • [MeSH-major] Adenocarcinoma / secondary. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma / secondary. Liver Neoplasms / secondary. Neoplasms, Unknown Primary / pathology

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  • (PMID = 18584969.001).
  • [ISSN] 1532-1967
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 22
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42. Pimiento JM, Teso D, Malkan A, Dudrick SJ, Palesty JA: Cancer of unknown primary origin: a decade of experience in a community-based hospital. Am J Surg; 2007 Dec;194(6):833-7; discussion 837-8
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  • [Title] Cancer of unknown primary origin: a decade of experience in a community-based hospital.
  • BACKGROUND: Cancer of unknown primary (CUP) origin is a very aggressive disease with a poor prognosis.
  • Most of the literature reports of CUP are generated from tertiary cancer centers.
  • METHODS: A retrospective chart review of all patients with a diagnosis of CUP was performed between January 1995 and January 2005.
  • The pathologic diagnoses included adenocarcinoma (42.8%), undifferentiated carcinoma (34.5%), squamous cell carcinoma (9.8%), neuroendocrine cancer (6.5%), sarcoma (3.2%), and nonspecific malignant neoplasm (3.2%).
  • CONCLUSIONS: CUP encompasses a variety of different pathologic entities with an overall dismal 5-year survival.
  • Nonetheless, squamous cell and neuroendocrine CUP are associated with a significantly better early prognosis than the other malignancies.
  • [MeSH-major] Neoplasms, Unknown Primary / epidemiology
  • [MeSH-minor] Adenocarcinoma / secondary. Adult. Aged. Aged, 80 and over. Brain Neoplasms / secondary. Carcinoma / secondary. Carcinoma, Neuroendocrine / mortality. Carcinoma, Neuroendocrine / secondary. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / therapy. Female. Head and Neck Neoplasms / secondary. Hospitals, Community. Hospitals, Teaching. Humans. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Male. Middle Aged. Prognosis. Retrospective Studies

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  • (PMID = 18005780.001).
  • [ISSN] 1879-1883
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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43. Yonemori K, Ando M, Shibata T, Katsumata N, Matsumoto K, Yamanaka Y, Kouno T, Shimizu C, Fujiwara Y: Tumor-marker analysis and verification of prognostic models in patients with cancer of unknown primary, receiving platinum-based combination chemotherapy. J Cancer Res Clin Oncol; 2006 Oct;132(10):635-42
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  • [Title] Tumor-marker analysis and verification of prognostic models in patients with cancer of unknown primary, receiving platinum-based combination chemotherapy.
  • OBJECTIVES: To evaluate the usefulness of tumor-marker measurements and to identify prognostic factors in patients with cancer of unknown primary (CUP), receiving platinum-based combination chemotherapy and to verify the adjustment of previously reported prognostic models in this population.
  • METHODS: We conducted univariate and multivariate analyses in consecutive patients with CUP receiving platinum-based combination chemotherapy.
  • The ST-439 level was significantly higher in patients with histologically confirmed adenocarcinoma than in patients with poorly differentiated adenocarcinoma or poorly differentiated carcinoma.
  • CONCLUSION: Tumor-marker measurements are not helpful in the management of patients with CUP.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Carboplatin / therapeutic use. Cisplatin / therapeutic use. Neoplasms, Unknown Primary / drug therapy

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  • (PMID = 16791594.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; BG3F62OND5 / Carboplatin; EC 1.1.1.27 / L-Lactate Dehydrogenase; Q20Q21Q62J / Cisplatin
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44. Schuette K, Folprecht G, Kretzschmar A, Link H, Koehne CH, Gruenwald V, Stahl M, Huebner G: Phase II trial of capecitabine and oxaliplatin in patients with adeno- and undifferentiated carcinoma of unknown primary. Onkologie; 2009 Apr;32(4):162-6
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  • [Title] Phase II trial of capecitabine and oxaliplatin in patients with adeno- and undifferentiated carcinoma of unknown primary.
  • BACKGROUND: Carcinomas of unknown primary (CUP) account for approximately 2-5% of all cancer diagnoses.
  • We performed a phase II study with oxaliplatin (OX) and capecitabine (CAP) as first-line treatment for patients with histo-or cytologically proven adeno- or undifferentiated CUP.
  • The primary endpoint was the response rate (RR).
  • RESULTS: 51 patients with CUP (71% with poorly differentiated adenocarcinoma; 41% ECOG performance status (PS) 0, 39% PS 1, 10% PS 2, 55% with elevated lactate dehydrogenase (LDH), and 39% with liver metastases) were enrolled in this study.
  • CONCLUSION: CAP/OX did not reach higher RR compared to a standard regimen with paclitaxel/carboplatin, which discourages further investigation of this schedule in CUP.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / secondary. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Deoxycytidine / analogs & derivatives. Fluorouracil / analogs & derivatives. Neoplasms, Unknown Primary / drug therapy. Organoplatinum Compounds / administration & dosage

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • [CommentIn] Onkologie. 2009 Apr;32(4):159-60 [19372709.001]
  • (PMID = 19372710.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil
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45. Jariengprasert C, Laothamatas J, Janwityanujit T, Phudhichareonrat S: Bilateral sudden sensorineural hearing loss as a presentation of metastatic adenocarcinoma of unknown primary mimicking cerebellopontine angle tumor on the magnetic resonance image. Am J Otolaryngol; 2006 Mar-Apr;27(2):143-5
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  • [Title] Bilateral sudden sensorineural hearing loss as a presentation of metastatic adenocarcinoma of unknown primary mimicking cerebellopontine angle tumor on the magnetic resonance image.
  • Surgical biopsy and histopathologic finding identified masses secondary to direct invasion of adenocarcinoma of gastrointestinal origin.
  • Many investigations could not discover the primary site of the metastatic adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / diagnosis. Cerebellar Neoplasms / diagnosis. Cerebellopontine Angle / pathology. Hearing Loss, Sensorineural / diagnosis. Magnetic Resonance Imaging
  • [MeSH-minor] Diagnosis, Differential. Fatal Outcome. Female. Humans. Middle Aged. Neoplasms, Unknown Primary

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  • (PMID = 16500481.001).
  • [ISSN] 0196-0709
  • [Journal-full-title] American journal of otolaryngology
  • [ISO-abbreviation] Am J Otolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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46. Pentheroudakis G, Briasoulis E, Karavassilis V, Fountzilas G, Xeros N, Samelis G, Samantas E, Pavlidis N: Chemotherapy for patients with two favourable subsets of unknown primary carcinoma: active, but how effective? Acta Oncol; 2005;44(2):155-60

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy for patients with two favourable subsets of unknown primary carcinoma: active, but how effective?
  • Carcinoma of unknown primary (CUP) is characterized by dismal patient survival.
  • The outcome of patients with two favourable risk CUP subsets was studied.
  • The majority had poorly differentiated adenocarcinoma or undifferentiated carcinoma, treated with platinum-taxane based chemotherapy from 1996 till 2002.
  • Modern combination chemotherapy has satisfactory activity, with a minority of CUP patients enjoying long-term responses.
  • [MeSH-major] Adenocarcinoma / drug therapy. Carcinoma / drug therapy. Neoplasms, Unknown Primary / drug therapy. Peritoneal Neoplasms / drug therapy

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  • (PMID = 15788295.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Bridged Compounds; 0 / Taxoids; 1605-68-1 / taxane
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47. Friberg E, Orsini N, Mantzoros CS, Wolk A: Coffee drinking and risk of endometrial cancer--a population-based cohort study. Int J Cancer; 2009 Nov 15;125(10):2413-7
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  • During 17.6 years of follow-up, 677 participants were diagnosed with incident endometrial cancer (adenocarcinoma).
  • Each additional cup (200 g) of coffee per day was associated with a rate ratio (RR) of 0.90 [95% confidence interval (CI), 0.83-0.97].
  • In women drinking 4 or more cups of coffee a day, the RR for the risk reduction of endometrial cancer was 0.75 (95% CI, 0.58-0.97) when compared with those who drank 1 cup or less.
  • The association seemed largely confined to overweight and obese women, who showed a respective risk reduction of 12% (95% CI, 0-23%) and 20% (95% CI, 7-31%) for every cup of coffee, but was not observed among normal-weight women.

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  • (PMID = 19585497.001).
  • [ISSN] 1097-0215
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] ENG
  • [Grant] United States / NIDDK NIH HHS / DK / R01 DK058785; United States / NIDDK NIH HHS / DK / R01 DK058845; United States / NIDDK NIH HHS / DK / R56 DK058785; United States / NIDDK NIH HHS / DK / K24 DK081913; United States / NIDDK NIH HHS / DK / DK58845; United States / NIDDK NIH HHS / DK / DK 081913; United States / NIDDK NIH HHS / DK / DK58785; United States / NIDDK NIH HHS / DK / DK79929; United States / NIDDK NIH HHS / DK / R01 DK058785-07; United States / NIDDK NIH HHS / DK / R01 DK079929; United States / NIDDK NIH HHS / DK / DK058785-07
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Coffee
  • [Other-IDs] NLM/ NIHMS143562; NLM/ PMC2773380
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48. Kolesnikov-Gauthier H, Levy E, Merlet P, Kirova J, Syrota A, Carpentier P, Meignan M, Piedbois P: FDG PET in patients with cancer of an unknown primary. Nucl Med Commun; 2005 Dec;26(12):1059-66

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] FDG PET in patients with cancer of an unknown primary.
  • BACKGROUND: This prospective study was undertaken to address the capacity of positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) to determine the primary tumour site of carcinomas with unknown primary site.
  • PATIENTS AND METHODS: Twenty-five patients with metastases from adenocarcinoma or undifferentiated carcinoma of unknown primary site (CUP) were included prospectively.
  • For all patients, extensive imaging was unsuccessful in localizing the primary site.
  • All hot spots that could not be attributed to a metastatic site were considered as the primary tumour.
  • In six patients, FDG PET showed a primary tumour site which was confirmed by follow-up or surgery.
  • In five patients, the primary tumour site was suggested by FDG PET but not confirmed by clinical outcome.
  • No primary tumour was found in the other patients, with a mean follow-up of 15 months.
  • CONCLUSION: In our series, FDG PET allowed the identification of primary tumour site in one quarter of patients with CUP (6/24).
  • [MeSH-major] Fluorodeoxyglucose F18. Neoplasms / diagnosis. Neoplasms / radionuclide imaging. Neoplasms, Unknown Primary / diagnosis. Positron-Emission Tomography / methods
  • [MeSH-minor] Adenocarcinoma / pathology. Adult. Aged. False Positive Reactions. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Prospective Studies. Time Factors. Tomography, X-Ray Computed. Treatment Outcome. Whole-Body Counting

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  • (PMID = 16264351.001).
  • [ISSN] 0143-3636
  • [Journal-full-title] Nuclear medicine communications
  • [ISO-abbreviation] Nucl Med Commun
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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49. Hill HC: Challenges of utilizing immunostains to facilitate the diagnosis and management of metastatic adenocarcinoma. J Natl Med Assoc; 2008 Dec;100(12):1469-73
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  • [Title] Challenges of utilizing immunostains to facilitate the diagnosis and management of metastatic adenocarcinoma.
  • Women presenting with metastases from an unknown primary site represent a growing diagnostic challenge.
  • Treatment is based upon the results of several diagnostic radiographic modalities that may locate the occult primary and determine the extent of metastatic tumor burden.
  • Immunostaining represents another modality that can be used to facilitate identification and management of occult primary carcinoma.
  • We describe metastatic adenocarcinoma of unknown primary presenting as a pericardial effusion and coincident supraclavicular adenopathy.
  • Although immunohistochemical staining initially suggested metastatic breast carcinoma, her clinical course confirmed a lung primary.
  • [MeSH-major] Adenocarcinoma / secondary. Lung Neoplasms / diagnosis. Lung Neoplasms / pathology. Neoplasms, Unknown Primary / diagnosis

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  • [CommentIn] J Natl Med Assoc. 2009 May;101(5):478 [19476202.001]
  • (PMID = 19110917.001).
  • [ISSN] 1943-4693
  • [Journal-full-title] Journal of the National Medical Association
  • [ISO-abbreviation] J Natl Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q1J152VB1P / Bromhexine
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50. Pentheroudakis G, Golfinopoulos V, Pavlidis N: Switching benchmarks in cancer of unknown primary: from autopsy to microarray. Eur J Cancer; 2007 Sep;43(14):2026-36
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  • [Title] Switching benchmarks in cancer of unknown primary: from autopsy to microarray.
  • INTRODUCTION: Cancer of unknown primary (CUP) is associated with unknown biology and dismal prognosis.
  • Information on the primary site of origin is scant and has never been analysed.
  • We systematically reviewed all published evidence on the CUP primary site identified by two different approaches, either autopsy or microarray gene expression profiling.
  • METHODS: Published reports on identification of CUP primary site by autopsy or microarray-based multigene expression platforms were retrieved and analysed for year of publication, primary site, patient age, gender, histology, rate of primary identification, manifestations and metastatic deposits, microarray chip technology, training and validation sets, mathematical modelling, classification accuracy and number of classifying genes.
  • RESULTS: From 1944 to 2000, a total of 884 CUP patients (66% males) underwent autopsy in 12 studies after presenting with metastatic or systemic symptoms and succumbing to their disease.
  • A primary was identified in 644 (73%) of them, mostly in the lung (27%), pancreas (24%), hepatobiliary tree (8%), kidneys (8%), bowel, genital system and stomach, as a small focus of adenocarcinoma or poorly differentiated carcinoma.
  • Four studies using microarray technology profiled more than 500 CUP cases using classifier set of genes (ranging from 10 to 495) and reported strikingly dissimilar frequencies of assigned primary sites (lung 11.5%, pancreas 12.5%, bowel 12%, breast 15%, hepatobiliary tree 8%, kidneys 6%, genital system 9%, bladder 5%) in 75-90% of the cases.
  • CONCLUSIONS: Evolution in medical imaging technology, diet and lifestyle habits probably account for changing epidemiology of CUP primaries in autopsies.
  • Discrepant assignment of primary sites by microarrays may be due to the presence of 'sanctuary sites' in autopsies, molecular misclassification and the postulated presence of a pro-metastatic genetic signature.
  • In view of the absence of patient therapeutic or prognostic benefit with primary identification, gene expression profiling should be re-orientated towards unraveling the complex pathophysiology of metastases.
  • [MeSH-major] Microarray Analysis / methods. Neoplasms, Unknown Primary / diagnosis

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  • (PMID = 17698346.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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51. Centeno BA: Pathology of liver metastases. Cancer Control; 2006 Jan;13(1):13-26
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  • BACKGROUND: The liver is the most frequent site of metastatic disease, and metastatic disease to the liver is far more common than primary liver carcinoma in the United States.
  • Subclassification of carcinoma of unknown primary remains problematic.
  • Adenocarcinoma of unknown primary remains enigmatic since current immunohistochemical markers for this differential diagnosis lack specificity.
  • However, subtyping of some carcinomas and identification of site of unknown primary remains problematic.

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  • (PMID = 16508622.001).
  • [ISSN] 1073-2748
  • [Journal-full-title] Cancer control : journal of the Moffitt Cancer Center
  • [ISO-abbreviation] Cancer Control
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 101
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52. Pejcić I, Vrbić S, Filipović S, Sćekić M, Petković I, Pejcić L, Djenić N: [Significance of serum tumor markers monitoring metastases in carcinomas of unknown primary site]. Vojnosanit Pregl; 2010 Sep;67(9):723-31
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  • [Title] [Significance of serum tumor markers monitoring metastases in carcinomas of unknown primary site].
  • BACKGROUND/AIM: Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis.
  • Cancer of unknown primary site (CUP) is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies.
  • On histological examination, all the patients were presented with metastatic tumors whose primary site (origin) could not be detected with noninvasive diagnostic techniques.
  • Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma--8 patients; adenocarcinoma--33 patients; unclassifiable (undifferentiated) carcinoma--22 patients.
  • CONCLUSION: Increased values of serum tumor markers are very often in CUP.
  • [MeSH-major] Adenocarcinoma / secondary. Biomarkers, Tumor / blood. Carcinoma / secondary. Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary / pathology


53. Schneider BJ, El-Rayes B, Muler JH, Philip PA, Kalemkerian GP, Griffith KA, Zalupski MM: Phase II trial of carboplatin, gemcitabine, and capecitabine in patients with carcinoma of unknown primary site. Cancer; 2007 Aug 15;110(4):770-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II trial of carboplatin, gemcitabine, and capecitabine in patients with carcinoma of unknown primary site.
  • BACKGROUND: The purposes of this study were to evaluate efficacy and toxicity of the combination of carboplatin, gemcitabine, and capecitabine in patients with carcinoma of unknown primary site (CUP).
  • METHODS: Patients with CUP received carboplatin AUC 5 mg/mL a minute intravenously Day 1, gemcitabine 1000 mg/m(2) intravenously Days 1 and 8, and capecitabine 1600 mg/m(2) orally in divided doses, Days 1-14 of a 21-day cycle for up to 8 cycles.
  • The primary endpoint of the study was objective response rate by intent-to-treat analysis.
  • The objective response rate was 39.4% (95% CI, 22.9%-57.9%) in all patients, 36.4% in 22 patients with well to moderately differentiated adenocarcinoma, and 40.0% in 20 patients with liver metastases.
  • CONCLUSIONS: The combination of carboplatin, gemcitabine, and capecitabine is active in CUP, especially in patients with liver metastases.
  • This regimen may be a potential therapy for CUP patients with good performance status, particularly those with a suspected origin below the diaphragm.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Unknown Primary / drug therapy

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  • (PMID = 17594717.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Carcinoembryonic Antigen; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; B76N6SBZ8R / gemcitabine; BG3F62OND5 / Carboplatin; U3P01618RT / Fluorouracil
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54. Kubisch CH, Beigel F, Ihrler S, Goke B, Reiser MF, Hoffmann RT: Oesophageal ulceration after selective internal radiation therapy in a patient with carcinoma of unknown primary. Z Gastroenterol; 2010 May;48(5):546-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oesophageal ulceration after selective internal radiation therapy in a patient with carcinoma of unknown primary.
  • BACKGROUND: Cancer of unknown primary (CUP) is defined as histologically confirmed metastases in the absence of an identifiable primary tumor.
  • CASE: We present a patient with hepatic CUP.
  • CONCLUSIONS: SIRT is a new, effective treatment in patients with hepatic CUP.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Brachytherapy / adverse effects. Duodenal Ulcer / pathology. Embolization, Therapeutic. Esophageal Diseases / pathology. Esophagus / radiation effects. Liver Neoplasms / radiotherapy. Liver Neoplasms / secondary. Neoplasms, Unknown Primary / radiotherapy. Radiation Injuries / pathology. Stomach Ulcer / pathology. Ulcer / pathology

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  • (PMID = 20449787.001).
  • [ISSN] 1439-7803
  • [Journal-full-title] Zeitschrift für Gastroenterologie
  • [ISO-abbreviation] Z Gastroenterol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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55. Shibata H: [Treatment of cancer of unknown primary, today and future]. Gan To Kagaku Ryoho; 2009 Jun;36(6):918-22

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Treatment of cancer of unknown primary, today and future].
  • Cancer of unknown primary(CUP)is a malignant disease with metastases such as lymph nodes, lung or liver metastasis, and without an identified primary site.
  • CUP constitutes 5% of all human malignant diseases.
  • Chemotherapy based on the primary site is not applicable for the treatment of CUP.
  • It is very difficult to apply any regimens without information on the primary sites.
  • To resolve this problem, molecular diagnostic technologies using a gene expression profiling platform to identify the primary site of CUP are now applied.
  • Primary site-dependent chemotherapy could be conducted in accordance with the result of the molecular diagnosis of the primary site.
  • Identification of the underlying mechanism that is specific to the unfavorable CUP may be a clue to develop a novel treatment for CUP.
  • [MeSH-major] Neoplasms, Unknown Primary / drug therapy
  • [MeSH-minor] Adenocarcinoma / diagnosis. Carcinoma, Squamous Cell / diagnosis. Female. Gene Expression Profiling. Humans. Lymphatic Metastasis. Male. Prognosis

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  • (PMID = 19542712.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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56. Shinoda M, Hatano S, Kawakubo H, Kakefuda T, Omori T, Ishii S: Adult cecoanal intussusception caused by cecum cancer: report of a case. Surg Today; 2007;37(9):802-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We manually pushed the mass back into the rectum and performed a gastrograffin enema, which showed a cup-shaped filling defect in the rectum.
  • The pathological finding was submucosal adenocarcinoma in adenoma.

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  • [Cites] Dis Colon Rectum. 1988 Aug;31(8):629-31 [3402288.001]
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  • (PMID = 17713738.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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57. Sève P, Mackey J, Sawyer M, Lesimple T, de La Fouchardière C, Broussolle C, Dumontet C, Ray-Coquard I: Impact of clinical practice guidelines on the management for carcinomas of unknown primary site: a controlled "before-after" study. Bull Cancer; 2009 Apr;96(4):E7-17
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of clinical practice guidelines on the management for carcinomas of unknown primary site: a controlled "before-after" study.
  • BACKGROUND: In 2002, the French Federation of Comprehensive Cancer Centers published clinical practice guidelines (CPGs) for the management of carcinomas of unknown primary (CUP).
  • METHODS: A controlled "before-after" study at two centers (experimental in Lyon, France and control in Edmonton, Canada) to assess the impact of CPGs on CUP management.
  • Fifty-CUP patients treated in 2000-2001, i.e. before CPG publication, and 50 patients treated in 2003-2004, were analyzed for both centers.
  • Non-adenocarcinoma histology and performance status (PS) < 2 were independent factors for CPGs compliance.
  • CONCLUSIONS: Our study show that simply distributing CUP CPGs did not change practice and underline the necessity to disseminate and implement CPGs, both to oncologists and organ-specialist physicians.
  • [MeSH-major] Guideline Adherence. Neoplasms, Unknown Primary / diagnosis. Practice Guidelines as Topic

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  • (PMID = 19435692.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Multicenter Study
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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58. Karavasilis V, Malamou-Mitsi V, Briasoulis E, Tsanou E, Kitsou E, Kalofonos H, Fountzilas G, Fotsis T, Pavlidis N: Matrix metalloproteinases in carcinoma of unknown primary. Cancer; 2005 Nov 15;104(10):2282-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Matrix metalloproteinases in carcinoma of unknown primary.
  • BACKGROUND: The purpose was to study proteolysis-related molecules, matrix metalloproteinase-2 (MMP-2) and MMP-9 and tissue inhibitor of metalloproteinases-1 (TIMP-1), in carcinoma of unknown primary (CUP).
  • METHODS: Paraffin-embedded tumor material from 75 patients diagnosed with CUP was used.
  • Tumor histologies were adenocarcinoma (77%), undifferentiated carcinoma (19%), and squamous cell carcinoma (4%) and patients were categorized into favorable (62%) and unfavorable (38%) subsets.
  • CONCLUSIONS: MMP-2, MMP-9, and TIMP-1 are widely expressed in CUP, suggesting an essential role of proteolysis in these tumors.
  • TIMP-1 may be considered a possible marker of poor prognosis in CUP patients.
  • [MeSH-major] Carcinoma / enzymology. Carcinoma / secondary. Matrix Metalloproteinases / metabolism. Neoplasms, Unknown Primary / enzymology

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  • [Copyright] Copyright 2005 American Cancer Society
  • (PMID = 16220559.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tissue Inhibitor of Metalloproteinases; EC 3.4.24.- / Matrix Metalloproteinases
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59. Karavasilis V, Malamou-Mitsi V, Briasoulis E, Tsanou E, Kitsou E, Kalofonos H, Fountzilas G, Fotsis T, Pavlidis N: Angiogenesis in cancer of unknown primary: clinicopathological study of CD34, VEGF and TSP-1. BMC Cancer; 2005 Mar 3;5:25
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  • [Title] Angiogenesis in cancer of unknown primary: clinicopathological study of CD34, VEGF and TSP-1.
  • BACKGROUND: Cancer of unknown primary remains a mallignancy of elusive biology and grim prognosis that lacks effective therapeutic options.
  • We investigated angiogenesis in cancer of unknown primary to expand our knowledge on the biology of these tumors and identify potential therapeutic targets.
  • METHODS: Paraffin embedded archival material from 81 patients diagnosed with CUP was used.
  • Tumor histology was adenocarcinoma (77%), undifferentiated carcinoma (18%) and squamous cell carcinoma (5%).
  • CONCLUSION: Angiogenesis is very active and expression of VEGF is almost universal in cancers of unknown primary.
  • [MeSH-major] Antigens, CD34 / analysis. Biomarkers, Tumor / analysis. Brain Neoplasms / chemistry. Neoplasms, Unknown Primary / chemistry. Thrombospondin 1 / analysis. Vascular Endothelial Growth Factor A / analysis
  • [MeSH-minor] Adenocarcinoma / blood supply. Adenocarcinoma / chemistry. Adenocarcinoma / pathology. Adult. Aged. Aged, 80 and over. Carcinoma / blood supply. Carcinoma / chemistry. Carcinoma / pathology. Female. Humans. Male. Middle Aged. Neovascularization, Pathologic

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  • (PMID = 15743540.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, CD34; 0 / Biomarkers, Tumor; 0 / Thrombospondin 1; 0 / VEGFA protein, human; 0 / Vascular Endothelial Growth Factor A
  • [Other-IDs] NLM/ PMC555600
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60. Randén M, Rutqvist LE, Johansson H: Cancer patients without a known primary: incidence and survival trends in Sweden 1960-2007. Acta Oncol; 2009;48(6):915-20

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cancer patients without a known primary: incidence and survival trends in Sweden 1960-2007.
  • BACKGROUND: Metastatic cancer from an unknown primary tumour (CUP) is a common and heterogeneous clinical entity.
  • MATERIAL AND METHODS: Data on CUP cases reported to the Swedish Cancer Registry during 1960 through 2007 was used to assess time trends for incidence, survival, and histological tumour type.
  • The increase of CUP mainly concerned patients aged above 50 years, and tumours classified as adenocarcinomas.
  • The relative survival at 12 months after a diagnosis of CUP was estimated at 20%.
  • However, after 12 months the relative survival levelled of and the 5-year estimate was 10-15% which suggests that a small proportion of CUP cases may be cured.
  • DISCUSSION: Cases diagnosed as CUP includes patients with metastatic spread from a wide variety of tumours although certain tumour types probably are overrepresented, for example, cancers in sites that are difficult to examine clinically.
  • The decreased incidence observed during the last decade might thus be explained in terms of a combination of improved diagnostic methods to detect primary tumours and decreasing incidence for e.g. pancreatic cancer and lung cancer among males.
  • There is a need of evidence-based programs that define the continuum of care for CUP patients.
  • [MeSH-major] Adenocarcinoma / mortality. Neoplasms, Unknown Primary / mortality

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  • (PMID = 19363713.001).
  • [ISSN] 1651-226X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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61. Briasoulis E, Fountzilas G, Bamias A, Dimopoulos MA, Xiros N, Aravantinos G, Samantas E, Kalofonos H, Makatsoris T, Mylonakis N, Papakostas P, Skarlos D, Varthalitis I, Pavlidis N: Multicenter phase-II trial of irinotecan plus oxaliplatin [IROX regimen] in patients with poor-prognosis cancer of unknown primary: a hellenic cooperative oncology group study. Cancer Chemother Pharmacol; 2008 Jul;62(2):277-84

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multicenter phase-II trial of irinotecan plus oxaliplatin [IROX regimen] in patients with poor-prognosis cancer of unknown primary: a hellenic cooperative oncology group study.
  • BACKGROUND: Cancer of unknown primary (CUP) lacks established therapy although it affects 3% of cancer patients.
  • We evaluated the irinotecan-oxaliplatin combination (IROX regimen) in previously untreated patients with non-favorable subsets of unknown primary carcinomas.
  • The primary end points were response rate and toxicity, and secondary end points were time to progression and survival.
  • CONCLUSIONS: The IROX regimen demonstrated similar efficacy and a favorable toxicity profile compared to other more toxic chemotherapy combinations in patients with poor-prognosis CUP.
  • [MeSH-major] Adenocarcinoma. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Unknown Primary / drug therapy

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  • (PMID = 17901952.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin; IROX protocol
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62. Morawietz L, Floore A, Stork-Sloots L, Folprecht G, Buettner R, Rieger A, Dietel M, Huebner G: [Comparing immunohistochemical diagnosis of cancer of unknown primary with gene expression-based tumor classification]. Pathologe; 2009 Dec;30 Suppl 2:168-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Comparing immunohistochemical diagnosis of cancer of unknown primary with gene expression-based tumor classification].
  • If the primary tumor cannot be identified after diagnostic workup, the disease is referred to as cancer of unknown primary (CUP) and is classified as C80.9 according to ICD-10.
  • In Germany, CUP is among the ten most common causes of tumor-related death, with mortality similar to mortality in gastric or pancreatic cancer.
  • Gene expression profiling (GEP) is a new diagnostic technique that might further contribute to tumor specification.In a retrospective study, 43 CUP cases underwent central immunohistochemical review and centrally performed GEP using a classifier based on 495 genes.
  • In four cases, the combination of methods led to an unequivocal identification of the primary tumor.In conclusion, we regard detailed IHC workup and complementary GEP advisable for the purposes of targeted therapy, as well as to identify or exclude specific tumors in a CUP situation.
  • [MeSH-major] Adenocarcinoma / genetics. Adenocarcinoma / pathology. Adenocarcinoma / secondary. Biomarkers, Tumor / analysis. Biomarkers, Tumor / genetics. Carcinoma / genetics. Carcinoma / pathology. Carcinoma / secondary. Gene Expression Profiling. Gene Expression Regulation, Neoplastic / genetics. Immunohistochemistry / methods. Neoplasms, Unknown Primary / genetics. Neoplasms, Unknown Primary / pathology

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  • (PMID = 19756615.001).
  • [ISSN] 1432-1963
  • [Journal-full-title] Der Pathologe
  • [ISO-abbreviation] Pathologe
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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63. Shaw PH, Adams R, Jordan C, Crosby TD: A clinical review of the investigation and management of carcinoma of unknown primary in a single cancer network. Clin Oncol (R Coll Radiol); 2007 Feb;19(1):87-95
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A clinical review of the investigation and management of carcinoma of unknown primary in a single cancer network.
  • AIMS: Carcinoma of unknown primary (CUP) is a common encounter in oncological practice and represents 2.0-6.0% of all invasive malignancies.
  • Evidence to support particular therapeutic strategies in this patient population is scarce, and empirical therapies are frequently derived from research on patients where the primary tumour site is known.
  • MATERIALS AND METHODS: This retrospective study reviewed the management of all patients recorded to have a diagnosis of CUP in a single cancer centre over a period of 12 months.
  • Health records were reviewed documenting the CUP subtype, the investigations carried out both in the referring cancer unit and subsequently at the cancer centre and the recommended treatment (type and regimen), together with survival.
  • RESULTS: One hundred and sixty-six patients were recorded to have a diagnosis of CUP, representing 3.7% of all referrals to the cancer centre.
  • The three most common CUP subgroups were CUP-liver/multiple sites (25.0%), CUP-bone (21.0%) and CUP-brain (16.0%).
  • Even within a single subtype, 41 patients with CUP-liver/multiple sites underwent a total of 19 different investigations before any treatment being given.
  • Nine different 5-fluorouracil-containing regimens were used in 11 patients treated with chemotherapy for CUP-liver.
  • CONCLUSIONS: The appropriate management of patients with CUP is unclear and this study revealed a high degree of variation in clinical practice.
  • This area is in urgent need of clinical research to ensure that the treatment of CUP is evidence based.
  • Therapeutic progress will be facilitated by designating a clinical lead for CUP in each clinical network.
  • [MeSH-major] Adenocarcinoma / secondary. Bone Neoplasms / secondary. Brain Neoplasms / secondary. Liver Neoplasms / secondary. Neoplasms, Unknown Primary / therapy

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  • (PMID = 17305260.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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64. Lequin D, Fizazi K, Toujani S, Souquère S, Mathieu MC, Hainaut P, Bernheim A, Praz F, Busson P: Biological characterization of two xenografts derived from human CUPs (carcinomas of unknown primary). BMC Cancer; 2007;7:225
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Biological characterization of two xenografts derived from human CUPs (carcinomas of unknown primary).
  • BACKGROUND: Carcinomas of unknown primary site (CUP) are epithelial malignancies revealed by metastatic lesions in the absence of any detectable primary tumor.
  • METHODS: We attempted xenografts of CUP clinical specimens in immunodeficient mice and subsequent in vitro culture of transplanted malignant cells.
  • Distinct rare missense mutations of the TP53 gene were detected in Capi1 (codon 312) and Capi3 (codon 181); the codon 181 mutation is consistent with a previously reported similar finding in a small series of CUP specimens.
  • CONCLUSION: Our data suggest that xenografted tumors can be obtained from a substantial fraction of CUP clinical specimens.
  • [MeSH-major] Adenocarcinoma / genetics. Adenocarcinoma / secondary. Gene Expression Regulation, Neoplastic. Neoplasm Transplantation / pathology. Neoplasms, Unknown Primary / genetics. Neoplasms, Unknown Primary / pathology. Transplantation, Heterologous / pathology

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  • (PMID = 18088404.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
  • [Other-IDs] NLM/ PMC2241840
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65. Petrović D, Muzikravić L, Jovanović D: [Metastases of unknown origin--principles of diagnosis and treatment]. Med Pregl; 2007 Jan-Feb;60(1-2):29-36
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  • [Title] [Metastases of unknown origin--principles of diagnosis and treatment].
  • DEFINITION: Cancer of unknown primary (CUP) origin refers to patients who present with histologicaly confirmed metastatic cancer in whom a detailed medical history, complete physical examination, including pelvic and rectal examination, full blood count and biochemistry, urinalysis and stool occult blood testing, hisinpathological review oJ biopsy speimens with the use of immunohistochemistry, chest radiography, computed tomography of the abdomen and pelvis, and in certain cases mammography, fail to identify the primary site.
  • EPIDEMIOLOGY OF CUP: The cancer of unknown primary accounts for 3%-5% of all human cancers.
  • DIAGNOSIS OF CUP: The standard diagnostic procedure for the majority of patients includes histopathologic review of biopsy specimens with the use of immunoltistochemistry, chest radiography, computed tomography of the abdomen and pelvis, and in certain cases mamography, fail to identify the abdomen and pelvis.
  • The four common histologic diagnoses are: adenocarcinoma (70%), poorly differentiated carcinoma (20%), squamous carcinoma (10%), and poorly differentiated neoplasms (5%).
  • PROGNOSIS OF CUP: The prognosis for most patients with unknown primary tumors is poor, with survival often less than 6 months from diagnosis.
  • THERAPY OF CUP: Based on clinical and pathologic features, approximately 40% of patients can be categorized within subsets for which specific treatment has been defined.
  • CONCLUSION: Metastatic tumors of unknown origin have a unique clinical presentation due to a specific biology.
  • Insight into the molecular biology of unknown primary tumors will be essential for the development of more effective treatments.
  • [MeSH-major] Neoplasm Metastasis / diagnosis. Neoplasm Metastasis / therapy. Neoplasms, Unknown Primary / diagnosis

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  • (PMID = 17853708.001).
  • [ISSN] 0025-8105
  • [Journal-full-title] Medicinski pregled
  • [ISO-abbreviation] Med. Pregl.
  • [Language] srp
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Serbia and Montenegro
  • [Number-of-references] 41
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66. Dockery KF, Puri S, Qazi R, Davis D: FDG-PET on the trail of an unsuspected primary malignancy in the breast. Clin Nucl Med; 2008 Mar;33(3):175-80
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  • [Title] FDG-PET on the trail of an unsuspected primary malignancy in the breast.
  • Proper identification of the primary malignancy can radically alter clinical management for the patient's benefit.
  • This is a report of an unsuspected primary breast cancer in a patient being worked up for presumptive lymphoma.
  • Prior investigation of lymphedema in the left lower extremity found widespread lymphadenopathy on computed tomography imaging, leading to initial biopsy revealing adenocarcinoma of unknown primary.
  • F-18 fluorodeoxyglucose PET/computed tomography altered management by localizing an F-18 fluorodeoxyglucose avid breast nodule, directing breast biopsy with specific immunohistochemical analysis for breast cancer lineage in metastatic adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / radionuclide imaging. Breast Neoplasms / radiography. Fluorodeoxyglucose F18. Positron-Emission Tomography. Radiopharmaceuticals

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  • (PMID = 18287839.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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67. Soepenberg O, de Jonge MJ, Sparreboom A, de Bruin P, Eskens FA, de Heus G, Wanders J, Cheverton P, Ducharme MP, Verweij J: Phase I and pharmacokinetic study of DE-310 in patients with advanced solid tumors. Clin Cancer Res; 2005 Jan 15;11(2 Pt 1):703-11
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  • One patient with metastatic adenocarcinoma of unknown primary achieved a histologically proven complete remission.

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  • (PMID = 15701859.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / DE-310 cpd; 0 / Topoisomerase I Inhibitors; XT3Z54Z28A / Camptothecin
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68. Pouessel D, Thezenas S, Culine S, Becht C, Senesse P, Ychou M: Hepatic metastases from carcinomas of unknown primary site. Gastroenterol Clin Biol; 2005 Dec;29(12):1224-32
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  • [Title] Hepatic metastases from carcinomas of unknown primary site.
  • AIM: Hepatic metastases are often present at diagnosis of carcinoma of unknown primary site (CUP).
  • METHODS: One hundred and eighteen patients were treated at the Cancer Center of Montpellier from 1993 to 2002 for CUP initially metastatic to the liver.
  • RESULTS: The most frequent histological types observed were adenocarcinoma, undifferentiated, neuroendocrine and squamous-cell carcinomas.
  • CONCLUSIONS: According to this study, pretreatment evaluations, which were very extensive in some patients, were insufficient to identify the primary site of liver metastases.
  • [MeSH-major] Liver Neoplasms / mortality. Liver Neoplasms / secondary. Neoplasms, Unknown Primary / pathology

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  • (PMID = 16518276.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] EC 1.1.1.27 / L-Lactate Dehydrogenase
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69. Klosterman E, Colitz CM, Chandler HL, Kusewitt DF, Saville WJ, Dubielzig RR: Immunohistochemical properties of ocular adenomas, adenocarcinomas and medulloepitheliomas. Vet Ophthalmol; 2006 Nov-Dec;9(6):387-94
MedlinePlus Health Information. consumer health - Eye Cancer.

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  • Ocular medulloepitheliomas, adenomas and adenocarcinomas share a common phenotype and originate from the optic cup neuroectoderm.
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / immunology. Adenocarcinoma / veterinary. Adenoma / diagnosis. Adenoma / immunology. Adenoma / veterinary. Animals. Dogs. Female. Immunohistochemistry / veterinary. Male. Neuroectodermal Tumors, Primitive / diagnosis. Neuroectodermal Tumors, Primitive / immunology. Neuroectodermal Tumors, Primitive / veterinary. Predictive Value of Tests

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  • (PMID = 17076871.001).
  • [ISSN] 1463-5216
  • [Journal-full-title] Veterinary ophthalmology
  • [ISO-abbreviation] Vet Ophthalmol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies; 0 / Biomarkers, Tumor
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70. Mahmalji W, Mackenzie H, Chopada A, Raza A: A novel use for the rigid cystoscope: the removal of sacral tacks after a coloanal anastamosis dehiscence. Adv Urol; 2009;:978038

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  • She subsequently developed fresh rectal bleeding and after further investigations a Dukes B adenocarcinoma of the rectum was found.
  • The sacral tacks (pins) were removed by the urologist using a rigid cystoscope and cold cup biopsy forceps.

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  • [Cites] Int J Colorectal Dis. 2004 Nov;19(6):569-73 [15103489.001]
  • [Cites] Colorectal Dis. 2005 Jan;7(1):47-50 [15606584.001]
  • (PMID = 19197375.001).
  • [ISSN] 1687-6369
  • [Journal-full-title] Advances in urology
  • [ISO-abbreviation] Adv Urol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2633451
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71. Ren JS, Freedman ND, Kamangar F, Dawsey SM, Hollenbeck AR, Schatzkin A, Abnet CC: Tea, coffee, carbonated soft drinks and upper gastrointestinal tract cancer risk in a large United States prospective cohort study. Eur J Cancer; 2010 Jul;46(10):1873-81
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  • During 2,584,953 person-years of follow-up on 481,563 subjects, 392 oral cavity, 178 pharynx, 307 larynx, 231 gastric cardia, 224 gastric non-cardia cancer, 123 Oesophageal Squamous Cell Carcinoma (ESCC) and 305 Oesophageal Adenocarcinoma (EADC) cases were accrued.
  • Compared to non-drinking, the hazard ratio for hot tea intake of > or =1 cup/day was 0.37 (95% CI: 0.20, 0.70) for pharyngeal cancer.
  • The authors also observed a significant association between coffee drinking and risk of gastric cardia cancer (compared to <1 cup/day, the hazard ratio for drinking >3 cups/day was 1.57 (95% CI: 1.03, 2.39)), and an inverse association between coffee drinking and EADC for the cases occurring in the last 3 years of follow-up (compared to <1 cup/day, the hazard ratio for drinking >3 cups/day was 0.54 (95% CI: 0.31, 0.92)), but no association in earlier follow-up.

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  • [Copyright] Published by Elsevier Ltd.
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  • (PMID = 20395127.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z01 CP010196-02; United States / Intramural NIH HHS / / Z99 CA999999
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Intramural
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Coffee; 0 / Tea
  • [Other-IDs] NLM/ NIHMS192095; NLM/ PMC2891563
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72. Horlings HM, van Laar RK, Kerst JM, Helgason HH, Wesseling J, van der Hoeven JJ, Warmoes MO, Floore A, Witteveen A, Lahti-Domenici J, Glas AM, Van't Veer LJ, de Jong D: Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary. J Clin Oncol; 2008 Sep 20;26(27):4435-41
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  • [Title] Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary.
  • PURPOSE: Patients with adenocarcinoma of unknown primary origin (ACUP) constitute approximately 4% of all malignancies.
  • For effective treatment of these patients, it is considered optimal to identify the primary tumor origins.
  • PATIENTS AND METHODS: Formalin-fixed, paraffin-embedded (FFPE) samples were obtained from 84 patients with a known primary adenocarcinoma and from 38 patients with ACUP.
  • RESULTS: The gene expression-based assay classified the primary site correctly in 70 (83%) of 84 patient cases of primary and metastatic tumors of known origin, with good sensitivity for the majority of the tumor classes and relatively poor sensitivity for primary lung adenocarcinoma.
  • CONCLUSION: The gene expression platform can classify correctly from FFPE samples the majority of tumors classes both in patients with known primary and in patients with ACUP.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / secondary. Gene Expression Profiling. Neoplasms, Unknown Primary / diagnosis. Neoplasms, Unknown Primary / genetics

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  • [CommentIn] J Clin Oncol. 2009 Feb 1;27(4):649-50; author reply 650-2 [19114684.001]
  • [CommentIn] J Clin Oncol. 2008 Sep 20;26(27):4373-5 [18802148.001]
  • (PMID = 18802156.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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73. Verbruggen MB, Verheijen RH, van de Goot FR, van Beurden M, Dorsman JC, van Diest PJ: Serous borderline tumor of the ovary presenting with cervical lymph node involvement: a report of 3 cases. Am J Surg Pathol; 2006 Jun;30(6):739-43
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  • In all the 3 cases, fine needle aspiration cytology initially indicated metastatic adenocarcinoma.
  • The primary tumor was not immediately apparent, and multiple diagnostic examinations had to be done before the definitive diagnosis of serous BOT, International Federation of Gynecology and Obstetrics stage IV could be made.
  • When fine needle aspiration cytology of such a lymph node is compatible with adenocarcinoma of unknown primary, serous BOT should be included in the differential diagnosis and pelvic examination should be performed.
  • [MeSH-minor] Adenocarcinoma / pathology. Adult. Arm / pathology. Biopsy, Fine-Needle. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Inclusion Bodies / pathology. Thrombosis / etiology

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  • (PMID = 16723852.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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74. Hameed O, Humphrey PA: Immunohistochemistry in diagnostic surgical pathology of the prostate. Semin Diagn Pathol; 2005 Feb;22(1):88-104
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  • Alpha-methylacyl-coenzyme-A racemase (AMACR) is a sensitive marker of PC (except for a few uncommon variants: atrophic, foamy gland, and pseudohyperplastic variants), and its detection by immunohistochemical staining in atypical prostatic lesions can be very useful in confirming an impression of adenocarcinoma.
  • CDX2 and villin are useful markers to diagnostically separate colonic adenocarcinoma from PC.
  • PSA and PSAP immunohistochemical stains are valuable in confirming metastatic carcinoma as being of prostatic origin and should always be utilized in the diagnostic evaluation of metastatic adenocarcinoma of unknown primary origin in males.

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  • (PMID = 16512601.001).
  • [ISSN] 0740-2570
  • [Journal-full-title] Seminars in diagnostic pathology
  • [ISO-abbreviation] Semin Diagn Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 192
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75. Sato KT, Lewandowski RJ, Mulcahy MF, Atassi B, Ryu RK, Gates VL, Nemcek AA Jr, Barakat O, Benson A 3rd, Mandal R, Talamonti M, Wong CY, Miller FH, Newman SB, Shaw JM, Thurston KG, Omary RA, Salem R: Unresectable chemorefractory liver metastases: radioembolization with 90Y microspheres--safety, efficacy, and survival. Radiology; 2008 May;247(2):507-15
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  • Primary sites (origins) included colon, breast, neuroendocrine, pancreas, lung, cholangiocarcinoma, melanoma, renal, esophageal, ovary, adenocarcinoma of unknown primary, lymphoma, gastric, duodenal, bladder, angiosarcoma, squamous cell carcinoma, thyroid, adrenal, and parotid.

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  • [Copyright] (c) RSNA, 2008.
  • (PMID = 18349311.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00532740
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Yttrium Radioisotopes
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76. Collins KA, Presnell SE: Asphyxia by tracheobronchial thrombus. Am J Forensic Med Pathol; 2005 Dec;26(4):327-9
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  • We report the deaths of 2 individuals, a 43-year-old female and a 78-year-old female, both with adenocarcinoma.
  • Experiencing a decline in mental status, the 78-year-old had metastatic adenocarcinoma of unknown primary.
  • [MeSH-minor] Adenocarcinoma / secondary. Adult. Aged. Breast Neoplasms / complications. Carcinoma, Ductal, Breast / complications. Female. Forensic Medicine. Humans. Neoplasms, Unknown Primary / complications. Respiratory Distress Syndrome, Adult / etiology


77. Pittman KB, Olver IN, Koczwara B, Kotasek D, Patterson WK, Keefe DM, Karapetis CS, Parnis FX, Moldovan S, Yeend SJ, Price TJ, Adelaide Cancer Trials and Education Collaborative (ACTEC): Gemcitabine and carboplatin in carcinoma of unknown primary site: a phase 2 Adelaide Cancer Trials and Education Collaborative study. Br J Cancer; 2006 Nov 20;95(10):1309-13
Hazardous Substances Data Bank. CARBOPLATIN .

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  • [Title] Gemcitabine and carboplatin in carcinoma of unknown primary site: a phase 2 Adelaide Cancer Trials and Education Collaborative study.
  • Cancer of unknown primary site (CUP) represents up to 5% of all cancer diagnoses and is associated with poor survival.
  • We have performed a prospective multicentre phase 2 trial to evaluate efficacy and toxicity of the combination of gemcitabine (G) and carboplatin (C) for patients with CUP.
  • Patients with histologically confirmed metastatic carcinoma in which the primary site of cancer was not evident after prospectively designated investigation and who had ECOG performance status 0-2 were treated with G 1000 mg m(-2) intravenously (i.v.) days 1 and 8, and C AUC 5 i.v. on day 8 every 3 weeks to a maximum of nine cycles.
  • The primary end points were response rate, and toxicity, with secondary end points of progression-free survival and overall survival.
  • The GC regimen is an active regimen in CUP with excellent tolerability and should be considered particularly for elderly patients with CUP.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Unknown Primary / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / secondary. Adult. Aged. Aged, 80 and over. Australia. Carboplatin / administration & dosage. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / secondary. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Humans. Male. Maximum Tolerated Dose. Middle Aged. Prognosis. Prospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 17088914.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; BG3F62OND5 / Carboplatin
  • [Other-IDs] NLM/ PMC2360587
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78. Ghosh SB, Tempe A: Retroperitoneal adenocarcinoma of unknown origin presenting as a rare cause of obstructed labor. Arch Gynecol Obstet; 2009 Mar;279(3):427-9
MedlinePlus Health Information. consumer health - Tumors and Pregnancy.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Retroperitoneal adenocarcinoma of unknown origin presenting as a rare cause of obstructed labor.
  • BACKGROUND: Metastatic retroperitoneal adenocarcinoma presenting as obstructed labor is extremely rare.
  • A diagnosis of retroperitoneal adenocarcinoma with an unknown primary was made based on histopathology and a negative workup for the possible primary sites.
  • [MeSH-major] Adenocarcinoma / complications. Dystocia / etiology. Pregnancy Complications, Neoplastic / pathology. Retroperitoneal Neoplasms / complications

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  • (PMID = 18665376.001).
  • [ISSN] 1432-0711
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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79. Matsuura T, Sugihara K, Kohmura Y, Sugimura H, Kanayama N: Rare form of extraovarian peritoneal serous papillary carcinoma with solitary tumor in the abdominal wall: a case report and literature review. J Obstet Gynaecol Res; 2009 Dec;35(6):1142-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Cases of cancer presenting with microscopically confirmed metastatic malignancies for which no primary site can be detected are a challenge to stage clinically.
  • Adenocarcinoma of unknown primary site is a subtype with high frequency that has no standard treatment and a poor prognosis.
  • A pathological examination indicated serous papillary adenocarcinoma, and peritoneal or ovarian cancer was suspected.
  • This is an extremely rare case of serous papillary adenocarcinoma with a cystic tumor that was categorized as extraovarian peritoneal serous papillary carcinoma (EPSPC) without other clinical findings.

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  • (PMID = 20144179.001).
  • [ISSN] 1447-0756
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
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80. Yoo KH, Rho YK, Kim JY, Li K, Seo SJ, Hong CK: Cutaneous paraneoplastic syndrome in a patient with adenocarcinoma of unknown primary site syndrome. J Clin Oncol; 2009 Jan 10;27(2):309-11
MedlinePlus Health Information. consumer health - Skin Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cutaneous paraneoplastic syndrome in a patient with adenocarcinoma of unknown primary site syndrome.
  • [MeSH-major] Adenocarcinoma / secondary. Neoplasms, Unknown Primary / pathology. Paraneoplastic Syndromes / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 19064961.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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