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Cancer of Unknown Primary pp 151–172Cite as

Favorable Subsets Among Cancers of Unknown Primary

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Abstract

Although cancers of unknown primary origin (CUP) are a heterogeneous group of cancers characterized by absence of an identifiable primary site, there are several distinctive favorable clinicopathological CUP subsets that warrant a tailored management. The favorable designation was based on a presentation that overwhelmingly suggested a specific treatable primary. When originally defined, the designation was based on anatomic and morphological considerations on pathology. In the modern era, these favorable subsets still exist although the anatomic diagnosis is now supported by immunohistochemistry or molecular profiling confirmation. The “favorable subsets” and their putative primary include patients with solitary metastatic disease, osteoblastic metastases with elevated prostate-specific antigen in men (prostate), adenocarcinoma with isolated axillary lymph node involvement in women (breast cancer), serous papillary carcinoma of the peritoneal cavity in women (ovarian cancer), poorly differentiated carcinoma with midline distribution, neuroendocrine carcinomas, squamous cell carcinoma involving cervical lymph nodes, and adenocarcinoma with immunohistochemical profile consistent with a gastrointestinal primary (colon, small bowel, appendix cancers). While not all patients with these subsets have favorable prognosis, recognizing these subsets is vital for making therapeutic decisions. Survival of these CUP patients is favorable compared to survival of disseminated CUP patients that do not fit into these specific subsets.

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  1. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kanwal Raghav & Gauri R. Varadhachary

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  1. German Cancer Research Center (DKFZ) and University of Heidelberg, Clinical Cooperation Unit Molecular, Hematology/Oncology, Heidelberg, Germany

    Alwin Krämer

  2. German Cancer Research Center (DKFZ) and University of Heidelberg, Clinical Cooperation Unit Molecular, Hematology/Oncology, Heidelberg, Germany

    Harald Löffler

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Raghav, K., Varadhachary, G.R. (2016). Favorable Subsets Among Cancers of Unknown Primary. In: Krämer, A., Löffler, H. (eds) Cancer of Unknown Primary. Springer, Cham. https://doi.org/10.1007/978-3-319-22581-4_10

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