Table 3.
Favorable subsets in cancer of unknown primary.
Adapted from [24]
| Histopathology | Clinical subset | Recommended evaluationa | Treatment |
|---|---|---|---|
| Adenocarcinoma | Women with isolated axillary adenopathy | Breast MRI ER/PR/HER-2 stains | Treat as stage II–III breast cancer |
| Women with peritoneal carcinomatosis | CA-125 | Treat as stage III ovarian cancer | |
| Men with blastic bone metastases or elevated serum PSA | Treat as metastatic prostate cancer | ||
| Single metastatic site | PET scan | Local therapy ± chemotherapy | |
| Squamous carcinoma | Cervical adenopathy | Endoscopy | Treat as locally advanced |
| Inguinal adenopathy | PET scan | Treat as head and neck cancer | |
| Inguinal node dissection ± radiotherapy ± chemotherapy | |||
| Poorly differentiated carcinoma | Young men, mediastinal and/or retroperitoneal mass | HCG, alfaFP | Treat as extragonadal germ-cell tumor |
| All others with good performance status | HCG, alfaFP | Treat with empirical CUP regimen |
MRI magnetic resonance imaging, ER estrogen receptor, PR progesterone receptor, PSA prostate-specific antigen, HCG human chorionic gonadotropin, AFP alpha-fetoprotein, CUP cancer of unknown primary site
aIn addition to standard evaluation for cancer of unknown primary site