不明原发灶肿瘤的诊断2-ed研究.ppt

Metastatic CancerUnknown Primary Site Synonyms and related keywords ◆ tumor of unknown primary ◆ cancer of unknown origin ◆ carcinoma of unknown origin ◆ unknown primary cancer Metastatic CancerUnknown Primary Site ◆ unknown primary carcinoma ◆ carcinoma of unknown primary origin Metastatic CancerUnknown Primary Site ◆ cancer of unknown primary site (cups) ◆ carcinoma of unknown primary origin (CUP) Metastatic CancerUnknown Primary Site ◆ metastatic cancer ◆ metastatic carcinoma ◆ metastatic tumor ◆ metastases ◆ occult primary malignancy CUP Background(in the United States) ◆ 32,100 pats with CUPS in 2007 (15,720 males; 16,380 females) ◆ About 2% of all cancers CUP ◆ Deaths due to CUPS :45,230 (24,440 males; 20,790 females) CUP ◆ This discrepancy between incidence and mortality is believed to be due to a lack of specificity in the listing of?cause of death on death certificates CUP ◆ Its true incidence is most probably between 2% and 6% ◆ In 15-25% of cases, the primary site cannot be identified even on postmortem CUP Pathophysiology ◆Cancers are thought to arise from a single cell that escapes the controls of normal cell replication ◆Forms a tumor at the site of origin ◆Ultimately metastasizes to other organs CUP  Pathophysiology ◆ In some cases the original tumor may remain small or undetectable at the time of metastasis ◆ Leading to the clinical presentation of CUP CUP Frequency ◆ United States:2-6%? ◆ International:2-9% CUP Mortality/Morbidity ◆ Median survival?ranges from 11 weeks to 11 months ◆ The 5-year overall survival rate is about 11% CUP Sex ◆ An approximate equal incidence for men and women CUP  Age ◆ The median age on presentation for both men and women ranges from 59- 66 years CUP  CLINICAL(History) ◆ Because most patients with cup have fairly advanced-staged cancers ◆ The con