MethodsRetrospective case series of patients with CUP. Patients belonged to one of two favourable risk sub-sets: those with midline lymph node metastases or women with peritoneal carcinomatosis.
Participants and Country80 patients. Greece. 47 women in the peritoneal carcinomatosis group and 33 patients in the midline lymph node group (21 men and 12 women). Histology was poorly differentiated or undifferentiated carcinoma in most cases. Performance status was 0 to 1 in 54/80 (68%) and 2 to 3 in 25/80 (31%).
InterventionsMost patients received at least 6 cycles of platinum based chemotherapy, often combined with a taxane. Chemotherapy regimen was platinum-taxane in 48/80 patients (60%), platinum without taxane 20/80 (25%), taxane without platinum 6/80 (7.5%) or neither platinum or taxane 6/80(7.5%).
OutcomesPatients with peritoneal carcinomatosis (N=47)
Treatment response
Complete response 36%,
Partial response 17%,
Overall response rate 53%
Overall survival
Median survival was 15 months (95% CI 13 to 17 months), range 1 to 102 months.
Patients with midline lymph node involvement (N=33)
Treatment response
Complete response 9%,
Partial response 21%,
Overall response rate 30%
Overall survival
Median survival was 10 months (95% CI 7 to 13 months), range 2 to 54+ months.
NotesAuthors note the high complete response rate in women with peritoneal carcinomatosis treated with platinum-taxane therapy, compared with historical rates of 10 to 20% in those treated with platinum alkylator regimes.

From: Guideline chapter 5, Systemic Therapy

Cover of Diagnosis and Management of Metastatic Malignant Disease of Unknown Primary Origin
Diagnosis and Management of Metastatic Malignant Disease of Unknown Primary Origin.
NICE Clinical Guidelines, No. 104.
National Collaborating Centre for Cancer (UK).
Copyright © 2010, National Collaborating Centre for Cancer.

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