内容紹介
Summary
Carcinoma of unknown primary(CUP)is defined as the presence of metastatic cancer documented in the absence of an identifiable primary tumor site. According to this definition, between 1% and 5% of cancer patients are diagnosed with this clinical entity. CUPs are a heterogeneous group of neoplasms with widely varying natural histories and biologic characteristics. In this broad category, there are 5 major diagnoses, as assessed by light microscopy: (1)poorly differentiated neoplasm,(2)well differentiated and moderately differentiated adenocarcinoma,(3)squamous cell carcinoma(4)neuroendocrine tumor, and(5)poorly differentiated carcinoma(with or without features of adenocarcinoma). It has been reported that the prognosis of patients with CUP is poor. The median survival time(MST)is 6 to 9 months, and less than 25% of the CUP patients are alive 1 year after diagnosis. Previous trials with a variety of chemotherapeutic regimens have produced response rates of less than 50% with negligible benefit in terms of median survival. Platinum-containing regimens have induced higher response rates than those without it in patients with CUP, and platinum is considered a key drug in UPC treatment.
要旨
原発不明がんとは,十分な検索にもかかわらず原発巣が不明で組織学的に転移巣と判明している悪性腫瘍のことである。頻度はおおむね1～5%とされている。原発巣が確定できない悪性腫瘍が本カテゴリーに分類されるため,種々の腫瘍が混在した不均一な疾患グループよりなっており,様々な臨床形態をとる。まずは組織を光学顕微鏡で評価し,高・中分化腺癌,低分化腺癌/未分化癌,扁平上皮癌,神経内分泌腫瘍,低分化悪性新生物の五つに区分される。本疾患は一般的に予後不良であり,プラチナ系薬剤を使用するのが一般的ではあるものの生存期間の中央値は6～9か月とされる。
目次
Carcinoma of unknown primary(CUP)is defined as the presence of metastatic cancer documented in the absence of an identifiable primary tumor site. According to this definition, between 1% and 5% of cancer patients are diagnosed with this clinical entity. CUPs are a heterogeneous group of neoplasms with widely varying natural histories and biologic characteristics. In this broad category, there are 5 major diagnoses, as assessed by light microscopy: (1)poorly differentiated neoplasm,(2)well differentiated and moderately differentiated adenocarcinoma,(3)squamous cell carcinoma(4)neuroendocrine tumor, and(5)poorly differentiated carcinoma(with or without features of adenocarcinoma). It has been reported that the prognosis of patients with CUP is poor. The median survival time(MST)is 6 to 9 months, and less than 25% of the CUP patients are alive 1 year after diagnosis. Previous trials with a variety of chemotherapeutic regimens have produced response rates of less than 50% with negligible benefit in terms of median survival. Platinum-containing regimens have induced higher response rates than those without it in patients with CUP, and platinum is considered a key drug in UPC treatment.
要旨
原発不明がんとは,十分な検索にもかかわらず原発巣が不明で組織学的に転移巣と判明している悪性腫瘍のことである。頻度はおおむね1～5%とされている。原発巣が確定できない悪性腫瘍が本カテゴリーに分類されるため,種々の腫瘍が混在した不均一な疾患グループよりなっており,様々な臨床形態をとる。まずは組織を光学顕微鏡で評価し,高・中分化腺癌,低分化腺癌/未分化癌,扁平上皮癌,神経内分泌腫瘍,低分化悪性新生物の五つに区分される。本疾患は一般的に予後不良であり,プラチナ系薬剤を使用するのが一般的ではあるものの生存期間の中央値は6～9か月とされる。