Overview of the classification and management of cancers of unknown primary site
- John D Hainsworth, MD
John D Hainsworth, MD
- Chief Scientific Officer
- Sarah Cannon Research Institute
- F Anthony Greco, MD
F Anthony Greco, MD
- Medical Director
- Sarah Cannon Cancer Center
Cancer of unknown primary site (CUP) is a relatively common clinical entity, accounting for 4 to 5 percent of all invasive cancers . Within this category, tumors from many primary sites with varying biology are represented. This heterogeneity has made the design and interpretation of clinical studies difficult.
Patients with CUPs typically present with symptoms referable to metastases. The initial work-up, including physical examination, laboratory studies, and imaging procedures, often fails to identify the primary site.
Patients are initially placed into one of four categories based upon the light microscopic examination of the initial biopsy. This classification is then used to guide further evaluation:
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