Time trends in survival from cancer of unknown primary: Small steps forward.
(2013) In European Journal of Cancer 49(10). p.2403-2410- Abstract
- BACKGROUND: Cancer of unknown primary (CUP) is a fatal cancer for which incidence trends have changed but detailed survival trends remain unexplored. These could point out successful diagnostic and therapeutic approaches. We investigate survival trends in CUP according to histology, locations of metastases and site-specific causes of death. PATIENTS AND METHODS: A total of 20,523 CUP patients with nodal and extranodal metastases were identified from the Swedish Cancer Registry. Hazard ratios (HRs) were estimated, comparing three different time periods (1987-1993, 1994-2000 and 2001-2008) with respect to histological subtype, CUP location and the cause of death. RESULTS: Survival for patients with CUP increased over the study period... (More)
- BACKGROUND: Cancer of unknown primary (CUP) is a fatal cancer for which incidence trends have changed but detailed survival trends remain unexplored. These could point out successful diagnostic and therapeutic approaches. We investigate survival trends in CUP according to histology, locations of metastases and site-specific causes of death. PATIENTS AND METHODS: A total of 20,523 CUP patients with nodal and extranodal metastases were identified from the Swedish Cancer Registry. Hazard ratios (HRs) were estimated, comparing three different time periods (1987-1993, 1994-2000 and 2001-2008) with respect to histological subtype, CUP location and the cause of death. RESULTS: Survival for patients with CUP increased over the study period (HR=0.91 [95% confidence interval (CI): 0.78-0.84], p<0.001 for trend). Adenocarcinoma was the only histology associated with increased survival (0.78 [0.74-0.82], p<0.001 for trend). Survival was improved most clearly for CUP of the pelvis (0.55 [0.36-0.83]), peritoneum (0.58 [0.53-0.65]) and nervous system (0.46 [0.29-0.72]). Survival improved substantially in patients with ovarian (0.57 [0.46-0.70]), peritoneal (0.39 [0.24-0.65]) and biliary system cancers (0.67 [0.52-0.87]). Kaplan-Meier curves showed significant survival gains for all CUP and adenocarcinoma patients (p<0.001). CONCLUSIONS: Over time, survival for patients with CUP increased for adenocarcinoma and for CUP of the pelvis, peritoneum and nervous system. Survival trends in CUP may be related to (1) similar trends in other common metastatic tumours, particularly pancreatic and hepatobiliary cancers, which are common 'hidden' primaries for CUP, (2) earlier detection and (3) advances in the management of metastatic cancers. The improvement in survival at specific locations suggests true therapeutic gains. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3627825
- author
- Riihimäki, Matias LU ; Hemminki, Kari LU and Sundquist, Kristina LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Journal of Cancer
- volume
- 49
- issue
- 10
- pages
- 2403 - 2410
- publisher
- Elsevier
- external identifiers
-
- wos:000320504200014
- pmid:23518210
- scopus:84878395606
- pmid:23518210
- ISSN
- 1879-0852
- DOI
- 10.1016/j.ejca.2013.02.022
- language
- English
- LU publication?
- yes
- id
- a2f7ede9-2cd8-4a1a-9097-70fa4aec001a (old id 3627825)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23518210?dopt=Abstract
- date added to LUP
- 2016-04-01 10:09:27
- date last changed
- 2022-01-25 20:19:47
@article{a2f7ede9-2cd8-4a1a-9097-70fa4aec001a,
abstract = {{BACKGROUND: Cancer of unknown primary (CUP) is a fatal cancer for which incidence trends have changed but detailed survival trends remain unexplored. These could point out successful diagnostic and therapeutic approaches. We investigate survival trends in CUP according to histology, locations of metastases and site-specific causes of death. PATIENTS AND METHODS: A total of 20,523 CUP patients with nodal and extranodal metastases were identified from the Swedish Cancer Registry. Hazard ratios (HRs) were estimated, comparing three different time periods (1987-1993, 1994-2000 and 2001-2008) with respect to histological subtype, CUP location and the cause of death. RESULTS: Survival for patients with CUP increased over the study period (HR=0.91 [95% confidence interval (CI): 0.78-0.84], p<0.001 for trend). Adenocarcinoma was the only histology associated with increased survival (0.78 [0.74-0.82], p<0.001 for trend). Survival was improved most clearly for CUP of the pelvis (0.55 [0.36-0.83]), peritoneum (0.58 [0.53-0.65]) and nervous system (0.46 [0.29-0.72]). Survival improved substantially in patients with ovarian (0.57 [0.46-0.70]), peritoneal (0.39 [0.24-0.65]) and biliary system cancers (0.67 [0.52-0.87]). Kaplan-Meier curves showed significant survival gains for all CUP and adenocarcinoma patients (p<0.001). CONCLUSIONS: Over time, survival for patients with CUP increased for adenocarcinoma and for CUP of the pelvis, peritoneum and nervous system. Survival trends in CUP may be related to (1) similar trends in other common metastatic tumours, particularly pancreatic and hepatobiliary cancers, which are common 'hidden' primaries for CUP, (2) earlier detection and (3) advances in the management of metastatic cancers. The improvement in survival at specific locations suggests true therapeutic gains.}},
author = {{Riihimäki, Matias and Hemminki, Kari and Sundquist, Kristina}},
issn = {{1879-0852}},
language = {{eng}},
number = {{10}},
pages = {{2403--2410}},
publisher = {{Elsevier}},
series = {{European Journal of Cancer}},
title = {{Time trends in survival from cancer of unknown primary: Small steps forward.}},
url = {{http://dx.doi.org/10.1016/j.ejca.2013.02.022}},
doi = {{10.1016/j.ejca.2013.02.022}},
volume = {{49}},
year = {{2013}},
}