Abstract
Between 1992 and 1999, 1421 cases of cancer of unknown primary site (CUPS) were reported in Nova Scotia (1). The prognosis for this group of patients was very poor with a mean survival of 5.2 months. A retrospective study of the diagnostic workup, therapy, response to treatment, and survival for a randomly selected group of CUPS cases from four subsets was completed. The four subsets analyzed were: adenocarcinoma of varying degrees of differentiation, neoplasms not otherwise specified (NOS), poorly differentiated carcinoma or carcinoma not otherwise specified, and squamous cell carcinoma. Findings demonstrated variation in clinical practice. The data suggests that evidence-based and cost-effective guidelines should be developed to standardize diagnostic workup and best treatment options for patients presenting with CUPS. A standard provincial or national clinical practice guideline for patients with CUPS does not currently exist. The purpose of this paper is to present a Nova Scotian perspective on CUPS patient care to aid in the formation of a provincial and national, evidence based, and critically appraised practice guideline.
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