Abstract
Background: Cancers of unknown primary site (CUP) are heterogeneous neoplasms and patient survival remains extremely poor. Although several prognostic factors have been suggested, these have yet to be verified in daily practice. Therefore, in this study, we explored prognostic factors using data from CUP patients treated at our hospital.Method: The CUP patientś data obtained between October 2006 and March 2013 were respectively evaluated. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox's proportional hazards regression analysis was performed to identify independent prognostic factors using SPSS software.Results: In total, 46 patients were treated at our hospital, with a male/female ratio of 26/20, and a median age of 67 years (range, 25-88 years). The median overall survival was 6.0 months, and the significant adverse prognostic factors identified by univariate analysis were age (≥70 years), performance status (≥2), unfavorable subset, lung/pleural metastasis, liver metastasis, bone metastasis, number of involved organ sites (≥2), the presence of disseminated intravascular coagulation syndrome, high serum ALP (≥400 IU/l), high serum LDH (≥300 IU/l), low serum albumin (<3.5 g/dl), low hemoglobin (<12 g/dl), and low platelet count (<10 × 104/µl). Cox's multivariate analysis indicated age, liver metastasis, number of involved organ sites, and serum albumin level to be significant prognostic factors. Overall survival of patients with none of these factors was 22.9 months and that of patients with 1 or more was 3.7 months (log-rank p < 0.001).Conclusion: Age, liver metastasis, number of involved organ sites, and the serum albumin level were identified as significant prognostic factors in patients with CUP. These factors were comparable to those previously reported and this study validated these factors to be predictive in actual clinical settings.
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