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Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?

Publication ,  Journal Article
Lenzi, R; Hess, KR; Abbruzzese, MC; Raber, MN; Ordoñez, NG; Abbruzzese, JL
Published in: J Clin Oncol
May 1997

PURPOSE: The objectives of this study were to assess clinical outcomes and prognostic factors in unselected, consecutive patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA). PATIENTS AND METHODS: The 1,400 patients analyzed were referred to our unknown-primary tumor (UPT) clinic from January 1, 1987 through July 31, 1994. Clinical data from these patients were entered into a computerized data base for storage, retrieval, and analysis. Survival was measured from the time of diagnosis; survival distribution was estimated using the product-limit method. Multivariate survival analyses were performed using proportional hazards regression and by recursive partitioning. RESULTS: Nine hundred seventy-seven patients were diagnosed with unknown-primary carcinoma (UPC) and 337 of these patients had PDC or PDA. No clinical differences were identified among patients with PDC, PDA, or UPC patients with other carcinoma or adenocarcinoma subtypes. PDC patients enjoyed better survival than PDA patients. Poor cellular differentiation was not an important prognostic variable. Variables predictive of survival included lymph node metastases, sex, number of metastatic sites, histology (PDC v PDA), and age. Although chemotherapy did not appear to influence survival for the entire group of PDC or PDA patients, a subset of patients with good prognostic features experienced median survival durations of up to 40 months. CONCLUSION: The long median survival and chemotherapy responsiveness of UPC patients with PDC and PDA could not be confirmed. However, subpopulations with prolonged median survival durations could be defined, and the value of chemotherapy in this group remains to be determined. Identification and exclusion of treatable or slow-growing malignancies may account for the poor survival of the PDC and PDA patients reported in this study.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1997

Volume

15

Issue

5

Start / End Page

2056 / 2066

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasms, Unknown Primary
  • Neoplasm Proteins
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Lymphatic Metastasis
 

Citation

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Lenzi, R., Hess, K. R., Abbruzzese, M. C., Raber, M. N., Ordoñez, N. G., & Abbruzzese, J. L. (1997). Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma? J Clin Oncol, 15(5), 2056–2066. https://doi.org/10.1200/JCO.1997.15.5.2056
Lenzi, R., K. R. Hess, M. C. Abbruzzese, M. N. Raber, N. G. Ordoñez, and J. L. Abbruzzese. “Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?J Clin Oncol 15, no. 5 (May 1997): 2056–66. https://doi.org/10.1200/JCO.1997.15.5.2056.
Lenzi R, Hess KR, Abbruzzese MC, Raber MN, Ordoñez NG, Abbruzzese JL. Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma? J Clin Oncol. 1997 May;15(5):2056–66.
Lenzi, R., et al. “Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?J Clin Oncol, vol. 15, no. 5, May 1997, pp. 2056–66. Pubmed, doi:10.1200/JCO.1997.15.5.2056.
Lenzi R, Hess KR, Abbruzzese MC, Raber MN, Ordoñez NG, Abbruzzese JL. Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma? J Clin Oncol. 1997 May;15(5):2056–2066.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1997

Volume

15

Issue

5

Start / End Page

2056 / 2066

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasms, Unknown Primary
  • Neoplasm Proteins
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Lymphatic Metastasis