Chemotherapy in carcinomas of unknown primary site.

Purpose: Carcinomas of unknown primary site (CUPS) are highly malignant diseases with a usually ominous prognosis. We report on the efficacy of chemotherapy in the treatment and survival of patients with CUPS.

Patients And Methods: The study involved 63 patients with metastatic CUPS. Following routine light microscopy, the histological findings were classified into 3 groups: squamous cell carcinoma - 8 patients; adenocarcinoma - 33 patients; and undifferentiated carcinoma - 22 patients. Combination chemotherapy with doxorubicin 50 mg/m(2) (day 1), cisplatin 60 mg/m(2) (day 1), and etoposide 120 mg/m(2)/day (days 1-3) every 3 weeks was administered to 32 patients (20 females and 12 males), aged 29-70 years (median 54 years) who met the inclusion criteria. All patients with stable disease (SD), partial response (PR) or complete response (CR) received 6 cycles of chemotherapy.

Results: CR was achieved in 3 (9.4%), PR in 12 (37.5%), and SD in 10 (31.2%) patients. Seven (21.9%) patients had progressive disease (PD). The overall response rate (RR) was 46.9% (15/32) and the median response duration of CR+PR was 11 months (range 4-43(+) months). The overall survival (OS) of patients treated with chemotherapy (n=32; 50.8%) was better compared with the OS of those not receiving chemotherapy (n=31; 49.2%/; p <0.01). Also the 2-year survival of patients with chemotherapy (40%) and without chemotherapy (0%) implies potential curability in a specific subset of these patients.

Conclusion: The usage of the aforementioned doses and chemotherapy scheme appears to improve the outcome of patients with carcinoma of unknown primary site.