Corrales RRE, Senra ALA, Tamargo BTO

Language: Spanish
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Page: 12-25
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ABSTRACT

Introduction: Approximately 15 % of patients with cancer debut with metastasis. The search for a primary tumor is complex and in many cases unsuccessful. The carcinoma of unknown primary tumor defines a disseminated malignant neoplastic disease, demonstrated by anatomopathological study of one of its metastases, without being able to identify the primary tumor despite a study considered "optimal" during the patient's life.
Objective: To identify detection predictors of primary tumor in patients presenting metastasis.
Methods: A retrospective case-control observational study was conducted. The information was obtained from the database of the occult primary carcinoma protocol. It included 99 patients consecutively treated in the internal medicine service from 2010 to 2013 after debuting with metastasis. We assessed whether or not the variables site, number of metastases, physical condition according to Eastern Cancer Oncology Group (ECOG) scale and histological variety could be detection predictors of primary tumor.
Results: No statistically significant differences were found between patients with (47.5 % of the total) and no primary tumor identified (p< 0.05) regarding site, number of metastases and ECOG score. The odds ratio for detection of primary tumor in adenocarcinoma was moderately differentiated and well. It was 5 times higher than for poorly differentiated carcinoma and 11 times higher than for neuroendocrine carcinoma. The odds ratio of detecting a primary tumor was 8 times higher in squamous cell metastasis compared to poorly differentiated carcinoma and 15 times higher than in neuroendocrine carcinoma.
Conclusions: The score on the ECOG scale, site and number of metastases were not identified as independent variables in the detection of the primary tumor. The probability of detecting it was higher than the rest of the histologies, in those who debuted with metastasis due to squamous cell carcinoma and adenocarcinoma. The lowest probability was for those with neuroendocrine carcinoma.