International consensus on the initial diagnostic workup of cancer of unknown primary.

Autor: van der Strate I; Department of Research and Development, Comprehensive Cancer Organization the Netherlands, Utrecht, the Netherlands. Electronic address: i.h.vander.strate@student.vu.nl., Kazemzadeh F; Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands., Nagtegaal ID; Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands., Robbrecht D; Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., van de Wouw A; Department of Medical Oncology, VieCuri Medical Center, Venlo, the Netherlands., Padilla CS; Department of Research and Development, Comprehensive Cancer Organization the Netherlands, Utrecht, the Netherlands., Duijts S; Department of Research and Development, Comprehensive Cancer Organization the Netherlands, Utrecht, the Netherlands; Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Esteller M; Josep Carreras Leukemia Research Institute (IJC), Badalona, Barcelona, Catalonia, Spain; Centro de Investigacion Biomedica en Red Cancer (CIBERONC), Madrid, Spain; Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain; Physiological Sciences Department, School of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain., Greco FA; Sarah Cannon Research Institute and Cancer Center, Tennessee Oncology, Nashville, TN, USA., Pavlidis N; Medical School, University of Ioannina, Stavros Niarchou Avenue, 45110, Ioannina, Greece., Qaseem A; American College of Physicians, Philadelphia, PA, USA., Snaebjornsson P; Department of Pathology, The Netherlands Cancer Institute, 1066 CX, Amsterdam, the Netherlands., van Zanten SV; Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands., Loef C; Department of Research and Development, Comprehensive Cancer Organization the Netherlands, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: Critical reviews in oncology/hematology [Crit Rev Oncol Hematol] 2023 Jan; Vol. 181, pp. 103868. Date of Electronic Publication: 2022 Nov 23.
DOI: 10.1016/j.critrevonc.2022.103868
Abstrakt: Background: Although the incidence of Cancer of Unknown Primary (CUP) is estimated to be 1-2 % of all cancers worldwide, no international standards for diagnostic workup are yet established. Such an international guideline would facilitate international comparison, provide adequate incidence and survival rates, and ultimately improve care of patients with CUP.
Methods: Participants for a four round modified Delphi study were selected via a CUP literature search in PubMed and an international network of cancer researchers. A total of 90 CUP experts were invited, and 34 experts from 15 countries over four continents completed all Delphi survey rounds.
Findings: The Delphi procedure resulted in a multi-layer CUP classification for the diagnostic workup. Initial diagnostic workup should at least consist of history and physical examination, full blood count, analysis of serum markers, a biopsy of the most accessible lesion, a CT scan of chest/abdomen/pelvis, and immunohistochemical testing. Additionally, the expert panel agreed on the need of an ideal diagnostic lead time for CUP patients. There was no full consensus on the place in diagnostic workup of symptom-guided MRI or ultrasound, a PET/CT scan, targeted gene panels, immunohistochemical markers, and whole genome sequencing.
Interpretation: Consensus was reached on the contents of the first diagnostic layer of a multi-layer CUP classification. This is a first step towards full consensus on CUP diagnostics, that should also include supplementary and advanced diagnostics.
Competing Interests: Conflict of interest statements The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: