Sarcomatoid carcinoma presenting as cancers of unknown primary: a clinicopathological portrait
Autor: | Michael J. Overman, Ryan W. Huey, Aurelio Matamoros, Kanwal Pratap Singh Raghav, Jeannelyn S. Estrella, Lianchun Xiao, Gauri R. Varadhachary, Shalini Makawita |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Oncology Male Cancer Research Sarcomatoid carcinoma Kaplan-Meier Estimate CUP 0302 clinical medicine Carcinosarcoma Surgical oncology Neoplasms Pathology Molecular Targeted Therapy Prospective Studies Lymph node Aged 80 and over Univariate analysis Unknown primary High-Throughput Nucleotide Sequencing Middle Aged Prognosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Chemotherapy regimen Combined Modality Therapy Immunohistochemistry Survival Rate medicine.anatomical_structure Treatment Outcome Docetaxel 030220 oncology & carcinogenesis Female medicine.drug Research Article Adult medicine.medical_specialty lcsh:RC254-282 03 medical and health sciences Rare Diseases Internal medicine Genetics medicine Biomarkers Tumor Humans Aged Retrospective Studies business.industry Molecular medicine.disease Gemcitabine Log-rank test 030104 developmental biology Drug Resistance Neoplasm Neoplasms Unknown Primary business Follow-Up Studies |
Zdroj: | BMC Cancer, Vol 19, Iss 1, Pp 1-10 (2019) BMC Cancer |
ISSN: | 1471-2407 |
Popis: | Background Sarcomatoid carcinoma of unknown primary (SCUP) is a rare entity of either poorly differentiated carcinoma with sarcoma-like differentiation or a true mixed lineage neoplasm. Limited data regarding clinicopathological profile and management exists. Methods We retrospectively reviewed the MD Anderson Cancer of Unknown Primary database and tumor registry to identify 48 SCUP patients between 2001 and 2017. Patient characteristics, pathology, molecular diagnostics, treatments, and outcomes were obtained. Kaplan-Meier method was used to estimate overall survival (OS) and compared using log rank test. Results Median age at diagnosis was 59 years (range 27–86). Majority of patients were female (58%) and presented with ≥3 metastatic sites (52%), commonly lymph node (50%), bone (42%), lung (27%), and liver (21%). First line treatment included chemotherapy (35%), surgery (27%), and radiation (24%). Gemcitabine and docetaxel (18%) was the most common chemotherapy regimen. Median OS for entire cohort was 11 months (95% CI: 5.6 to 16.4). Poor performance status (PS), > 1 metastatic site, elevated lactate dehydrogenase (LDH), and high neutrophil-to-lymphocyte ratio (NLR) were significantly associated with worse OS on univariate analyses. On multivariate analyses, poor PS (HR 8.7; 95%CI: 3.0–25.0; p p = 0.011) emerged as independent prognostic factors for OS. Conclusions SCUP is a rare presentation with an aggressive clinical course and limited survival. Diagnosis is difficult to make and requires careful review and synthesis of histology, immunohistochemistry, and molecular diagnostics. Chemotherapy resistance remains a challenge. Early mutational profiling is warranted, and clinical trial participation should be encouraged for this subset. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |