演題抄録

ESMO/JSCO Joint Symposium

開催概要
開催回
第51回・2013年・京都
 

ESMO Guidelines in Cancer of Unknown Primary (CUP): the European perspective

演題番号 : EJS-1

[筆頭演者]
George E. Pentheroudakis:1 

1:ESMO Guidelines Working Group, Greece

 

Clinical Practice Guidelines (CPGs) are defined as systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Cancer of unknown primary site (CUP) is defined as histologically confirmed metastases in the absence of identifiable primary tumor despite a standardized diagnostic approach. Although it is widely accepted that CUP is a heterogeneous cohort of metastatic malignancies, no consensus exists yet on the true nature of this clinical entity. CUP might prove to be an artificial classification group or a unique clinical entity harboring distinct genetic and epigenetic aberrations.The ESMO Guidelines Working Group (GLWG) consists of: (i) an Editorial Board (ii) Subject Editors responsible for the topics, the authors, the revision of the manuscripts.The authorship of ESMO CPG on CUP is multidisciplinary. The CPG is structured in the following thematic sections:1. Incidence and Epidemiology2. Diagnosis and pathology/molecular biology3. Staging and Risk assessment4. Management of local/locoregional disease5. Management of advanced/metastatic disease6. Personalised Medicine7. Follow-up and Long-term implicationsThe ESMO CPG on CUP reflect the current knowledge and current practice on CUP. The distinction between favourable CUP subsets (20%) and poor CUP subsets (80%) is explicitly stated. Favourable CUP subset patients are managed similarly to the equivalent metastatic tumours of known primary and often enjoy long-term disease control. Unfortunately, most patients have poor-risk CUP (visceral metastases) and despite treatment with combination chemotherapy, they live less than 1 year from diagnosis. Optimal combination chemotherapy regimens are suggested in the ESMO CPG. Lately, multigene expression platforms biologically assing CUP tumours to various tissues of origin, making primary-tailored therapy with cytotoxic agents and biologicals feasible.

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