演題抄録

ESMO/JSCO Joint Symposium

開催概要
開催回
第51回・2013年・京都
 

Japanese clinical practice guideline for unknown primary carcinoma

演題番号 : EJS-2

[筆頭演者]
Hirofumi Mukai:1 

1:Breast and Medical Oncology Division, National Cancer Center Hospital East, Japan

 

Japanese Society of Medical Oncology (JSMO) published its first evidence-based clinical practice guideline on unknown primary carcinoma (UPC) in 2010.Generally, clinical practice guidelines serve as a guide for doctors and outline appropriate methods of treatment and care. Guidelines can address specific clinical situations (disease-oriented) or use of approved medical products, procedures, or tests (modality-oriented). Using the best available evidence, JSMO expert panels developed practice recommendations for UPC. UPC is defined as the presence of metastatic cancer documented in the absence of an identifiable primary tumor site. According to this definition, between 0.5% and 7% of cancer patients are diagnosed with this clinical entity. UPCs are a heterogeneous group of neoplasms with widely varying natural histories and biologic characteristics. In this broad category, there are 4 major diagnoses, as assessed by light microscopy: (1) poorly differentiated neoplasm, (2) well differentiated and moderately differentiated adenocarcinoma, (3) squamous cell carcinoma, and (4) poorly differentiated carcinoma (with or without features of adenocarcinoma). It has been reported that the prognosis of patients with UPC is poor. The median survival time (MST) is 6 to 9 months, and less than 25% of the UPC patients are alive 1 year after diagnosis. Previous trials with a variety of chemotherapeutic regimens have produced response rates of less than 50% with negligible benefit in terms of median survival. Platinum-containing regimens have induced higher response rates than those without it in patients with UPC, and platinum is considered a key drug in UPC treatment. JSMO considers adherence to this guideline to be voluntary, with the ultimate determination regarding its application to be made by the physician in light of each patient's individual circumstances.

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