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Abstract：
UNASSIGNED: Cancer of unknown primary (CUP) is a difficult clinical entity to manage. The aim of the study was to investigate the sociodemographic and pathological characteristics, treatment options, and factors affecting overall survival (OS) in CUP patients whose primary tumor was not detected during follow-up.
UNASSIGNED: A total of 243 CUP patients whose primary tumors could not be detected during follow-up were included in the study. Their demographic characteristics, survival outcomes, and prognostic factors were investigated.
UNASSIGNED: Of the 243 patients included in this study, 61.7% were male and 38.3% were female, and the median age was 61 (range: 19-90) years. The most common histological type was adenocarcinoma (79%). The median follow-up time of the patients was 30.3 months (95% CI: 11.4-49.3), the median OS time was 9.1 months (95% CI: 7.2-11.0), and 72.4% of the patients received at least 1 line of chemotherapy (CT). The difference in survival between the patients who did and did not receive CT was statistically significant (median OS: 10.1 vs. 4.2 months, p = 0.003). According to the multivariate analysis, the presence of cholestasis (HR: 0.48, 95% CI: 0.29-0.79, p = 0.004), lung metastasis (HR: 0.69, 95% CI: 0.51-0.95, p = 0.001), second-line chemotherapy (HR: 1.69, 95% CI: 1.14-2.49, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (HR: 0.20, 95% CI: 0.10-0.40, p < 0.001) were independent prognostic factors influencing OS.
UNASSIGNED: CUP patients who receive multiple lines of chemotherapy tend to have longer survival. This is the first study to report cholestasis as a prognostic factor in CUP patients. In addition, the presence of lung metastases, not receiving second-line chemotherapy, and ECOG performance status (≥2) were found to be independent poor prognostic factors.
UNASSIGNED: A total of 243 CUP patients whose primary tumors could not be detected during follow-up were included in the study. Their demographic characteristics, survival outcomes, and prognostic factors were investigated.
UNASSIGNED: Of the 243 patients included in this study, 61.7% were male and 38.3% were female, and the median age was 61 (range: 19-90) years. The most common histological type was adenocarcinoma (79%). The median follow-up time of the patients was 30.3 months (95% CI: 11.4-49.3), the median OS time was 9.1 months (95% CI: 7.2-11.0), and 72.4% of the patients received at least 1 line of chemotherapy (CT). The difference in survival between the patients who did and did not receive CT was statistically significant (median OS: 10.1 vs. 4.2 months, p = 0.003). According to the multivariate analysis, the presence of cholestasis (HR: 0.48, 95% CI: 0.29-0.79, p = 0.004), lung metastasis (HR: 0.69, 95% CI: 0.51-0.95, p = 0.001), second-line chemotherapy (HR: 1.69, 95% CI: 1.14-2.49, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (HR: 0.20, 95% CI: 0.10-0.40, p < 0.001) were independent prognostic factors influencing OS.
UNASSIGNED: CUP patients who receive multiple lines of chemotherapy tend to have longer survival. This is the first study to report cholestasis as a prognostic factor in CUP patients. In addition, the presence of lung metastases, not receiving second-line chemotherapy, and ECOG performance status (≥2) were found to be independent poor prognostic factors.
摘要：
■未知原发癌（CUP）是一种难以管理的临床实体。这项研究的目的是调查社会人口统计学和病理学特征，治疗方案,以及影响在随访期间未检测到原发肿瘤的CUP患者总生存期（OS）的因素。
■共有243例CUP患者在随访过程中无法检测到原发肿瘤。他们的人口特征，生存结果，并对预后因素进行了调查。
■纳入本研究的243例患者中，61.7%为男性，38.3%为女性，中位年龄为61岁（范围：19-90）。最常见的组织学类型是腺癌（79％）。患者的中位随访时间为30.3个月(95%CI:11.4-49.3),中位OS时间为9.1个月（95%CI：7.2-11.0），72.4%的患者接受了至少1行化疗(CT)。接受和未接受CT的患者之间的生存率差异具有统计学意义（中位OS：10.1vs.4.2个月,p=0.003)。根据多变量分析，胆汁淤积的存在（HR：0.48，95％CI：0.29-0.79，p=0.004），肺转移（HR：0.69，95％CI：0.51-0.95，p=0.001），二线化疗（HR：1.69，95%CI：1.14-2.49，p<0.001），和东部肿瘤协作组（ECOG）的表现状态（HR：0.20，95％CI：0.10-0.40，p<0.001）是影响OS的独立预后因素。
■接受多行化疗的CUP患者往往具有更长的生存期。这是第一项报道胆汁淤积作为CUP患者预后因素的研究。此外,肺转移的存在，没有接受二线化疗，和ECOG表现状态（≥2）被发现是独立的不良预后因素。
■共有243例CUP患者在随访过程中无法检测到原发肿瘤。他们的人口特征，生存结果，并对预后因素进行了调查。
■纳入本研究的243例患者中，61.7%为男性，38.3%为女性，中位年龄为61岁（范围：19-90）。最常见的组织学类型是腺癌（79％）。患者的中位随访时间为30.3个月(95%CI:11.4-49.3),中位OS时间为9.1个月（95%CI：7.2-11.0），72.4%的患者接受了至少1行化疗(CT)。接受和未接受CT的患者之间的生存率差异具有统计学意义（中位OS：10.1vs.4.2个月,p=0.003)。根据多变量分析，胆汁淤积的存在（HR：0.48，95％CI：0.29-0.79，p=0.004），肺转移（HR：0.69，95％CI：0.51-0.95，p=0.001），二线化疗（HR：1.69，95%CI：1.14-2.49，p<0.001），和东部肿瘤协作组（ECOG）的表现状态（HR：0.20，95％CI：0.10-0.40，p<0.001）是影响OS的独立预后因素。
■接受多行化疗的CUP患者往往具有更长的生存期。这是第一项报道胆汁淤积作为CUP患者预后因素的研究。此外,肺转移的存在，没有接受二线化疗，和ECOG表现状态（≥2）被发现是独立的不良预后因素。
