Tumor-marker analysis and verification of prognostic models in patients with cancer of unknown primary, receiving platinum-based combination chemotherapy

J Cancer Res Clin Oncol. 2006 Oct;132(10):635-42. doi: 10.1007/s00432-006-0110-z. Epub 2006 Jun 22.

Abstract

Objectives: To evaluate the usefulness of tumor-marker measurements and to identify prognostic factors in patients with cancer of unknown primary (CUP), receiving platinum-based combination chemotherapy and to verify the adjustment of previously reported prognostic models in this population.

Methods: We conducted univariate and multivariate analyses in consecutive patients with CUP receiving platinum-based combination chemotherapy. Previously reported prognostic models were then validated in this population.

Results: A total of 93 patients were analyzed and the response rate to platinum-based chemotherapeutic regimens among the 93 patients was 39.8%. The median time to progression and overall survival period were 4.1 and 12.4 months, respectively. The ST-439 level was significantly higher in patients with histologically confirmed adenocarcinoma than in patients with poorly differentiated adenocarcinoma or poorly differentiated carcinoma. A multivariate analysis indicated that performance status, the number of involved organs, and the serum lactate dehydrogenase level were the prognostic factors of the outcome. Both the previously reported prognostic models for predicting the duration of survival in this population were shown to be valid.

Conclusion: Tumor-marker measurements are not helpful in the management of patients with CUP. Previously reported prognostic models may be useful for selecting indication for chemotherapy or for stratifying the patients in clinical trial.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / blood*
  • Carboplatin / administration & dosage
  • Carboplatin / therapeutic use*
  • Cisplatin / administration & dosage
  • Cisplatin / therapeutic use*
  • Disease Progression
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Male
  • Middle Aged
  • Models, Biological
  • Multivariate Analysis
  • Neoplasms, Unknown Primary / diagnosis
  • Neoplasms, Unknown Primary / drug therapy*
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Carboplatin
  • L-Lactate Dehydrogenase
  • Cisplatin