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Prognostic Factors and Their Role in the Management of CUP

  • Chapter
Cancer of Unknown Primary

Abstract

CUP is heterogeneous in terms of prognosis, which underscores the importance of assessment of prognostic factors. Two different approaches exist: Firstly, specific subgroups have been defined, usually by a combination of clinical distribution pattern and histologic criteria which suggest a specific working hypothesis regarding the site of origin. These subgroups are treated in analogy to specific organ cancers, as suggested by the respective working hypothesis. The other approach is to look at prognostic factors that are valid for CUP as a whole or for cases where no such working hypothesis exists, which account for the majority of CUP patients. Among the most important parameters relevant for CUP prognostication are the performance status, the number of metastatic sites, specific metastatic sites such as the liver that confer poor prognosis, the histological type, and lactate dehydrogenase, alkaline phosphatase, and albumin as serum parameters. These and other factors have been combined into several different prognostic scoring systems, some of which involving sophisticated decision algorithms, others being simpler and therefore more practical for routine use. In practice, we recommend consideration of specific subgroups first. Only in cases where patients do not qualify for any specific subgroup, more general prognosis predictors should be considered.

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Authors and Affiliations

  1. Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and University of Heidelberg, Heidelberg, Germany

    Harald Löffler & Alwin Krämer

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  1. Harald Löffler
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  2. Alwin Krämer
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Correspondence to Harald Löffler .

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Editors and Affiliations

  1. German Cancer Research Center (DKFZ) and University of Heidelberg, Clinical Cooperation Unit Molecular, Hematology/Oncology, Heidelberg, Germany

    Alwin Krämer

  2. German Cancer Research Center (DKFZ) and University of Heidelberg, Clinical Cooperation Unit Molecular, Hematology/Oncology, Heidelberg, Germany

    Harald Löffler

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Löffler, H., Krämer, A. (2016). Prognostic Factors and Their Role in the Management of CUP. In: Krämer, A., Löffler, H. (eds) Cancer of Unknown Primary. Springer, Cham. https://doi.org/10.1007/978-3-319-22581-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-22581-4_4

  • Publisher Name: Springer, Cham

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