C S Kim1, M B Hannouf1, S Sarma1, G B Rodrigues2, P K Rogan3, S M Mahmud4, E Winquist5, M Brackstone6, G S Zaric1,7. 1. Department of Epidemiology and Biostatistics, Western University, London, ON. 2. Department of Radiation Oncology, London Regional Cancer Program, London, ON. 3. Department of Biochemistry, Western University, London, ON. 4. Community Health Sciences and Pharmacy, University of Manitoba, Winnipeg, MB. 5. Department of Oncology, Western University, London, ON. 6. Department of Surgery, Western University, London, ON. 7. Richard Ivey School of Business, Western University, London, ON.
Abstract
Introduction: Patients with cancer of unknown primary (cup) have pathologically confirmed metastatic tumours with unidentifiable primary tumours. Currently, very little is known about the relationship between the treatment of patients with cup and their survival outcomes. Thus, we compared oncologic treatment and survival outcomes for patients in Ontario with cup against those for a cohort of patients with metastatic cancer of known primary site. Methods: Using the Ontario Cancer Registry and the Same-Day Surgery and Discharge Abstract databases maintained by the Canadian Institute for Health Information, we identified all Ontario patients diagnosed with metastatic cancer between 1 January 2000 and 31 December 2005. Ontario Health Insurance Plan treatment records were linked to identify codes for surgery, chemotherapy, or therapeutic radiation related to oncology. Multivariable Cox regression models were constructed, adjusting for histology, age, sex, and comorbidities. Results: In 45,347 patients (96.3%), the primary tumour site was identifiable, and in 1743 patients (3.7%), cup was diagnosed. Among the main tumour sites, cup ranked as the 6th largest. The mean Charlson score was significantly higher (p < 0.0001) in patients with cup (1.88) than in those with a known primary (1.42). Overall median survival was 1.9 months for patients with cup compared with 11.9 months for all patients with a known-primary cancer. Receipt of treatment was more likely for patients with a known primary site (n= 35,012, 77.2%) than for those with cup (n = 891, 51.1%). Among patients with a known primary site, median survival was significantly higher for treated than for untreated patients (19.0 months vs. 2.2 months, p < 0.0001). Among patients with cup, median survival was also higher for treated than for untreated patients (3.6 months vs. 1.1 months, p < 0.0001). Conclusions: In Ontario, patients with cup experience significantly lower survival than do patients with metastatic cancer of a known primary site. Treatment is associated with significantly increased survival both for patients with cup and for those with metastatic cancer of a known primary site.
Introduction: Patients with cancer of unknown primary (cup) have pathologically confirmed metastatic tumours with unidentifiable primary tumours. Currently, very little is known about the relationship between the treatment of patients with cup and their survival outcomes. Thus, we compared oncologic treatment and survival outcomes for patients in Ontario with cup against those for a cohort of patients with metastatic cancer of known primary site. Methods: Using the Ontario Cancer Registry and the Same-Day Surgery and Discharge Abstract databases maintained by the Canadian Institute for Health Information, we identified all Ontario patients diagnosed with metastatic cancer between 1 January 2000 and 31 December 2005. Ontario Health Insurance Plan treatment records were linked to identify codes for surgery, chemotherapy, or therapeutic radiation related to oncology. Multivariable Cox regression models were constructed, adjusting for histology, age, sex, and comorbidities. Results: In 45,347 patients (96.3%), the primary tumour site was identifiable, and in 1743 patients (3.7%), cup was diagnosed. Among the main tumour sites, cup ranked as the 6th largest. The mean Charlson score was significantly higher (p < 0.0001) in patients with cup (1.88) than in those with a known primary (1.42). Overall median survival was 1.9 months for patients with cup compared with 11.9 months for all patients with a known-primary cancer. Receipt of treatment was more likely for patients with a known primary site (n= 35,012, 77.2%) than for those with cup (n = 891, 51.1%). Among patients with a known primary site, median survival was significantly higher for treated than for untreated patients (19.0 months vs. 2.2 months, p < 0.0001). Among patients with cup, median survival was also higher for treated than for untreated patients (3.6 months vs. 1.1 months, p < 0.0001). Conclusions: In Ontario, patients with cup experience significantly lower survival than do patients with metastatic cancer of a known primary site. Treatment is associated with significantly increased survival both for patients with cup and for those with metastatic cancer of a known primary site.
Entities:
Keywords:
Cancer of unknown primary; Ontario Cancer Registry; Ontario Health Insurance Plan; administrative data; cup; survival analyses
Authors: Chong S Kim; Malek B Hannouf; Sisira Sarma; George B Rodrigues; Peter K Rogan; Salaheddin M Mahmud; Eric Winquist; Muriel Brackstone; Gregory S Zaric Journal: Acta Oncol Date: 2015-03-31 Impact factor: 4.089
Authors: Alexander C Small; Che-Kai Tsao; Erin L Moshier; Benjamin A Gartrell; Juan P Wisnivesky; James H Godbold; Cardinale B Smith; Guru Sonpavde; William K Oh; Matthew D Galsky Journal: Cancer Date: 2012-06-15 Impact factor: 6.860
Authors: Eric Yaovi Amela; Géraldine Lauridant-Philippin; Sophie Cousin; Thomas Ryckewaert; Antoine Adenis; Nicolas Penel Journal: Crit Rev Oncol Hematol Date: 2012-04-11 Impact factor: 6.312
Authors: Pascal Seve; Michael Sawyer; John Hanson; Christiane Broussolle; Charles Dumontet; John R Mackey Journal: Cancer Date: 2006-05-01 Impact factor: 6.860
Authors: David H Brewster; Jaroslaw Lang; Lesley A Bhatti; Catherine S Thomson; Karin A Oien Journal: Cancer Epidemiol Date: 2014-04-13 Impact factor: 2.984
Authors: R Collado Martín; A García Palomo; L de la Cruz Merino; P Borrega García; F J Barón Duarte Journal: Clin Transl Oncol Date: 2014-11-13 Impact factor: 3.405
Authors: Lisa Guccione; Krista Fisher; Linda Mileshkin; Richard Tothill; David Bowtell; Stephen Quinn; Anna DeFazio; Chris S Karapetis; Nicholas Wilcken; Madhu Singh; Christopher Steer; Bo Gao; Mark Warren; Ian M Collins; Narayan Karanth; Cindy Bryant; Penelope Schofield Journal: Support Care Cancer Date: 2022-07-09 Impact factor: 3.359
Authors: Andrea L Schaffer; Sallie-Anne Pearson; Oscar Perez-Concha; Timothy Dobbins; Robyn L Ward; Marina T van Leeuwen; Joel J Rhee; Maarit A Laaksonen; Glynis Craigen; Claire M Vajdic Journal: PLoS One Date: 2020-03-19 Impact factor: 3.240