Characterisation and outcomes of patients referred to a regional cancer of unknown primary team: a 10-year analysis

Mark Stares, Karin Purshouse, Gillian Knowles, Rachel Haigh, Jenny Irvine, Aoife Gatenby, Rebekah Patton, Jo Mcginty, Alan Christie, Marjory Maclennan, Colin Barrie, Sally Clive

Research output: Contribution to journalArticlepeer-review

Abstract

Background
In the United Kingdom, national guidance published in 2010 recommended the establishment of specialist teams to improve clinical pathways for patients presenting with malignancies of undefined primary origin (MUO) and cancer of unknown primary (CUP). This study sought to define outcomes of patients referred to a regional MUO/CUP service.

Methods
Data were collected prospectively on all patients (n = 1225) referred to a regional CUP team over a 10-year period. Patient demographics, clinical, pathological and outcome data were recorded and analysed.

Results
Confirmed CUP (cCUP) was diagnosed in 25% of patients. A primary metastatic cancer was identified in 36%, 5% were diagnosed with provisional CUP (pCUP), 27% retained the diagnosis of MUO and in 8% a non-cancer diagnosis was made. Median survival was low in all patients with a final malignant diagnosis: primary identified 9.0 months, cCUP 4.0 months, pCUP 1.5 months and MUO 1.5 months.

Conclusions
Patients presenting with MUO have poor outcomes irrespective of the final diagnosis. These patients need a patient-centred, streamlined, rapid diagnostic pathway. There are clear benefits to primary and secondary care teams having access to a dedicated, multidisciplinary MUO/CUP service, with clinical nurse specialists supporting the patients, to help facilitate this pathway and ensure early oncology review.
Original languageEnglish
JournalBritish Journal of Cancer
DOIs
Publication statusAccepted/In press - 26 Aug 2021

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