397:
323:
because the primary tumor is not identified due to clinical or technological inefficiencies, or because the primary tumor regresses or stays dormant after spreading the cancer cells that generate the metastases. This view is widely accepted in oncology; in fact, these cancers are also referred to as occult primary tumors. Because the site of the primary tumor usually dictates the treatment and expected outcome, this view may help create uncertainty and anxiety among health professionals and patients, who may feel that their evaluation has been incomplete.
327:
site before or without generating a tumor in their original tissue. Forming a tumor in a tissue is not a prerequisite for stem cells to move away from that tissue. Stem cells can migrate from their natural tissue and initiate a cancer in the new site before generating a detectable tumor in their natural tissue. In this case, the primary tumor could be identified after some time. However, stem cells can also migrate away from their natural tissue without generating a cancer there. In this case, the "primary tumor" would never exist (see
482:
292:
2085:
2115:
2125:
33:
331:). This can explain why the primary site is not identified even on postmortem examination in many patients with these cancers. This view of CUP may provide relief to health professionals and patients. After a detailed imaging and pathologic analysis, oncologists can tell their patients with CUP that metastasis does not always involve the formation of a primary tumor, and that their diagnostic evaluation is complete.
409:
site is important because knowing its location and type often helps doctors plan the best treatment. Treatment that is specific to the suspected type of cancer is likely to be more effective. Still, when diagnostic tests have not identified the primary site, doctors must decide whether the potential benefits of more extensive testing outweigh a patient's discomfort, possible complications, and the financial costs.
2105:
125:
2095:
556:
may be used alone or in combination to treat patients who have CUP. Even when the cancer is unlikely to be cured, treatment may help the patient live longer or improve the patient's quality of life. Radiation may be used to shrink a variety of local tumors. However, the potential side effects of the
424:
sometimes helps to identify the source of the cancer. Individual tests often do not provide definitive answers, but sometimes patterns may be observed, suggesting a particular site of origin (e.g. lung, colon, etc.). Immunohistochemical testing suggests a single source of cancer origin in about one
569:
Most people with cancer of unknown primary origin have widely disseminated and incurable disease, although a few can be cured through treatment. With treatment, typical survival with CUP ranges from 6 to 16 months. Survival rates are lower in cases with visceral metastatic disease, ranging from 6
326:
Because stem cells have a natural ability to migrate and also play a key role in cancer development, it has been proposed that a cancer of unknown primary site may form when deregulated, premalignant or cancerous stem cells migrate away from their natural tissue and give rise to a cancer in the new
322:
Cancer of unknown primary source is not a single type of cancer, although researchers have attempted to find a common characteristic that explains why a cancer might spread very early without causing symptoms at the site of origin. It is generally accepted that cancer of unknown primary site exists
408:
Sometimes, however, even when doctors use very sophisticated methods to try to identify the primary site, the part of the body the cancer cells came from cannot be determined. About 2 to 4 percent of all cancer patients have a cancer whose primary site is never found. Identifying the primary tumor
516:
If the site of origin is unknown or undiscovered, then the histology of the tumor (e.g., adenocarcinoma, squamous cell or mesenchymal) can usually be identified, and a probable origin may be assumed. When this is possible, then treatment is based on the type of cell and probable origin. Based on
594:
From 1980 to 1990, definition of unknown primary cancer was based on imaging results. Subsequently, research on immunohistochemistry allowed for the classification of cancer of unknown primary into sub-types. From 2000 to 2010, tailored therapies began to evolve, targeting specific subtypes of
339:
In recent years, microscopic and other diagnostic techniques have improved dramatically. However, the tissue of origin can be still determined only about in one in four cases of CUPs with these methods. In some cases, the part of the body where cancer cells are first discovered helps the doctor
513:
involvement, treatment is offered along the lines of breast cancer. In patients, who have neck lymph node involvement, then treatment is offered along the lines of head and neck cancer. If inguinal lymph nodes are involved, then treatment may be offered along the lines of genitourinary cancer.
512:
Because CUP refers to many different cancers, treatment depends on where the cancer is found, the microscopic appearance of the cancer cells, the biochemical characterization of the cells, and the patient's age and overall physical condition. In women, who present with axillary lymph node
231:
performed for another indication. The disease typically develops rapidly, and metastases may occur in places in the body that are otherwise unusual. Comprehensive physical examination is part of the process to identify a possible primary source of cancer; this should include the
570:
to 9 months. Survival rates are higher when the cancer is more limited to lymph nodes, pleura, or peritoneal metastasis, which ranges from 14 to 16 months. Long-term prognosis is somewhat better if a particular source of cancer is strongly suggested by clinical evidence.
393:. Germ cell tumors usually begin in the ovaries and testes. In patients in whom the primary cancer is eventually found, the lung and pancreas are the most common primary cancer sites. CUP also may be traced to the breast, prostate, colon, or rectum as the primary site.
212:. Less commonly, a metastatic tumor is found first; but in most such cases, the primary tumor can then be located via examination and testing. Rarely (3–5% of the time), the primary tumor cannot be found because it is too small, or because it has
449:
refers to cancer that begins in the cells in glandular structures in the lining or covering of certain organs in the body. Common primary sites for adenocarcinomas include the lung, pancreas, breast, prostate, stomach, liver, and colon.
340:
decide which diagnostic tests will be most helpful. Additional clues which may be helpful in determining the primary site include the pattern of spread, and the cell type, which is based on its appearance under a microscope (
557:
treatment must be considered along with the potential benefits. In CUP to secondary neck nodes, surgery followed by external beam radiotherapy is sufficient. For CUP with an unfavorable prognosis, treatment with
382:, at sites such as the lung and breast. If the metastatic cancer appears first in the lower part of the body, the primary cancer is more likely to be at sites below the diaphragm, such as the pancreas and liver.
1245:
1230:
425:
in four cases of CUP. However, there is a lack of definitive research data showing that treatment guided by information from immunohistochemical testing improves outcomes or long-term prognosis.
578:
CUP sometimes runs in families. It has been associated with familial lung, kidney, and colorectal cancers, which suggests that these sites may often be the origin of unidentifiable CUP cancers.
420:
may be used to determine the expression of protein markers on the surface of cancer cells. Often the expression of these antigens is similar to the tissue that the cancer grew from, so
385:
When the cancer cells are poorly differentiated (that is, they look less evolved than normal cells when viewed under a microscope), the cancer may be either a lymphoma or a
208:. Over the course of time—particularly if the primary tumor is left untreated—smaller "satellite" tumors will appear at other places in the body, a phenomenon known as
530:
378:
The pattern of spread may suggest the location of the primary site. For example, metastatic cancer found in the upper body is more likely to have an origin above the
375:
should be done for squamous cell carcinoma involving lymph nodes of the neck region. For other types of cancer of unknown primary, a PET-CT offers uncertain benefit.
781:
255:
The location of metastases may be a clue as to the underlying source, even if this cannot be found on investigations. For instance, a woman in whom there is
1131:"Evaluation of survival benefits by platinums and taxanes for an unfavourable subset of carcinoma of unknown primary: a systematic review and meta-analysis"
43:
196:
in most (80 to 85%) of those circumstances. The other 15 to 20% of patients, however, have a relatively long survival with appropriate treatment.
561:
may provide a slight survival benefit. The uncertainties and ambiguity inherent in a CUP diagnosis may cause additional stress for the patient.
104:
586:
Around 9,800 people were diagnosed with cancer of unknown primary in the UK in 2011, and around 10,625 people died from the disease in 2012.
76:
972:
17:
83:
1614:
1955:
648:
90:
1554:
72:
1854:
1186:
996:
855:"The migration ability of stem cells can explain the existence of cancer of unknown primary site. Rethinking metastasis"
185:
cannot be identified. A diagnosis of CUP requires a clinical picture consistent with metastatic disease and one or more
1990:
1332:
526:
493:
404:
tumor cells which are undifferentiated, that is, the primary tumor cannot be determined by their histologic appearance.
303:
1129:
Lee, J.; Hahn, S.; Kim, D.-W.; Kim, J.; Kang, S. N.; Rha, S. Y.; Lee, K. B.; Kang, J.-H.; Park, B.-J. (Jan 15, 2013).
62:
2108:
1980:
1414:
97:
220:
activity or other factors. In such situations a diagnosis of cancer of unknown primary origin (CUP) is made.
1960:
58:
1604:
800:
1584:
442:
1080:"Survival in carcinoma of unknown primary to neck nodes treated with neck dissection and radiotherapy"
2013:
941:
223:
CUP usually comes to attention because of masses or swellings found somewhere in the body, either by
51:
2149:
1805:
1727:
1722:
1642:
1402:
1260:
256:
328:
1785:
1759:
466:
454:
396:
47:
1377:
1325:
936:
400:
Histopathology of a biopsy of a lymph node with cancer of unknown primary origin, showing high-
213:
192:
CUP is found in about 3 to 5% of all people diagnosed with invasive cancer, and carries a poor
2028:
1914:
1887:
1860:
1812:
1766:
1461:
927:
Varadhachary, Gauri R.; Raber, Martin N. (21 August 2014). "Cancer of
Unknown Primary Site".
534:
272:
1290:
453:
The remaining 10 percent are either poorly or undifferentiated malignant neoplasms (5%), or
2048:
2008:
1875:
1689:
1684:
1664:
1599:
1451:
685:"Cancers of unknown primary origin: current perspectives and future therapeutic strategies"
458:
356:
260:
224:
1029:
Ettinger, David S.; Agulnik, Mark; Cates, Justin M. M.; Cristea, Mihaela (December 2011).
8:
2128:
2070:
2053:
1712:
1429:
1249:
649:"Rarer cancers with unknown primary tumours diagnosed too late – Press releases – GOV.UK"
421:
2018:
1975:
1965:
1754:
1707:
1674:
1669:
1419:
1397:
1294:
1163:
1130:
1106:
1079:
879:
854:
764:
711:
684:
631:
606:
379:
351:
of the chest, abdomen, and pelvis, with IV contrast. Women with enlarged lymph nodes (
249:
245:
1254:
752:
367:
to evaluate for possible breast cancer. If those imaging studies are normal, then an
2114:
2088:
1970:
1940:
1919:
1882:
1865:
1780:
1744:
1734:
1629:
1549:
1493:
1456:
1441:
1382:
1349:
1318:
1305:
1168:
1150:
1111:
1060:
1052:
954:
884:
756:
716:
636:
618:
545:
153:
768:
445:
adenocarcinoma, while about 30% are poorly differentiated adenocarcinoma. The term
2098:
1790:
1775:
1652:
1527:
1483:
1158:
1142:
1101:
1091:
1042:
946:
874:
866:
748:
706:
696:
626:
434:
401:
390:
2118:
2063:
1924:
1909:
1892:
1832:
1827:
1771:
1749:
1446:
1392:
1372:
1265:
549:
517:
histological subtype, combination chemotherapy may be selected. A combination of
386:
372:
352:
276:
228:
1950:
1904:
1717:
1647:
1466:
824:
438:
1280:
1239:
787:
Clinical guideline 104: Metastatic malignant disease of unknown primary origin
2143:
2033:
1822:
1817:
1679:
1619:
1522:
1154:
1096:
1056:
870:
739:
Pavlidis N, Pentheroudakis G (April 2012). "Cancer of unknown primary site".
683:
Stella, GM; Senetta, R; Cassenti, A; Ronco, M; Cassoni, P (24 January 2012).
622:
264:
217:
205:
182:
1047:
1030:
701:
2038:
2023:
1849:
1574:
1424:
1409:
1355:
1172:
1115:
1064:
958:
888:
801:"Cancer of Unknown Primary Origin | Memorial Sloan Kettering Cancer Center"
760:
720:
640:
541:
950:
537:, which if identified, directs treatment for metastatic germ cell tumors.
1897:
1842:
1739:
1594:
1569:
1387:
1146:
786:
553:
518:
462:
268:
1222:
481:
291:
1985:
1870:
1837:
1609:
1559:
1544:
1539:
1532:
1517:
1507:
522:
417:
364:
241:
237:
209:
178:
61:
if you can. Unsourced or poorly sourced material may be challenged and
2058:
1800:
1795:
1659:
1637:
1512:
1476:
1285:
360:
341:
193:
1564:
1341:
158:
533:
may also be employed. Germ cell tumors often carry abnormality of
2043:
1503:
1471:
1364:
348:
1234:
558:
233:
186:
174:
1077:
437:. The majority of cancers of unknown primary, about 90%, are
347:
The initial work-up of a cancer of unknown primary includes a
1299:
1310:
1028:
682:
1302:– UK-based information and support for patients with CUP.
1291:
Clinically reviewed information on unknown primary cancer
368:
1078:
Krishnatreya M, Sharma JD, Kataki AC, Kalita M (2014).
738:
782:
National
Institute for Health and Clinical Excellence
1212:
1035:
Journal of the
National Comprehensive Cancer Network
825:"Carcinoma of Unknown Primary—Patient Version - NCI"
926:
848:
846:
844:
2141:
540:No method is standard for all forms of CUP, but
433:CUP may be classified by its appearance under a
922:
920:
918:
1084:Annals of Medical and Health Sciences Research
916:
914:
912:
910:
908:
906:
904:
902:
900:
898:
841:
734:
732:
730:
412:
57:Please review the contents of the article and
1326:
1128:
852:
604:
895:
727:
525:is often used. Advances techniques such as
441:, with 60% appearing as moderately to well-
204:Most cancers typically present as a single
1615:Reproductive endocrinology and infertility
1333:
1319:
267:, and men with lymph node deposits in the
1956:Bachelor of Medicine, Bachelor of Surgery
1162:
1105:
1095:
1046:
940:
878:
710:
700:
630:
189:results inconsistent with a tumor cancer
678:
676:
395:
973:"Tests for a Cancer of Unknown Primary"
775:
14:
2142:
1187:"Cancer of unknown primary statistics"
181:stage at the time of diagnosis, but a
1314:
1024:
1022:
1020:
1018:
1016:
673:
607:"Carcinoma of Unknown Primary Origin"
371:of the breast may be appropriate. A
199:
2094:
1855:Physical medicine and rehabilitation
476:
465:, such as sarcomatoid, basaloid, or
286:
26:
2104:
244:, external genitals, as well as an
24:
1991:Medical Scientist Training Program
1306:Cancer.Net: Unknown Primary Cancer
1013:
598:
246:internal examination of the rectum
73:"Cancer of unknown primary origin"
25:
2161:
1300:The CUP Foundation – Jo's Friends
1208:
689:Journal of Translational Medicine
428:
2123:
2113:
2103:
2093:
2084:
2083:
611:Gastrointestinal Cancer Research
480:
457:(5%). Rarely, CUP may appear as
290:
177:that is determined to be at the
167:Cancer of unknown primary origin
140:Cancer of unknown primary origin
123:
31:
2124:
1179:
1122:
1071:
929:New England Journal of Medicine
605:Varadhachary, Gauri R. (2007).
573:
265:cancer originated in the breast
1981:Doctor of Osteopathic Medicine
1415:Oral and maxillofacial surgery
989:
965:
817:
793:
59:add the appropriate references
13:
1:
753:10.1016/S0140-6736(11)61178-1
666:
472:
1961:Bachelor of Medical Sciences
1728:Neurosurgical anesthesiology
1340:
564:
334:
282:
18:Carcinoma of unknown primary
7:
997:"Cancer of unknown primary"
853:López-Lázaro (1 May 2015).
422:immunohistochemical testing
413:Immunohistochemical testing
44:reliable medical references
10:
2166:
589:
275:of the abdomen may have a
2079:
2001:
1939:
1700:
1628:
1583:
1492:
1363:
1348:
1216:
1135:British Journal of Cancer
389:. Lymphomas begin in the
261:lymph nodes of the armpit
152:
144:
139:
50:or relies too heavily on
1915:Transplantation medicine
1806:Clinical neurophysiology
1723:Obstetric anesthesiology
1643:Interventional radiology
1403:Digestive system surgery
1097:10.4103/2141-9248.138050
871:10.18632/oncoscience.159
531:tissue of origin testing
467:adenosquamous carcinomas
455:squamous cell carcinomas
263:) it is likely that the
257:axillary lymphadenopathy
1786:Intensive care medicine
1760:Mass gathering medicine
1605:Maternal–fetal medicine
1048:10.6004/jnccn.2011.0117
702:10.1186/1479-5876-10-12
359:with CUP should have a
1378:Cardiothoracic surgery
405:
2029:Personalized medicine
1888:Reproductive medicine
1813:Occupational medicine
1767:Evolutionary medicine
951:10.1056/NEJMra1303917
581:
459:neuroendocrine tumors
399:
273:retroperitoneal space
2049:Traditional medicine
2009:Alternative medicine
1876:Addiction psychiatry
1690:Transfusion medicine
1685:Medical microbiology
1600:Gynecologic oncology
1452:Reproductive surgery
1147:10.1038/bjc.2012.516
1090:(Suppl 2): S165–S6.
1001:www.macmillan.org.uk
271:of the chest and/or
250:of the pelvic organs
225:physical examination
2071:History of medicine
2054:Veterinary medicine
1861:Preventive medicine
1713:Adolescent medicine
1555:Infectious diseases
1293:for patients, from
2019:Molecular oncology
1976:Doctor of Medicine
1966:Master of Medicine
1883:Radiation oncology
1755:Emergency medicine
1708:Addiction medicine
1675:Clinical chemistry
1670:Clinical pathology
1462:Transplant surgery
1420:Orthopedic surgery
1398:Colorectal surgery
1295:Cancer Research UK
1191:Cancer Research UK
492:. You can help by
406:
355:) confined to the
302:. You can help by
200:Signs and symptoms
2137:
2136:
1971:Master of Surgery
1935:
1934:
1920:Tropical medicine
1866:Prison healthcare
1781:Hospital medicine
1745:Disaster medicine
1735:Aviation medicine
1550:Hospital medicine
1457:Surgical oncology
1442:Pediatric surgery
1436:
1383:Endocrine surgery
1275:
1274:
1041:(12): 1358–1395.
747:(9824): 1428–35.
595:unknown primary.
546:radiation therapy
510:
509:
320:
319:
259:(swelling in the
164:
163:
134:Medical condition
132:
131:
108:
16:(Redirected from
2157:
2127:
2126:
2117:
2107:
2106:
2097:
2096:
2087:
2086:
1791:Medical genetics
1776:General practice
1653:Nuclear medicine
1528:Gastroenterology
1484:Vascular surgery
1434:
1361:
1360:
1335:
1328:
1321:
1312:
1311:
1214:
1213:
1202:
1201:
1199:
1197:
1183:
1177:
1176:
1166:
1126:
1120:
1119:
1109:
1099:
1075:
1069:
1068:
1050:
1031:"Occult primary"
1026:
1011:
1010:
1008:
1007:
993:
987:
986:
984:
983:
969:
963:
962:
944:
942:10.1.1.1019.2799
924:
893:
892:
882:
850:
839:
838:
836:
835:
821:
815:
814:
812:
811:
797:
791:
779:
773:
772:
736:
725:
724:
714:
704:
680:
662:
660:
659:
644:
634:
505:
502:
484:
477:
435:light microscope
391:lymphatic system
315:
312:
294:
287:
137:
136:
127:
126:
118:
115:
109:
107:
66:
35:
34:
27:
21:
2165:
2164:
2160:
2159:
2158:
2156:
2155:
2154:
2150:Types of cancer
2140:
2139:
2138:
2133:
2075:
2064:Chief physician
1997:
1942:
1931:
1925:Travel medicine
1910:Sports medicine
1893:Sexual medicine
1833:Palliative care
1828:Pain management
1772:Family medicine
1750:Diving medicine
1696:
1624:
1586:
1579:
1495:
1488:
1447:Plastic surgery
1393:General surgery
1373:Cardiac surgery
1354:
1352:
1344:
1339:
1276:
1271:
1270:
1225:
1211:
1206:
1205:
1195:
1193:
1185:
1184:
1180:
1127:
1123:
1076:
1072:
1027:
1014:
1005:
1003:
995:
994:
990:
981:
979:
971:
970:
966:
925:
896:
851:
842:
833:
831:
823:
822:
818:
809:
807:
799:
798:
794:
790:. London, 2010.
780:
776:
737:
728:
681:
674:
669:
657:
655:
647:
601:
599:Further reading
592:
584:
576:
567:
550:hormone therapy
506:
500:
497:
490:needs expansion
475:
439:adenocarcinomas
431:
415:
387:germ cell tumor
357:axillary region
353:lymphadenopathy
337:
316:
310:
307:
300:needs expansion
285:
277:germ cell tumor
229:medical imaging
202:
135:
128:
124:
119:
113:
110:
67:
56:
52:primary sources
36:
32:
23:
22:
15:
12:
11:
5:
2163:
2153:
2152:
2135:
2134:
2132:
2131:
2121:
2111:
2101:
2091:
2080:
2077:
2076:
2074:
2073:
2068:
2067:
2066:
2056:
2051:
2046:
2041:
2036:
2031:
2026:
2021:
2016:
2011:
2005:
2003:
2002:Related topics
1999:
1998:
1996:
1995:
1994:
1993:
1983:
1978:
1973:
1968:
1963:
1958:
1953:
1951:Medical school
1947:
1945:
1937:
1936:
1933:
1932:
1930:
1929:
1928:
1927:
1917:
1912:
1907:
1905:Sleep medicine
1902:
1901:
1900:
1890:
1885:
1880:
1879:
1878:
1868:
1863:
1858:
1852:
1847:
1846:
1845:
1835:
1830:
1825:
1820:
1815:
1810:
1809:
1808:
1798:
1793:
1788:
1783:
1778:
1769:
1764:
1763:
1762:
1752:
1747:
1742:
1737:
1732:
1731:
1730:
1725:
1718:Anesthesiology
1715:
1710:
1704:
1702:
1698:
1697:
1695:
1694:
1693:
1692:
1687:
1682:
1677:
1672:
1667:
1657:
1656:
1655:
1650:
1648:Neuroradiology
1645:
1634:
1632:
1626:
1625:
1623:
1622:
1617:
1612:
1607:
1602:
1597:
1591:
1589:
1585:Obstetrics and
1581:
1580:
1578:
1577:
1572:
1567:
1562:
1557:
1552:
1547:
1542:
1537:
1536:
1535:
1525:
1520:
1515:
1510:
1500:
1498:
1490:
1489:
1487:
1486:
1481:
1480:
1479:
1469:
1467:Trauma surgery
1464:
1459:
1454:
1449:
1444:
1439:
1438:
1437:
1430:Otolaryngology
1427:
1422:
1417:
1412:
1407:
1406:
1405:
1400:
1390:
1385:
1380:
1375:
1369:
1367:
1358:
1356:subspecialties
1346:
1345:
1338:
1337:
1330:
1323:
1315:
1309:
1308:
1303:
1297:
1288:
1273:
1272:
1269:
1268:
1257:
1242:
1226:
1221:
1220:
1218:
1217:Classification
1210:
1209:External links
1207:
1204:
1203:
1178:
1121:
1070:
1012:
988:
977:www.cancer.org
964:
935:(8): 757–765.
894:
840:
829:www.cancer.gov
816:
792:
774:
726:
671:
670:
668:
665:
664:
663:
645:
617:(6): 229–235.
600:
597:
591:
588:
583:
580:
575:
572:
566:
563:
508:
507:
487:
485:
474:
471:
447:adenocarcinoma
443:differentiated
430:
429:Classification
427:
414:
411:
336:
333:
318:
317:
297:
295:
284:
281:
201:
198:
162:
161:
156:
150:
149:
146:
142:
141:
133:
130:
129:
122:
120:
39:
37:
30:
9:
6:
4:
3:
2:
2162:
2151:
2148:
2147:
2145:
2130:
2122:
2120:
2116:
2112:
2110:
2102:
2100:
2092:
2090:
2082:
2081:
2078:
2072:
2069:
2065:
2062:
2061:
2060:
2057:
2055:
2052:
2050:
2047:
2045:
2042:
2040:
2037:
2035:
2034:Public health
2032:
2030:
2027:
2025:
2022:
2020:
2017:
2015:
2014:Allied health
2012:
2010:
2007:
2006:
2004:
2000:
1992:
1989:
1988:
1987:
1984:
1982:
1979:
1977:
1974:
1972:
1969:
1967:
1964:
1962:
1959:
1957:
1954:
1952:
1949:
1948:
1946:
1944:
1938:
1926:
1923:
1922:
1921:
1918:
1916:
1913:
1911:
1908:
1906:
1903:
1899:
1896:
1895:
1894:
1891:
1889:
1886:
1884:
1881:
1877:
1874:
1873:
1872:
1869:
1867:
1864:
1862:
1859:
1856:
1853:
1851:
1848:
1844:
1841:
1840:
1839:
1836:
1834:
1831:
1829:
1826:
1824:
1823:Oral medicine
1821:
1819:
1818:Ophthalmology
1816:
1814:
1811:
1807:
1804:
1803:
1802:
1799:
1797:
1794:
1792:
1789:
1787:
1784:
1782:
1779:
1777:
1773:
1770:
1768:
1765:
1761:
1758:
1757:
1756:
1753:
1751:
1748:
1746:
1743:
1741:
1738:
1736:
1733:
1729:
1726:
1724:
1721:
1720:
1719:
1716:
1714:
1711:
1709:
1706:
1705:
1703:
1699:
1691:
1688:
1686:
1683:
1681:
1680:Cytopathology
1678:
1676:
1673:
1671:
1668:
1666:
1663:
1662:
1661:
1658:
1654:
1651:
1649:
1646:
1644:
1641:
1640:
1639:
1636:
1635:
1633:
1631:
1627:
1621:
1620:Urogynecology
1618:
1616:
1613:
1611:
1608:
1606:
1603:
1601:
1598:
1596:
1593:
1592:
1590:
1588:
1582:
1576:
1573:
1571:
1568:
1566:
1563:
1561:
1558:
1556:
1553:
1551:
1548:
1546:
1543:
1541:
1538:
1534:
1531:
1530:
1529:
1526:
1524:
1523:Endocrinology
1521:
1519:
1516:
1514:
1511:
1509:
1505:
1502:
1501:
1499:
1497:
1491:
1485:
1482:
1478:
1475:
1474:
1473:
1470:
1468:
1465:
1463:
1460:
1458:
1455:
1453:
1450:
1448:
1445:
1443:
1440:
1433:
1432:
1431:
1428:
1426:
1423:
1421:
1418:
1416:
1413:
1411:
1408:
1404:
1401:
1399:
1396:
1395:
1394:
1391:
1389:
1386:
1384:
1381:
1379:
1376:
1374:
1371:
1370:
1368:
1366:
1362:
1359:
1357:
1351:
1347:
1343:
1336:
1331:
1329:
1324:
1322:
1317:
1316:
1313:
1307:
1304:
1301:
1298:
1296:
1292:
1289:
1287:
1283:
1282:
1278:
1277:
1267:
1263:
1262:
1258:
1256:
1252:
1251:
1247:
1243:
1241:
1237:
1236:
1232:
1228:
1227:
1224:
1219:
1215:
1192:
1188:
1182:
1174:
1170:
1165:
1160:
1156:
1152:
1148:
1144:
1140:
1136:
1132:
1125:
1117:
1113:
1108:
1103:
1098:
1093:
1089:
1085:
1081:
1074:
1066:
1062:
1058:
1054:
1049:
1044:
1040:
1036:
1032:
1025:
1023:
1021:
1019:
1017:
1002:
998:
992:
978:
974:
968:
960:
956:
952:
948:
943:
938:
934:
930:
923:
921:
919:
917:
915:
913:
911:
909:
907:
905:
903:
901:
899:
890:
886:
881:
876:
872:
868:
865:(5): 467–75.
864:
860:
856:
849:
847:
845:
830:
826:
820:
806:
805:www.mskcc.org
802:
796:
789:
788:
783:
778:
770:
766:
762:
758:
754:
750:
746:
742:
735:
733:
731:
722:
718:
713:
708:
703:
698:
694:
690:
686:
679:
677:
672:
654:
650:
646:
642:
638:
633:
628:
624:
620:
616:
612:
608:
603:
602:
596:
587:
579:
571:
562:
560:
555:
551:
547:
543:
538:
536:
535:chromosome 12
532:
528:
524:
520:
514:
504:
495:
491:
488:This section
486:
483:
479:
478:
470:
468:
464:
460:
456:
451:
448:
444:
440:
436:
426:
423:
419:
410:
403:
398:
394:
392:
388:
383:
381:
376:
374:
370:
366:
362:
358:
354:
350:
345:
343:
332:
330:
324:
314:
305:
301:
298:This section
296:
293:
289:
288:
280:
278:
274:
270:
266:
262:
258:
253:
251:
247:
243:
239:
235:
230:
226:
221:
219:
218:immune system
215:
211:
207:
206:primary tumor
197:
195:
190:
188:
184:
183:primary tumor
180:
176:
172:
168:
160:
157:
155:
151:
148:Occult cancer
147:
143:
138:
121:
117:
106:
103:
99:
96:
92:
89:
85:
82:
78:
75: –
74:
70:
69:Find sources:
64:
60:
54:
53:
49:
45:
40:This article
38:
29:
28:
19:
2039:Rural health
2024:Nanomedicine
1575:Rheumatology
1506: /
1425:Hand surgery
1410:Neurosurgery
1279:
1259:
1244:
1229:
1194:. Retrieved
1190:
1181:
1141:(1): 39–48.
1138:
1134:
1124:
1087:
1083:
1073:
1038:
1034:
1004:. Retrieved
1000:
991:
980:. Retrieved
976:
967:
932:
928:
862:
858:
832:. Retrieved
828:
819:
808:. Retrieved
804:
795:
785:
777:
744:
740:
692:
688:
656:. Retrieved
652:
614:
610:
593:
585:
577:
574:Epidemiology
568:
542:chemotherapy
539:
515:
511:
498:
494:adding to it
489:
463:mixed tumors
452:
446:
432:
416:
407:
384:
377:
346:
338:
325:
321:
308:
304:adding to it
299:
254:
222:
203:
191:
170:
166:
165:
111:
101:
94:
87:
80:
68:
48:verification
41:
2109:Wikiproject
1898:Venereology
1843:Neonatology
1740:Dermatology
1595:Gynaecology
1587:gynaecology
1570:Pulmonology
1388:Eye surgery
1350:Specialties
859:Oncoscience
519:carboplatin
501:August 2014
373:PET CT scan
311:August 2014
269:mediastinum
238:lymph nodes
145:Other names
42:needs more
1871:Psychiatry
1857:(PM&R)
1850:Phlebology
1838:Pediatrics
1665:Anatomical
1630:Diagnostic
1610:Obstetrics
1560:Nephrology
1545:Hematology
1540:Geriatrics
1533:Hepatology
1518:Cardiology
1508:Immunology
1196:27 October
1006:2024-09-07
982:2024-09-07
834:2024-09-07
810:2024-09-07
667:References
658:2015-07-06
653:www.gov.uk
523:paclitaxel
473:Management
418:Antibodies
365:ultrasound
210:metastasis
179:metastatic
84:newspapers
2059:Physician
1943:education
1801:Neurology
1796:Narcology
1660:Pathology
1638:Radiology
1513:Angiology
1477:Andrology
1286:eMedicine
1155:1532-1827
1057:1540-1413
937:CiteSeerX
623:1934-7820
565:Prognosis
380:diaphragm
361:mammogram
342:histology
335:Diagnosis
283:Mechanism
214:regressed
194:prognosis
154:Specialty
114:July 2015
2144:Category
2089:Category
1565:Oncology
1496:medicine
1494:Internal
1342:Medicine
1281:med/1463
1173:23175147
1116:25184090
1065:22157556
959:25140961
889:26097879
769:44385281
761:22414598
721:22272606
641:19262901
159:Oncology
2129:Outline
2099:Commons
2044:Therapy
1941:Medical
1504:Allergy
1472:Urology
1365:Surgery
1266:D009382
1164:3553519
1107:4145520
880:4468332
712:3315427
632:2631214
590:History
559:taxanes
554:surgery
349:CT scan
234:breasts
216:due to
173:) is a
98:scholar
63:removed
2119:Portal
1986:MD–PhD
1171:
1161:
1153:
1114:
1104:
1063:
1055:
957:
939:
887:
877:
767:
759:
741:Lancet
719:
709:
695:: 12.
639:
629:
621:
552:, and
329:Figure
240:, the
227:or on
187:biopsy
175:cancer
100:
93:
86:
79:
71:
1701:Other
1255:199.1
1240:C80.0
765:S2CID
461:, or
402:grade
105:JSTOR
91:books
1261:MeSH
1250:9-CM
1198:2014
1169:PMID
1151:ISSN
1112:PMID
1061:PMID
1053:ISSN
955:PMID
885:PMID
757:PMID
717:PMID
637:PMID
619:ISSN
529:and
527:FISH
521:and
248:and
242:skin
77:news
46:for
1435:ENT
1353:and
1284:at
1246:ICD
1231:ICD
1159:PMC
1143:doi
1139:108
1102:PMC
1092:doi
1043:doi
947:doi
933:371
875:PMC
867:doi
749:doi
745:379
707:PMC
697:doi
627:PMC
496:.
369:MRI
363:or
344:).
306:.
171:CUP
2146::
1774:/
1264::
1253::
1238::
1235:10
1189:.
1167:.
1157:.
1149:.
1137:.
1133:.
1110:.
1100:.
1086:.
1082:.
1059:.
1051:.
1037:.
1033:.
1015:^
999:.
975:.
953:.
945:.
931:.
897:^
883:.
873:.
861:.
857:.
843:^
827:.
803:.
784:.
763:.
755:.
743:.
729:^
715:.
705:.
693:10
691:.
687:.
675:^
651:.
635:.
625:.
613:.
609:.
582:UK
548:,
544:,
469:.
279:.
252:.
236:,
65:.
1334:e
1327:t
1320:v
1248:-
1233:-
1223:D
1200:.
1175:.
1145::
1118:.
1094::
1088:4
1067:.
1045::
1039:9
1009:.
985:.
961:.
949::
891:.
869::
863:2
837:.
813:.
771:.
751::
723:.
699::
661:.
643:.
615:1
503:)
499:(
313:)
309:(
169:(
116:)
112:(
102:·
95:·
88:·
81:·
55:.
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.