Evidence map›Paper›PMID 39520389›Full record

ArticleThe oncologist2025

Evolution in the diagnosis and treatment of carcinoma of unknown primary: a multicenter Canadian analysis.

Boaz Wong, Jessica Liu, Sarah Yeo, Deborah Akurang, Alexandra Lo, Ying Hui Xu, Ying Wang, Stephen Welch, Paul Wheatley-Price

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Boaz WongDepartment of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.ORCID 0000-0001-9407-4315
Jessica LiuSchulich School of Medicine, Western University, London, ON N6A 5C1, Canada.
Sarah YeoFaculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Deborah AkurangDepartment of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Alexandra LoDepartment of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Ying Hui XuFaculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Ying WangFaculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Stephen WelchDivision of Medical Oncology, London Health Sciences Centre, London, ON N6A 5W9, Canada.
Paul Wheatley-PriceCancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.ORCID 0000-0002-3725-9767

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidelines for the management of patients with cancer of unknown primary (CUP), who have metastatic disease without an identified primary tumor site, have evolved. We sought to describe the diagnostic work-up and outcomes of patients with CUP in Canada over the last decade. We also sought to identify factors associated with improved prognosis in CUP, including primary tumor site identification, identification of "favorable subtypes," and concordance with published guidelines.

methodsWith ethics board approval, patients with histologically confirmed CUP between 2012 and 2021 in 3 Canadian cancer centers were reviewed and clinicopathological variables retrospectively collected. The primary endpoint was to describe significant trends in CUP diagnosis and management over the decade using linear regression models. Univariable (UVA) and multivariable (MVA) logistic regression analyses identified variables correlated with primary site identification and overall survival (OS). Kaplan-Meier curves with the log-rank test were used to compare OS outcomes.

resultsIn total, 907 patients were included, with a median follow-up of 5.1 months. There was an increase in both 5-year survival and identification of primary tumors over the decade. Diagnostic tests including next-generation sequencing were independently associated with primary site identification on UVA. However, primary site identification was not found to be predictive of survival; instead, patients with "favorable subtypes" of CUP had significantly longer OS.

conclusionsSurvival in patients with CUP in Canada has been increasing over the last decade. Identifying the primary site does not influence survival, and efforts should be focused on discovering novel "favorable subtypes" which have superior outcomes.

Indexed as

Neoplasms, Unknown PrimaryAdultAgedAged, 80 and overCanadaFemaleHumansMaleMiddle AgedPrognosisRetrospective Studiesdiagnosisdifferentialneoplasmsprognosisretrospective studiestherapeuticsunknown primary

Identifiers

PMID39520389
PMCPMC12311280

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