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Treatment of patients with cancer of unknown primary site.

Advances in the management and treatment of the large, heterogeneous population of patients with carcinoma of unknown primary site have been achieved by recognizing treatable subsets within this group. Each of these subsets has been thoroughly discussed; Table 10-9 summarizes the treatable subsets and the evaluations necessary for their identification. Even within treatable subsets, treatment data remain limited, and optimal therapy is still evolving. Despite these advances, a large group of patients with relatively insensitive tumors remains. Improved therapy for these patients will probably await therapy breakthroughs in the treatment of non-small cell lung cancer, pancreatic cancer, and the various other GI malignancies, since these tumors represent the majority of occult primary sites.