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Liver metastases from adenocarcinomas of unknown primary site: management and prognosis in 68 consecutive patients

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Summary

Background

In this retrospective study, we aimed to evaluate the clinicopathological characteristics of the patients presenting with liver metastases from unknown primary site besides survival rates, treatment outcomes, and prognostic factors.

Methods

In all, 68 patients followed-up at our center with adenocarcinoma of unknown primary (ACUP) metastatic to the liver between 2005 and 2013 were enrolled. All of the liver metastases were proven by liver biopsy and all yielded diagnosis of adenocarcinoma.

Results

Median age was 61 years (29–90) and most of the patients were male (male/female: 43/25). The liver was the only metastatic site in 2 (3 %) patients whilst 66 patients (97 %) had extrahepatic metastases. The most common extrahepatic metastatic sites were lymph nodes (89.7 %), lungs (32.4 %), bones (25 %), peritoneum (11.8 %), brain (4.4 %), and adrenal glands (2.9 %). Of all 68 patients, 39 (57.4 %) were treated with chemotherapy. Median overall survival (OS) was significantly higher in ACUP patients treated with chemotherapy [12.5 months (95 % CI 8.3–16.7) vs. 4 months (95 % CI 1.2–6.8), (p = 0.026), respectively]. In multivariate analysis, ECOG (Eastern Cooperative Oncology Group) performance status (p = 0.009), chemotherapy (p = 0.024), serum albumin (p = 0.012), and serum CA 19-9 level (p = 0.026) at initial diagnosis were identified as independent prognostic factors influencing survival for the patients with liver metastases from ACUP.

Conclusion

Patients with liver metastases from ACUP have poor prognosis and chemotherapy improves survival. Decreased serum albumin level, increased CA 19-9 level and poor performance status are independent poor prognostic factors.

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Authors and Affiliations

  1. Department of Medical Oncology, Ankara Numune Education and Research Hospital, 06100, Sihhiye/Ankara, Turkey

    Efnan Algin MD

  2. Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Ahmet Ozet, Suleyman Buyukberber, Ugur Coskun, Ramazan Yıldız & Mustafa Benekli

  3. Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey

    Ozge Gumusay

  4. Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Guldal Yilmaz

  5. Department of Medical Oncology, Sakarya Education and Research Hospital, Sakarya, Turkey

    Meltem Baykara

  6. Department of Medical Oncology, Van Education and Research Hospital, Van, Turkey

    Bulent Cetin

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  1. Efnan Algin MD
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  2. Ahmet Ozet
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Correspondence to Efnan Algin MD.

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Algin, E., Ozet, A., Gumusay, O. et al. Liver metastases from adenocarcinomas of unknown primary site: management and prognosis in 68 consecutive patients. Wien Klin Wochenschr 128, 42–47 (2016). https://doi.org/10.1007/s00508-015-0858-8

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  • DOI: https://doi.org/10.1007/s00508-015-0858-8

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