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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Article

The Clinical Significance of Occult Gynecologic Primary Tumours in Metastatic Cancer

1
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
2
Ivey Business School, Western University, London, ON, Canada
3
Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
4
Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
5
Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
6
Department of Radiation Oncology, London Regional Cancer Program, London, ON, Canada
7
Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
8
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
9
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
10
Department of Public Health Sciences, University of California, Davis, CA, USA
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(5), 368-378; https://doi.org/10.3747/co.24.3594
Received: 3 July 2017 / Revised: 7 August 2017 / Accepted: 4 September 2017 / Published: 1 October 2017
Objective: We estimated the frequency of occult gynecologic primary tumours (GPTS) in patients with metastatic cancer from an uncertain primary and evaluated the effect on disease management and overall survival (OS). Methods: We used Manitoba administrative health databases to identify all patients initially diagnosed with metastatic cancer during 2002–2011. We defined patients as having an “occult” primary tumour if the primary was classified at least 6 months after the initial diagnosis. Otherwise, we considered patients to have “obvious” primaries. We then compared clinicopathologic and treatment characteristics and 2-year OS for women with occult and with obvious GPTS. We used Cox regression adjustment and propensity score methods to assess the effect on OS of having an occult GPT. Results: Among the 5953 patients diagnosed with metastatic cancer, occult primary tumours were more common in women (n = 285 of 2552, 11.2%) than in men (n = 244 of 3401, 7.2%). In women, GPTS were the most frequent occult primary tumours (n = 55 of 285, 19.3%). Compared with their counterparts having obvious GPTS, women with occult GPTS (n = 55) presented with similar histologic and metastatic patterns but received fewer gynecologic diagnostic examinations during diagnostic work-up. Women with occult GPTS were less likely to undergo surgery, waited longer for radiotherapy, and received a lesser variety of chemotherapeutic agents. Having an occult compared with an obvious gpt was associated with decreased OS (hazard ratio: 1.62; 95% confidence interval: 1.2 to 2.35). Similar results were observed in adjusted analyses. Conclusions: In women with metastatic cancer from an uncertain primary, GPTS constitute the largest clinical entity. Accurate diagnosis of occult GPTS early in the course of metastatic cancer might lead to more effective treatment decisions and improved survival outcomes.
Keywords: cohort studies; data linkage; gynecologic cancers; matched groups; metastasis; occult primary neoplasms; propensity score cohort studies; data linkage; gynecologic cancers; matched groups; metastasis; occult primary neoplasms; propensity score
MDPI and ACS Style

Hannouf, M.B.; Winquist, E.; Mahmud, S.M.; Brackstone, M.; Sarma, S.; Rodrigues, G.; Rogan, P.K.; Hoch, J.S.; Zaric, G.S. The Clinical Significance of Occult Gynecologic Primary Tumours in Metastatic Cancer. Curr. Oncol. 2017, 24, 368-378. https://doi.org/10.3747/co.24.3594

AMA Style

Hannouf MB, Winquist E, Mahmud SM, Brackstone M, Sarma S, Rodrigues G, Rogan PK, Hoch JS, Zaric GS. The Clinical Significance of Occult Gynecologic Primary Tumours in Metastatic Cancer. Current Oncology. 2017; 24(5):368-378. https://doi.org/10.3747/co.24.3594

Chicago/Turabian Style

Hannouf, M. B., E. Winquist, S. M. Mahmud, M. Brackstone, S. Sarma, G. Rodrigues, P. K. Rogan, J. S. Hoch, and G. S. Zaric 2017. "The Clinical Significance of Occult Gynecologic Primary Tumours in Metastatic Cancer" Current Oncology 24, no. 5: 368-378. https://doi.org/10.3747/co.24.3594

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