Cancer site
Searched over 200M research papers for "cancer site"
Summary
10 papers analyzed
These studies suggest that the site of the primary tumor significantly impacts prognosis and treatment outcomes in various cancers, including breast cancer, prostate cancer, and cancer of unknown primary site (CUP).
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Cancer Site: Insights from Recent Research
Site-Specific Treatment for Cancer of Unknown Primary Site (CUP)
Molecular Profiling and Targeted Therapy
Recent advancements in next-generation sequencing (NGS) have enabled the molecular profiling of cancers of unknown primary site (CUP), allowing for site-specific and targeted therapies. A phase 2 clinical trial conducted in Japan demonstrated that using RNA and DNA sequencing to predict tumor origin and guide treatment can improve clinical outcomes for CUP patients. The study found that the most common predicted cancer types were lung, liver, kidney, and colorectal cancer, with frequent gene alterations in TP53, KRAS, and CDKN2A. The 1-year survival probability was 53.1%, with a median overall survival (OS) of 13.7 months and progression-free survival (PFS) of 5.2 months.
Comparative Effectiveness of Site-Specific Therapy
A randomized phase II trial compared site-specific treatment based on gene expression profiling with empirical chemotherapy using carboplatin and paclitaxel. The study found no significant improvement in 1-year survival for site-specific therapy compared to empirical chemotherapy, although the prediction of the original site was of prognostic value. Median OS and PFS were similar between the two groups, suggesting that while molecular profiling can guide treatment, it may not always lead to better outcomes compared to standard chemotherapy.
Prognostic Role of Tumor Site in Breast Cancer
Impact of Primary Tumor Location
The location of the primary tumor in breast cancer significantly affects prognosis. A study analyzing over 5,000 patients found that tumors originating from the upper-outer quadrant had different survival outcomes compared to other locations. Tumors from overlapping lesions had higher odds of positive axillary lymph nodes and a higher risk of death, while those from the lower-outer quadrant were associated with a lower risk of death. Another study confirmed that medial breast tumors have a worse prognosis compared to lateral tumors, particularly in patients with node-negative disease.
Metastatic Site and Survival in Prostate Cancer
Differential Survival Based on Metastatic Site
In men with metastatic castration-resistant prostate cancer (mCRPC), the site of metastasis is a crucial predictor of overall survival. A meta-analysis of data from nine phase III trials involving 8,820 men revealed that those with liver metastases had the worst median OS (13.5 months), followed by lung metastases (19.4 months), bone metastases (21.3 months), and lymph node-only metastases (31.6 months). These findings highlight the importance of metastatic site in guiding treatment decisions and designing clinical trials.
Lung Cancer Staging and Multiple Pulmonary Sites
Revised TNM Classification
The International Association for the Study of Lung Cancer has proposed revisions to the TNM classification for lung cancers with multiple pulmonary sites. The new classification aims to provide more consistent staging and better reflect the unique aspects of different patterns of disease presentation. For instance, second primary lung cancers are now designated with separate T, N, and M categories, while tumors with separate nodules are classified based on their location relative to the index tumor.
Conclusion
The site of the primary tumor and the metastatic site play critical roles in the prognosis and treatment of various cancers. Advances in molecular profiling and targeted therapies offer promising avenues for improving outcomes, particularly for cancers of unknown primary site. However, the effectiveness of site-specific treatments compared to standard therapies remains an area of ongoing research. Understanding the prognostic implications of tumor location and metastatic sites can guide more personalized and effective treatment strategies.
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