Begum et al reported prognostic factors for a patient with a neuroendocrine carcinoma with unknown primary (CUP). These can help to identify a patient who may benefit from more aggressive management. The authors are from University Hospital Schleswig-Holstein.
Patient selection: metastatic neuroendocrine carcinoma with unknown primary
Predictors of better survival from multivariate analysis:
(1) WHO/ECOG performance status 0 or 1 (HR 7.6)
(2) treatment with surgery (HR 0.1)
Additional predictors from univariate analysis:
(1) lower patient age
(2) lower WHO histologic grade
(3) lower number of metastatic sites (a patient with a high number might not be treated with surgery)
(4) no treatment with chemotherapy
The 5-year survival was:
(1) 70% if surgery performed and no primary found
(2) 80% if surgery performed and primary found
(3) 17% if no surgery performed
If an R0 resection was performed, then long-term survival tended to be very good.
