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Yamagata Med J（ISSN 0288-030X）2020；38
癌性腹膜炎を主とする原発不明癌患者の予後解析
（1）
：12-18
DOI 00.00000/00000000
DOI 10.15022/00004782
The prognosis of patients with cancer of unknown primary
origin showing mainly carcinomatous peritonitis
Eri Kimura＊， Shuhei Suzuki＊＊， Tomomi Sanomachi＊＊， Koushi Takahashi＊＊，
Kaname Watanabe＊＊， Tadahisa Fukui＊＊， Takashi Yoshioka＊＊
Medical student, Yamagata University Facutly of Medicine
＊＊
Department of Clinical Oncorogy, Yamagata University Hospital
ABSTRACT
Background: Cancer of unknown primary origin is associated with a poor prognosis, but there is a
group of patients with a favorable prognosis. A subset of patients fulfilling the following 4 criteria
shows a course similar to that of patients with peritoneal cancer: female, peritoneal lesion, increased
CA125, and serous adenocarcinoma. However, only a few patients fulfill all 4 criteria. There are also
patients who only partly fulfill these criteria but show a course similar to that of those with peritoneal
cancer and favorable outcomes. Therefore, we performed a retrospective study of criteria to identify
a group showing a favorable course resembling that of those with peritoneal cancer among patients
with cancer of unknown primary origin.
Methods: We retrospectively evaluated 26 patients with cancer of unknown primary origin showing
mainly carcinomatous peritonitis who underwent chemotherapy at the Clinical Oncology Department
of our hospital, and performed exploratory data analysis. This study was performed with the approval
of the ethical committee.
Results: Only 1 patient fulfilled all 4 criteria（serous adenocarcinoma, female, carcinomatous
peritonitis, and increased CA125）
. When serous adenocarcinoma was changed to adenocarcinoma
as relaxation of the criterion, 8 patients fulfilled the 4 criteria. However, adequate sensitivity/
specificity or differences in survival were not detected. Considering clinical practice, pleural effusion
and lymph node metastasis were included in the criteria, and the increased CA125 was changed to
CA125/CEA>100. Consequently, a high sensitivity（100%）and specificity（86%）to responses and
a significant difference in overall survival（standard vs new criteria: 890 vs 64 days）were obtained
（p<0.001）
Discussion: Although only a few patients completely fulfill the criteria for peritoneal cancer, new
criteria including pleural effusion, lymph node metastasis, and CA125/CEA may be useful.
Keywords: cancer of unknown primary origin, peritoneal cancer, pleural effusion, lymph node, CA125
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