Cancer of unknown primary.

Abstract:

:Cancers of unknown primary (CUPs) are histologically confirmed, metastatic malignancies with a primary tumor site that is unidentifiable on the basis of standard evaluation and imaging studies. CUP comprises 2-5% of all diagnosed cancers worldwide and is characterized by early and aggressive metastasis. Current standard evaluation of CUP requires histopathologic evaluation and identification of favorable risk subtypes that can be more definitively treated or have superior outcomes. Current standard treatment of the unfavorable risk subtype requires assessment of prognosis and consideration of empiric chemotherapy. The use of molecular tissue of origin tests to identify the likely primary tumor site has been extensively studied, and here we review the rationale and the evidence for and against the use of such tests in the assessment of CUPs. The expanding use of next generation sequencing in advanced cancers offers the potential to identify a subgroup of patients who have actionable genomic aberrations and may allow for further personalization of therapy.

journal_name

BMJ

authors

Lee MS,Sanoff HK

doi

10.1136/bmj.m4050

subject

Has Abstract

pub_date

2020-12-07 00:00:00

pages

m4050

eissn

0959-8138

issn

1756-1833

journal_volume

371

pub_type

杂志文章,评审
  • Antibiotic prescribing without documented indication in ambulatory care clinics: national cross sectional study.

    abstract:OBJECTIVES:To identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with ant...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.l6461

    authors: Ray MJ,Tallman GB,Bearden DT,Elman MR,McGregor JC

    更新日期:2019-12-11 00:00:00

  • Different systolic blood pressure targets for people with history of stroke or transient ischaemic attack: PAST-BP (Prevention After Stroke--Blood Pressure) randomised controlled trial.

    abstract:OBJECTIVE:To assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease. DESIGN:Open label randomised controlled trial. SETTING:99 general practices in England, with participants recruited in 2009-11. PARTICIPANTS:Peo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.i708

    authors: Mant J,McManus RJ,Roalfe A,Fletcher K,Taylor CJ,Martin U,Virdee S,Greenfield S,Hobbs FD

    更新日期:2016-02-24 00:00:00

  • Molecular genetics in clinical practice: evolution of a DNA diagnostic service.

    abstract::The development of a molecular genetics diagnostic service over a three year period was studied in a National Health Service region with a population of three million. Starting from a time when few diagnostic applications were possible, the number of disorders and the overall demand had grown rapidly. Conditions for w...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6652.843

    authors: Meredith AL,Upadhyaya M,Harper PS

    更新日期:1988-10-01 00:00:00

  • Can contracts drive clinical care?

    abstract::The instrument through which a commissioner purchases health services from a provider is, as in other walks of life, a contract, so considerable importance has been attached by the NHS Executive to the contracting mechanism. A contract should in theory influence the quality of the service provided, but they are in man...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7055.477

    authors: Hopkins A,Solomon JK

    更新日期:1996-08-24 00:00:00

  • Association of bacteria and viruses with wheezy episodes in young children: prospective birth cohort study.

    abstract:OBJECTIVE:To study the association between wheezy symptoms in young children and the presence of bacteria in the airways. DESIGN:Birth cohort study. SETTING:Clinical research unit in Copenhagen. PARTICIPANTS:Children of asthmatic mothers, from age 4 weeks to 3 years, with planned visits and acute admissions to the r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.c4978

    authors: Bisgaard H,Hermansen MN,Bønnelykke K,Stokholm J,Baty F,Skytt NL,Aniscenko J,Kebadze T,Johnston SL

    更新日期:2010-10-04 00:00:00

  • Patient characteristics and clinical caseload of short stay independent hospitals in England and Wales, 1992-3.

    abstract:OBJECTIVE:To describe and quantify the patients and clinical activities of independent short stay hospitals. DESIGN:Retrospective survey of hospital records for sampled periods of one financial year and comparison with data from 1981 to 1986. SETTING:217 independent hospitals in England and Wales, 1992-3. MAIN OUTCO...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6945.1699

    authors: Williams BT,Nicholl JP

    更新日期:1994-06-25 00:00:00

  • Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study.

    abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f866

    authors: De S,Williams GJ,Hayen A,Macaskill P,McCaskill M,Isaacs D,Craig JC

    更新日期:2013-02-13 00:00:00

  • Management of acute diarrhoea in diabetic patients using oral rehydration solutions containing glucose, rice, or glycine.

    abstract:OBJECTIVE:To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea. DESIGN:Prospective randomised allocation to one of three oral rehydration solutions (World Healt...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.308.6929.624

    authors: Haider R,Azad Khan AK,Roy SK,Dewan N,Alam AN,Mahalanabis D

    更新日期:1994-03-05 00:00:00

  • Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia.

    abstract:OBJECTIVE:To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture. DESIGN:Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland. PARTICIPANTS:243 independently living patients aged 65 years or older admitted to hospital with ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.321.7269.1107

    authors: Huusko TM,Karppi P,Avikainen V,Kautiainen H,Sulkava R

    更新日期:2000-11-04 00:00:00

  • Occurrence and repetition of hospital admissions for accidents in preschool children.

    abstract:OBJECTIVES:To examine trends over time in the rates of admission to hospital for accidents of preschool children and to study patterns of repeated admissions for accidents in these children. DESIGN:Analysis of linked, routine abstracts of hospital inpatient records for accidents. SETTING:Six districts in the Oxford R...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.302.6767.16

    authors: Sellar C,Ferguson JA,Goldacre MJ

    更新日期:1991-01-05 00:00:00

  • Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey.

    abstract:AIM:To compare perinatal morbidity and mortality for babies delivered in water with rates for babies delivered conventionally (not in water). DESIGN:Surveillance study (of all consultant paediatricians) and postal survey (of all NHS maternity units). SETTING:British Isles (surveillance study); England and Wales (post...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.319.7208.483

    authors: Gilbert RE,Tookey PA

    更新日期:1999-08-21 00:00:00

  • Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients.

    abstract::Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome (HHS) are life threatening complications that occur in patients with diabetes. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids wi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.l1114

    authors: Karslioglu French E,Donihi AC,Korytkowski MT

    更新日期:2019-05-29 00:00:00

  • Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.

    abstract:OBJECTIVE:To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women. DESIGN:Nested case-control study. SETTING:Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des evenements demog...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38313.624352.8F

    authors: Martel MJ,Rey E,Beauchesne MF,Perreault S,Lefebvre G,Forget A,Blais L

    更新日期:2005-01-29 00:00:00

  • Sleep related vehicle accidents.

    abstract:OBJECTIVES:To assess the incidence, time of day, and driver morbidity associated with vehicle accidents where the most likely cause was the driver falling asleep at the wheel. DESIGN:Two surveys were undertaken, in southwest England and the midlands, by using police databases or on the spot interviews. SUBJECTS:Drive...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6979.565

    authors: Horne JA,Reyner LA

    更新日期:1995-03-04 00:00:00

  • Outcomes of elective surgery undertaken in independent sector treatment centres and NHS providers in England: audit of patient outcomes in surgery.

    abstract:OBJECTIVE:To compare characteristics of patients and outcomes after elective surgery in independent sector treatment centres (ISTCs) and NHS providers. DESIGN:Follow-up study with outcomes reported by patients three to six months after surgery. SETTING:25 ISTCs and 72 NHS providers in England. Population Consecutive ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d6404

    authors: Chard J,Kuczawski M,Black N,van der Meulen J,POiS Audit Steering Committee.

    更新日期:2011-10-19 00:00:00

  • Audit of prenatal diagnosis for haemoglobin disorders in the United Kingdom: the first 20 years.

    abstract:OBJECTIVES:To audit services for prenatal diagnosis for haemoglobin disorders in the United Kingdom. DESIGN:Comparison of the annual number of cases recorded in a United Kingdom register of prenatal diagnoses for haemoglobin disorders, with the annual number of pregnancies at risk of these disorders, by ethnic group a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.315.7111.779

    authors: Modell B,Petrou M,Layton M,Varnavides L,Slater C,Ward RH,Rodeck C,Nicolaides K,Gibbons S,Fitches A,Old J

    更新日期:1997-09-27 00:00:00

  • Systematic review of randomised controlled trials of over the counter cough medicines for acute cough in adults.

    abstract:OBJECTIVES:To determine whether over the counter cough medicines are effective for acute cough in adults. DESIGN:Systematic review of randomised controlled trials. DATA SOURCES:Search of the Cochrane Acute Respiratory Infections Group specialised register, Cochrane Controlled Trials Register, Medline, Embase, and the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.324.7333.329

    authors: Schroeder K,Fahey T

    更新日期:2002-02-09 00:00:00

  • Computer system for assisting with clinical interpretation of tumour marker data.

    abstract:OBJECTIVE:To design and evaluate a computer advisory system for the treatment of gestational trophoblastic tumour. DESIGN:A comparison of clinicians' treatment decisions with those of the computer system. Two datasets were used: one to calibrate the system and one to independently evaluate it. SETTING:Department of m...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.305.6857.804

    authors: Leaning MS,Gallivan S,Newlands ES,Dent J,Brampton M,Smith DB,Bagshawe KD

    更新日期:1992-10-03 00:00:00

  • A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database.

    abstract:OBJECTIVES:To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. DESIGN:Feasibility study. SETTING:Seven paediatric intensive care units in England. PARTICIP...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.38404.650208.AE

    authors: McKinney PA,Jones S,Parslow R,Davey N,Darowski M,Chaudhry B,Stack C,Parry G,Draper ES,PICANet Consent Study Group.

    更新日期:2005-04-16 00:00:00

  • Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014).

    abstract:OBJECTIVE:To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals. DESIGN:Observational study. STUDY SAMPLE:All original research articles published in Annals of Internal Med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i847

    authors: Filardo G,da Graca B,Sass DM,Pollock BD,Smith EB,Martinez MA

    更新日期:2016-03-02 00:00:00

  • Ultrasonography compared with intravenous urography in the investigation of adults with haematuria.

    abstract:OBJECTIVE:To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN:Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.301.6760.1074

    authors: Spencer J,Lindsell D,Mastorakou I

    更新日期:1990-11-10 00:00:00

  • Management of labour in an isolated rural maternity hospital.

    abstract:OBJECTIVES:To evaluate the use of a maternity unit run by general practitioners and midwives, describing the outcome of labour in an unselected group of women and quantifying the contribution made by general practitioners. DESIGN:Retrospective population based review of obstetric patients who had access to an isolated...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7025.223

    authors: Baird AG,Jewell D,Walker JJ

    更新日期:1996-01-27 00:00:00

  • Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical outcome at one year.

    abstract::A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting th...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.298.6679.985

    authors: Jolley AG,Hirsch SR,McRink A,Manchanda R

    更新日期:1989-04-15 00:00:00

  • Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars.

    abstract:OBJECTIVES:To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. DESIGN:Prospective intervention study which was later costed. SETTING:Inner city acci...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7042.1340

    authors: Dale J,Lang H,Roberts JA,Green J,Glucksman E

    更新日期:1996-05-25 00:00:00

  • Impact of rice based oral rehydration solution on stool output and duration of diarrhoea: meta-analysis of 13 clinical trials.

    abstract:OBJECTIVE:To define the benefit of rice oral rehydration salts solution in relation to the glucose based World Health Organisation oral rehydration salts solution for treating and preventing dehydration in patients with severe dehydrating diarrhoea. DESIGN:Meta-analysis using data from 13 available randomised trials t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.304.6822.287

    authors: Gore SM,Fontaine O,Pierce NF

    更新日期:1992-02-01 00:00:00

  • Cancer morbidity in British military veterans included in chemical warfare agent experiments at Porton Down: cohort study.

    abstract:OBJECTIVE:To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. DESIGN:Historical cohort study, with cohort members followed up to December 2004. DATA SOURCE:Archive of UK government research facility at Porton Down, UK military personnel rec...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.b655

    authors: Carpenter LM,Linsell L,Brooks C,Keegan TJ,Langdon T,Doyle P,Maconochie NE,Fletcher T,Nieuwenhuijsen MJ,Beral V,Venables KM

    更新日期:2009-03-24 00:00:00

  • Sharing of clinical trial data among trialists: a cross sectional survey.

    abstract:OBJECTIVE:To investigate clinical trialists' opinions and experiences of sharing of clinical trial data with investigators who are not directly collaborating with the research team. DESIGN AND SETTING:Cross sectional, web based survey. PARTICIPANTS:Clinical trialists who were corresponding authors of clinical trials ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e7570

    authors: Rathi V,Dzara K,Gross CP,Hrynaszkiewicz I,Joffe S,Krumholz HM,Strait KM,Ross JS

    更新日期:2012-11-20 00:00:00

  • Association between hormone replacement therapy and subsequent stroke: a meta-analysis.

    abstract:OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference li...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.38331.655347.8F

    authors: Bath PM,Gray LJ

    更新日期:2005-02-12 00:00:00

  • Acceptability of low molecular weight heparin thromboprophylaxis for inpatients receiving palliative care: qualitative study.

    abstract:OBJECTIVE:To find out what inpatients with advanced cancer who are receiving palliative care think about the effect of thromoprophylaxis on overall quality of life. DESIGN:Qualitative study using audiotaping of semistructured interviews. SETTING:Regional cancer centre in Wales. PARTICIPANTS:28 inpatients with advanc...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38733.616065.802

    authors: Noble SI,Nelson A,Turner C,Finlay IG

    更新日期:2006-03-11 00:00:00

  • Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial.

    abstract:OBJECTIVE:To evaluate the efficacy and safety of 4% dimeticone lotion for treatment of head louse infestation. DESIGN:Randomised controlled equivalence trial. SETTING:Community, with home visits. PARTICIPANTS:214 young people aged 4 to 18 years and 39 adults with active head louse infestation. INTERVENTIONS:Two app...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.38497.506481.8F

    authors: Burgess IF,Brown CM,Lee PN

    更新日期:2005-06-18 00:00:00