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The National Federation of Centres for Combating Cancer (FNCLCC) and Regional Centres for Combating Cancer (CRLCC), in cooperation with partners from the public sector (general and teaching hospitals), the private sector and some professional societies, have been working since 1993 on drawing up a list of recommendations for clinical cancerology practice known as "Standards, Options and Recommendations" (SOR).
Their goal is to make recommendations regarding diagnosis, prognosis and treatment of adult patients suffering from unknown primary site carcinoma by systematically reviewing scientific data drawn from literature and consensus among specialists.
In France, the rate of unknown primary site carcinoma is between 5% and 7% of solid tumours in adults, i.e. 8/100,000 cases per year. It is a highly complex subject because of the numerous ways in which such tumours may manifest, depending on their histopathology and anatomical location. This book looks at the diagnostic strategy of all the clinical cases encountered using these two parameters, taking histopathology as the starting point. The treatment strategy depends on the prognosis: specific anatomoclinical entities (neuro-endocrinal tumours, cervical lymph node metastases of an epidermoid carcinoma, axillary lymph gland metastases of an adenocarcinoma in women, undifferentiated carcinoma of the median line in young men) and other, non-specific, cases. Although treatment of papillary serous carcinomas of the peritoneum in women does not fall into the category of unknown primary site carcinoma, it has been included in order to give a complete picture.
The prognosis of unknown primary site carcinoma is generally very unfavourable. The doctor is faced with two questions: how thoroughly should the primary site be sought, and what treatment should be given to patients who are usually only expected to live for a few months?
Contents:
Les Standards, Options et Recommandations
Synthèse des recommandations
Méthodologie d’élaboration du SOR « carcinome de site primitif inconnu »
Arbres de décision
Anatomie et cytologie pathologiques
Stratégie diagnostique
Facteurs pronostiques
Stratégie thérapeutique