Carcinoma of unknown primary site

Objectives: To verify the spectrum of manifestations of carcinoma of unknown primary site, histopathological type and outcome, as well as to identify the prognostic factors for patient's outcome and their survival rate. Methods: From January 2001 to July 2002, in Basrah Teaching Hospital, Basrah, Iraq, 60 patients (27 males and 33 females), (mean age 58.8 +/- 11.1 years) who had fulfilled the criteria for carcinoma of unknown primary site were studied. Results: Forty-one patients were with one site of metastasis and 19 patients were with multiple site of metastasis. Liver was the most common site of metastasis (in single site group) with 42% of the patients while in the bone with 22% of patients. The mean age of male patients was higher than the female patients (62.1 versus 55 years). Twenty-three female patients were less than 60-years-old (70%), while 10 male patients were less than 60 years (30%). These findings were statistically significant. Adenocarcinoma was the most common histopathological type (63% of cases), while sequamous cell carcinoma was the least (13%). Fifty percent of patients were smokers. Weight loss was the most common presentation (37% of cases). Follow up was made for 48 patients (20 males and 28 females). Conclusion: The mean survival was 2.4 +/- 1.8 months. Age >= 60, smoking, adenocarcinoma type and multiple site of metastasis were bad prognostic factors for the outcome.