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Annals of Oncology 14:191-196, 2003
© 2003 European Society for Medical Oncology

Review Article

The unknown biology of the unknown primary tumour: a literature review

A. J. van de Wouw1,+, R. L. H. Jansen2, E. J. M. Speel3 and H. F. P. Hillen2

1 Department of Internal Medicine, Slingeland Hospital Doetinchem, Doetinchem; 2 Department of Internal Medicine, University Hospital Maastricht, Maastricht; 3 Department of Molecular Cell Biology, Growth & Development Research Institute, University of Maastricht, Maastricht, The Netherlands

Received 12 June 2002; revised 4 September 2002; accepted 17 September 2002

Abstract

The unknown primary tumour (UPT) is an intriguing clinical phenomenon found in approximately 5% of all newly diagnosed patients with cancer. It is unclear whether UPT forms a distinct biological entity with specific genetic and phenotypic characteristics, or whether it is merely a clinical presentation of metastases in patients in whom the primary tumour cannot be detected and does not result in any visible clinical signs. Understanding the basic biology of UPT may shed light on this issue and, moreover, may have a direct impact on clinical care. A review of the literature revealed only a limited number of publications describing the genetic and phenotypic features of UPT, most of which focus only on the potential of these markers to predict prognosis. The question as to whether the biology of UPT is different from tumours of known primaries therefore remains unanswered. Further insight into the molecular mechanisms underlying the oncogenesis of UPT, e.g. by applying newly available DNA and gene profiling microarray techniques, will be necessary to understand its specific biology and to develop more effective treatments.

Key words: biology, review, unknown primary tumour


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