CUP XXXX : Analysis of Risk Factors and Impact of Surgical Intervention.

@entity5 @entity1 @entity8799
BACKGROUND: Neuroendocrine @entity5 (NEN) with unknown primary site ( @entity8799 ) may have a poor prognosis. We evaluated the clinical presentation, therapy, outcome, and risk factors for adverse outcomes in @entity1 who had these @entity5 . METHODS: In 243 @entity1 who had NEN, a retrospective review was performed in 38 @entity1 who had @entity8799 . The 38 @entity1 who had @entity8799 were evaluated in three groups: group 1 (surgery; primary @entity5 detected; ten @entity1 ); group 2 (surgery; no primary @entity5 detected; ten @entity1 ); and group 3 (no surgery; 18 @entity1 ). Risk factors were evaluated with univariate and multivariate analyses. RESULTS: Most @entity1 who had @entity8799 [32 @entity1 (84  %)] had World Health Organization (WHO) performance score of 0 or 1, and most @entity5 [24 @entity1 (63  %)] were well differentiated (WHO grade, G1 or G2; Ki-67 index,  <=20  %). Univariate analysis showed that greater survival was significantly associated with lower @entity1 age, lower WHO performance score, lower WHO grade, lower number of metastatic sites, treatment with surgery, and no treatment with chemotherapy. Multivariate analysis showed that low WHO performance score (hazard ratio 7.63, 95  % confidence interval (CI) 2.63-22.19) and treatment with surgery (hazard ratio 0.10, CI 0.028-0.381) were significant independent predictors of improved survival. CONCLUSIONS: In @entity1 with @entity8799 , surgical treatment is an independent predictor of better survival. Therefore, surgical treatment may be indicated in @entity1 with good general health status and well-differentiated @entity8799 .
