Resumen

ANTUNA EGOCHEAGA, A. et al. Unknown primary cancer: diagnostic protocol. Revision of 157 cases. An. Med. Interna (Madrid) [online]. 2002, vol.19, n.8, pp.29-32. ISSN 0212-7199.

Objective: Decision-making to diagnose an Unknown Primary Cancer (UPC) is subject to great variability. It is possible to design a standard procedure using the scientífic literature, wich seems to be able to avoid this variability. We describe the characteristics of the UPC in Asturias and measure the degree of adaptation of the diagnostic decisions to the theoretic standard procedure.  Method: Descriptive retrospective study (1992-96)  Results: A pilot study included 157 cases: mean age 67 years and 59% male. The presentation form most frecuent was hepatomegaly (29%) and histology: adenocarcinoma (51%). The diagnosis of the primary was possible in 22%: lung (31%). Median survival: 13 weeks, higher for squamous carcinoma, but independent of the diagnosis of the primary tumour. Comparing with the recommended protocol, the average of unnecessary diagnostic techniques per patient was: 8 analyses, 3 image studies and 0,6 unnecesary aggresive techniques.  Conclusions: The great variability in decision-making for diagnosing advises the application of a diagnostic protocol that would avoid innecesary damage for the patient and sanitary costs. 

Palabras clave : Unknown primary cancer; Variability; Diagnostic producere.

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