Summary Indroduction Occult primitive tumors constitute 2-5% of adult neoplasms with an average age of onset of 60 years, in the US 31,000 new cases of TPO annually with a tendency to decrease the last 5 years. (1)The site of the tumor is identified only in 30% of cases, and even in the autopsy in 50% of cases it is not possible to reach the original site. The purpose of the study is to evaluate in relation to the clinical observation which is the most suitable therapeutic program that can offer a long survival associated with a dignified quality of life, Materials and methods from January 2007 to December 2017 consulted database of departmental surgery of the AOU Polyclinic University of Catania, 32 cases of TPO (primary occult tumor) were observed. We have considered occult all those cases in which the tumor origin has not emerged from the usual diagnostic investigations. The surgical intervention was limited to those cases in which the clinical onset was dramatic (obstructive uropathy, intestinal obstruction) as the opportunity of resectionin the presence of multiple lesions does not find indications, as well as it is always a palliative intervention. Chemotherapy was the most interested therapeutic measure with a positive response that ranged from 10% to 35% -40%. Results Surgery for TPOs has found indications even if palliative in segmental gut resection (5 cases) with extensive mesentery resection and with hepatic MTS that were grouped into a single limited number lobe in the absence of other repeats in other locations and with exeresis in a single surgical time. chemotherapy after research and histological confirmation of metastatic ca to occult site, provided a protocol with pharmacological associations such as: 5- fluoro uracil ,adriamycin ,mitomycin C, Cisplatin. Paclitaxel Discussion A problem that unfortunately still hinders the spread of molecular targets is also their high cost, their use on different tumors can and will contribute to reducing the costs in addition to the market competition between the various pharmaceutical companies that they are developing these drugs. the cancer therapy that is very useful for these patients is still based on the oncologist's experience since there are no randomized clinical trials. surgical resection in association with palliative pharmacological printouts have achieved median survival of 12.3 months. Conclusions TPOs require careful evaluation in each case. the current literature expresses conflicting opinions that tend to dissuade the prolonged treatment, even though it is evident that immunomodulatory drugs pose a cautious optimism in the treatment of neoplasm. the definition of the histological type of the tumor remains the fundamental moment of the therapeutic strategy and the immunohistochemistry in association with the tumor's genetic profile have been confirmed essential to the achievement of the diagnosis

Which Treatment For tpo (Primitive Occult Tumors)

graziano antonino
Membro del Collaboration Group
;
Antonio di Cataldo
Membro del Collaboration Group
2018

Abstract

Summary Indroduction Occult primitive tumors constitute 2-5% of adult neoplasms with an average age of onset of 60 years, in the US 31,000 new cases of TPO annually with a tendency to decrease the last 5 years. (1)The site of the tumor is identified only in 30% of cases, and even in the autopsy in 50% of cases it is not possible to reach the original site. The purpose of the study is to evaluate in relation to the clinical observation which is the most suitable therapeutic program that can offer a long survival associated with a dignified quality of life, Materials and methods from January 2007 to December 2017 consulted database of departmental surgery of the AOU Polyclinic University of Catania, 32 cases of TPO (primary occult tumor) were observed. We have considered occult all those cases in which the tumor origin has not emerged from the usual diagnostic investigations. The surgical intervention was limited to those cases in which the clinical onset was dramatic (obstructive uropathy, intestinal obstruction) as the opportunity of resectionin the presence of multiple lesions does not find indications, as well as it is always a palliative intervention. Chemotherapy was the most interested therapeutic measure with a positive response that ranged from 10% to 35% -40%. Results Surgery for TPOs has found indications even if palliative in segmental gut resection (5 cases) with extensive mesentery resection and with hepatic MTS that were grouped into a single limited number lobe in the absence of other repeats in other locations and with exeresis in a single surgical time. chemotherapy after research and histological confirmation of metastatic ca to occult site, provided a protocol with pharmacological associations such as: 5- fluoro uracil ,adriamycin ,mitomycin C, Cisplatin. Paclitaxel Discussion A problem that unfortunately still hinders the spread of molecular targets is also their high cost, their use on different tumors can and will contribute to reducing the costs in addition to the market competition between the various pharmaceutical companies that they are developing these drugs. the cancer therapy that is very useful for these patients is still based on the oncologist's experience since there are no randomized clinical trials. surgical resection in association with palliative pharmacological printouts have achieved median survival of 12.3 months. Conclusions TPOs require careful evaluation in each case. the current literature expresses conflicting opinions that tend to dissuade the prolonged treatment, even though it is evident that immunomodulatory drugs pose a cautious optimism in the treatment of neoplasm. the definition of the histological type of the tumor remains the fundamental moment of the therapeutic strategy and the immunohistochemistry in association with the tumor's genetic profile have been confirmed essential to the achievement of the diagnosis
Key words: treatment of occult tumors.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/373432
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