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The journal «ONCOSURGERY» 2012, Vol.4, No 4

New opportunities in search of the primary tumor in patients with metastatic disease with unknow primary origin

Zinchenko SV, Khasanov RSh, Burmistrov MV, Khamidullin RG, Chernyshev VA, Rudyk AN., Busygin MA

Republican Clinical Oncology Center, Department of Head and Neck Tumors, Kazan State Medical Academy, Faculty of clinical anatomy and outpatient and polyclinic surgery, Volga branch of N.N. Blochin Russian Oncological Science Center of Russian Academy of Medical Science, Kazan, Russia
Contact: Zinchenko SV, e-mail:

The issues of implementation of the mathematical model, which gives an opportunity to forecast the localization of the primary tumor with a high probability are discussed in the article.

Materials and methods. The study included five hundred eighty one patients with metastases with unidentified primary tumor site were observed in the Republican Clinical Oncology Center (Kazan) in the period from 1996 to 2008). There were 324 (55.7%) male and 257 (44.3%) female patients. Age varied between 17 and 83 years, the average age was 55.78±0.97.

Results. The primary site was identified in 181 (31.1%) cases during the life of the patient from 2 to 38 month (average 6.11±0.67 month). Using as an example the most numerous group (69 patients), who had primary lung tumor (result attribute) the method of mathematical analysis of connections between primary examination data (factor attributes – sex, age, abundance, morphology and localization of the metastases) was applied. The calculation was made using the method of determining the χ2 criterion. To evaluate the efficiency of the mathematical model the patients of control group with metastases with unidentified primary tumor site in the period from January 2009 to February 2010 were analyzed for revealing the primary tumor localization on the outpatient stage. There were 38 patients - 22 male and 16 female. Average age was 55±2.3 years. According to the suggested model the primary localization of tumor site was forecasted correctly in 32 (84.2%) cases. In 6 (15.8%) it was impossible to predict the primary tumor site using the available contingency tables. During the observation period the primary tumor site was implemented in 18 (47.4%) cases, 12 (31.6%) patients are under observation, 8 (21%) patients died in 2-8 month from the progressing date without implementing the signs of primary tumor. In 16 (42.1%) cases the revealed primary tumor site corresponded to the predicted localization.

Conclusion. The proposed mathematical model gave an opportunity to predict the possible primary tumor site with accuracy of 88.9% (in cases it has been applied) which is confirmed with its following identification.

KEY WORDS: metastases with unknown primary origin, correlation analysis, lung cancer, unknown primary origin.

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