Carcinoma of an Unknown Primary Site PDF

Preface

Talking about the unknown is not a typical task for scientists; it is a subject usually more familiar to erudite religious persons. This is one of the reasons why writing and editing a book on carcinomas of an unknown primary site was a challenge. These neoplasms are characterized by a specific and unique phenotype: early and usually aggressive metastatic dissemination with no identifiable primary tumor. When faced with a patient presenting such malignanices, the questions the oncologist must typically address are as follows: ‘‘Should I search for the primary or not?'' ‘‘If so, how should I proceed: use conventional radiology? endoscopies? PET scan?'' ‘‘Could immunohistochemistry or even genomics be contributive?'' As the primary tumor is not usually found, the next series of questions may typically be: ‘‘Is it a specific carcinoma of an unknown primary site entity requiring a particular treatment?'' ‘‘If not, should I use a regimen with a wide anticancer spectrum of activity?'' ‘‘Is there evidence for a better regimen in terms of progressionfree survival or overall survival'' ‘‘How can I assess the prognosis in this individual case?'' ‘‘Is there an ongoing clinical trial worth considering for this patient with a carcinoma of an unknown primary site?''

To try to answer these questions, I was delighted to receive favorable and often enthusiastic replies from a number of oncologists and nononcologists in six countries from Europe and America whom I contacted to co-author this book, which to my knowledge is the first of its kind. In order to give the reader the most objective information and the most balanced appraisal on the subject, our policy was to have chapters written by at least two contributors from different groups and countries when applicable.

Finally, it seemed to us didactic and useful to the reader to illustrate the information contained in the chapters by providing a series of comprehensive clinical cases, some of which describe typical carcinoma of unknown primary site cases, while others describe exceptional and challenging settings. Once again, the policy was to have these clinical cases written by an expert in carcinomas of an unknown primary site, with another contributor from a different country making a comment and putting the case into perspective.

Looking at the final result, I feel that it has more than fulfilled my initial hopes and expectations, and that the tremendous efforts required to get such a book written were definitely worth it. This is why I would like to thank all of the contributors and Taylor & Francis Health Sciences for having made this book a reality. Most of all, we collectively hope that this book will contribute to a better outcome for patients with carcinoma of an unknown primary site, thanks to better clinical care and improved clinical and translational research.