A clinical study of adenocarcinoma of unknown primary site in Hong Kong.

Forty-two patients with adenocarcinoma of unknown primary (ACUP) presented to the Prince of Wales Hospital in Hong Kong from 1984 to 1985. They were studied for the site of symptomatic metastases at presentation, survival, and response to treatment. Bony (21) and lymph nodal (14) metastases were common. Survival was short with a median duration of 32 weeks and was not affected by sex, site of metastases at presentation, and development of new metastases. Response to combination chemotherapy with cisplatinum, adriamycin and cyclophosphamide (CAP) occurred in 4/31 (12.9%) patients with two complete responses and two partial responses and the responders survived significantly longer than non-responders with a median survival of 51 and 29 weeks respectively (P less than 0.05). Twenty out of 36 (55.6%) treated with radiotherapy had a positive response including five complete responses and fifteen partial responses but there was no demonstrable improvement in survival for the responders.