Hess et al analyzed the pattern of metastatic adenocarcinoma to suggest the probable primary site. This can help determine which organ to evaluate first for evidence of an occult primary tumor. The authors are from M.D. Anderson Cancer Center in Houston, Texas.
Patient selection: adult >= 20 years of age with a metastatic adenocarcinoma with unknown primary
Parameters:
(1) axillary lymph nodes
(2) intestinal lymph nodes (ileocolic and paracolic lymph nodes)
(3) thoracic lymph nodes (tracheal, bronchial, thoracic, hilar, paratracheal, diaphragmatic, pulmonary, and presternal)
(4) gender/sex
(5) bone
(6) lung
(7) liver
(8) abdominal cavity
This data was represented in a precursive partitioning dendogram (Figure 3, page 1631).
|
Axilla LN |
Intest LN |
Thor LN |
Sex |
Bone |
Lung |
Liver |
Abdo Cavity |
Dx |
|---|---|---|---|---|---|---|---|---|
|
Y |
|
|
|
|
|
|
|
A |
|
N |
Y |
|
|
|
|
|
|
B |
|
N |
N |
|
F |
|
|
Y |
Y |
C |
|
N |
N |
|
F |
|
|
N |
Y |
D |
|
N |
N |
|
F |
Y |
|
Y |
N |
E |
|
N |
N |
|
F |
N |
|
Y |
N |
F |
|
N |
N |
|
F |
|
Y |
N |
N |
G |
|
N |
N |
|
F |
|
N |
N |
N |
H |
|
N |
N |
|
M |
Y |
Y |
|
|
I |
|
N |
N |
Y |
M |
Y |
N |
|
|
J |
|
N |
N |
N |
M |
Y |
N |
|
|
K |
|
N |
N |
|
M |
N |
|
Y |
|
L |
|
N |
N |
|
M |
N |
Y |
N |
|
M |
|
N |
N |
|
M |
N |
N |
N |
Y |
N |
|
N |
N |
|
M |
N |
N |
N |
N |
O |
|
Dx |
Primary Site |
|---|---|
|
A |
breast |
|
B |
colon |
|
C |
colon |
|
D |
ovary |
|
E |
breast |
|
F |
colon |
|
G |
kidney |
|
H |
lung |
|
I |
kidney |
|
J |
lung |
|
K |
prostate |
|
L |
colon |
|
M |
kidney |
|
N |
colon |
|
O |
lung |
Specialty: Hematology Oncology, Surgery, general
