ABSTRACT
Objectives: Carcinoma of unknown primary origin [CUP] is heterogeneous group of cancers. Role of gastrointestinal [GI] endoscopy in this entity is under investigated. Aim of this study was to evaluate yield of Colonoscopy and Esophagogastroduodenoscopy [EGD] in localizing primary tumor in patients with CUP
Methodology: Patients with histopathologically proven CUP who underwent colonoscopy / EGD to find the primary tumor from December 2009 to December 2011 were included in the study. Abdominal symptoms and cytokeratin [CK] 7 and 20 markers were correlated with presence of primary in GI tract
Results: After giving informed consent 86 patients were included in final analysis. All patients underwent colonoscopy while 60[70%] got EGD along with colonoscopy. Mean age was 55.10 +/-11.94 years with 52[60%] male. Abdominal symptoms were present in 50%. CK7+/CK20- in 34[40%]; CK7-/CK20+ in 2[2%] while CK7+/20+ in 7[8%] of metastatic tumor samples. Liver was metastatic site in 47[55%], Lymph node 12[14%] and Ascites in 8[9%]. Endoscopy detected primary in 6 [7%] patients with 3 each in stomach and colon. No association of abdominal symptoms and cytokeratin markers was found with presence of GI primary site
Conclusion: Yield of localizing primary lesion in the GI tract by pan-endoscopy was limited. Abdominal symptoms and cytokeratin markers do not predict presence of gastrointestinal malignancies