Occult primary cancer: Clinical practice guidelines

David S. Ettinger, Juan P. Arnoletti, Jon P. Gockerman, Charles Handorf, Kathleen Anne Havlin, Charlotte D. Jacobs, Milind Javle, Larry Kvols, Renato Lenzi, Asif Rashid, Chris A. Rhoades, John A. Ridge, Leonard Saltz, Lawrence N. Shulman, Vernon K. Sondak, John A. Thompson, Przemyslaw Twardowski, Weining Zhen

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Occult primary tumors, or cancers of unknown primary site, account for 5% to 10% of all diagnosed cancers. These tumors are manifested by a wide variety of clinical presentations, and for most patients, the disease is incurable. Multiple sites of involvement are shown in more than 50% of patients with occult primary tumors. Common sites of involvement are the liver, lungs, bones, and lymph nodes. Life expectancy is very short, with a median survival of about 6 to 9 months. Given the uncertainties and the generally poor prognosis, patients frequently experience significant psychosocial distress, and empathetic discussion about the natural history of these types of cancers and their prognosis is required. Patient and family education, support, and counseling by the primary oncology team and referral to specialized psychosocial services may help to alleviate this distress.

Original languageEnglish (US)
Pages (from-to)214-233
Number of pages20
JournalJNCCN Journal of the National Comprehensive Cancer Network
Issue number2
StatePublished - Mar 2005


  • Carcinoma
  • Chemotherapy
  • Diagnosis
  • Metastasis
  • NCCN Clinical Practice Guidelines
  • Occult primary disease

ASJC Scopus subject areas

  • Oncology


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