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A retrospective medical record review analyzed patients seen at Peter MacCallum Cancer Centre between July 2014 and August 2020. Among 361 referrals, under half completed diagnostic work-up; CUP was diagnosed in 38%. Genomic testing was completed in 62% and altered management in 32%, while site-specific targeted therapy or immunotherapy correlated with longer overall survival versus empirical chemotherapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/six-year-experience-of-australias-first-dedicated-cancer-of-unknown-primary-clinic/383788/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/six-year-experience-of-australias-first-dedicated-cancer-of-unknown-primary-clinic/383788.png","ImageObject",300,407,{"name":92,"@type":93},"Kyle","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this study of Australia’s dedicated CUP clinic?","Question",{"text":112,"@type":113},"To examine referral patterns, management practices, and outcomes for patients referred to Australia’s first dedicated cancer of unknown primary clinic.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the study find about diagnostic work-up completion at referral?",{"text":117,"@type":113},"Of 361 referred patients, fewer than half had completed diagnostic work-up at the time of referral.",{"name":119,"@type":110,"acceptedAnswer":120},"How did genomic testing and treatment choice relate to outcomes?",{"text":121,"@type":113},"Genomic testing was completed in 62% and impacted management in 32%. Site-specific targeted therapy or immunotherapy was independently associated with longer overall survival compared with empirical chemotherapy.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},383788,1790654849,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","British Journal of Cancer [www.nature.com/bjc](www.nature.com/bjc)  \nARTICLE OPEN   \nClinical Studies  \nSix-year experience of Australia’s first dedicated cancer of unknown primary clinic  \nArielle van Mourik1, Gina Tonkin-Hill 1, John O’Farrell1, Shohei Waller 1, Lavinia Tan1,2, Richard W. Tothill2,3, David Bowtell2,4, Stephen Fox2,3,4,5, Andrew Fellowes 4,5, Clare Fedele6, Penelope Schofield2,7,8, Tharani Sivakumaran 1,2, Hui-Li Wong 1,2,9 ✉ and Linda Mileshkin 1,2,9  \n© The Author(s) 2023  \nBACKGROUND: Diagnosis and management of cancers of unknown primary (CUP) remain challenging. This study examines the referral patterns, management and outcomes of patients referred to Australia’s first dedicated CUP clinic.  \nMETHODS: Retrospective medical record review was conducted for patients seen at the Peter MacCallum Cancer Centre CUP clinic between July 2014 and August 2020 . Overall survival (OS) was analysed for patients with a CUP diagnosis where treatment information was available.  \nRESULTS: Of 361 patients referred, fewer than half had completed diagnostic work-up at the time of referral. A diagnosis of CUP was established in 137 (38%), malignancy other than CUP in 177 (49%) and benign pathology in 36 (10%) patients. Genomic testing was successfully completed in 62% of patients with initial provisional CUP and impacted management in 32% by identifying atissue of origin or actionable genomic alteration. The use of site-specific, targeted therapy or immunotherapy was independently associated with longer OS compared to empirical chemotherapy.  \nCONCLUSION: Our specialised CUP clinic facilitated diagnostic work-up among patients with suspected malignancy and provided access to genomic testing and clinical trials for patients with a CUP diagnosis, all of which are important to improve outcomes in this patient population.  \nBritish Journal of Cancer (2023) 129:301–308; [https://doi.org/10.1038/s41416-023-02254-6](https://doi.org/10.1038/s41416-023-02254-6)  \nBACKGROUND  \nPatients with carcinoma of unknown primary site (CUP) present with metastatic disease for which an anatomical primary tumour cannot be identified despite standardised work-up, and account for 1–2% of advanced malignancies worldwide [1] . However, autopsy studies have demonstrated small invasive primary cancers in up to 73% of CUP patients, with additional cases potentially undetected considering the thousands of tissue sections required to detect a very small cancer [2] . In Australia, 2380 CUP cases were diagnosed in 2019 with a rate of 7.4/100,000 people [3] . Men and women are affected equally, and the average age at diagnosis is 60–75 years [3] .  \nPresentation of CUP varies widely, from solitary sites of disease to multiple metastases. Frequently affected sites include lymph nodes, bones, liver and lungs [4, 5] . Risk factors may include current or former smoking, whilst associations have also been made with low educational attainment, older age, and female sex [6] . In addition, some studies have identified a potential familial  \npredisposition to CUP with family members being at increased risk of lung, pancreatic and CUP malignancies [7] .  \nInternational guidelines exist to direct the diagnostic approach to patients with potential CUP, and include a thorough history and examination, basic blood analysis, computed tomography of chest, abdomen and pelvis (CTCAP), tissue biopsy with immunohistochemistry staining and mammogram in females [8–10] . Further investigations depend on the likely primary site, such as alpha fetoprotein and human chorionic gonadotropin in men with midline disease, prostate specific antigen in men with osteoblastic bone metastases, and endoscopy in patients with clinical features or immunohistochemistry suggestive of gastrointestinal origin. The cost of diagnostic work-up in this group of patients is typically higher than in those patients with carcinomas of known primaries [11], as is the emotional burden and impact on quality of life for a","cbCaifiDQ6cFqqZB","https://ap.wps.com/l/cbCaifiDQ6cFqqZB","pdf",576482,"English","# Background\n# Methods\n# Results\n# Conclusion","[{\"question\":\"What was the purpose of this study of Australia’s dedicated CUP clinic?\",\"answer\":\"To examine referral patterns, management practices, and outcomes for patients referred to Australia’s first dedicated cancer of unknown primary clinic.\"},{\"question\":\"What did the study find about diagnostic work-up completion at referral?\",\"answer\":\"Of 361 referred patients, fewer than half had completed diagnostic work-up at the time of referral.\"},{\"question\":\"How did genomic testing and treatment choice relate to outcomes?\",\"answer\":\"Genomic testing was completed in 62% and impacted management in 32%. Site-specific targeted therapy or immunotherapy was independently associated with longer overall survival compared with empirical chemotherapy.\"}]","Six-year experience of Australia’s first dedicated cancer of unknown primary clinic | PDF",1790259261]