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©2013 UpToDate ® Print Email Treatments for specific subsets of patients with CUP Histologic type Clinical feature Treatment recommendation Adenocarcinoma Women with isolated axillary adenopathy Treat as stage II breast cancer Women with peritoneal carcinomatosis Treat as stage III ovarian cancer Men with elevated PSA or blastic bone metastases Treat as advanced prostate cancer Colon cancer profile Treat as advanced colon cancer Adenocarcinoma or PDC Single metastatic lesion Definitive local therapy (resection and/or radiation therapy) Squamous cell carcinoma Cervical adenopathy Treat as head and neck cancer with involved neck nodes Inguinal adenopathy Inguinal node dissection Consider concurrent radiation therapy/chemotherapy (as in locally advanced cervical cancer) Poorly differentiated carcinoma Young men with midline tumor or elevated hCG/AFP Treat as extragonadal germ cell tumor Other clinical presentations Empiric platinum/paclitaxel chemotherapy Poorly differentiated neuroendocrine carcinoma Diverse clinical presentations Treat with platinum/etoposide or paclitaxel/platinum/etoposide Approximately 40 percent of patients with carcinoma of unknown primary (CUP) fit into defined subsets with specific, recommended treatment implications. AFP: alpha-fetoprotein; hCG: human chorionic gonadotropin; PDC: poorly differentiated carcinoma; PSA: prostate-specific antigen.