Approach to the patient with suspected solid cancer. Topic review
DOI:
https://doi.org/10.21615/cesmedicina.7230Keywords:
neoplasms, effusions, metastasisAbstract
Introduction: there is an association between time of diagnosis and prognosis in cancer patients. The non-oncologist physician is usually the first healthcare provider to establish contact with the patient, therefore, they must have an adequate clinical approach. Methodology: a narrative review was conducted, where an extensive search of the literature was performed in databases (PubMed, Scopus, Web of Science), and the most up-to-date articles were selected. Approach: a complete medical history, a thorough physical examination, and the recognition of possible oncologic emergencies should be carried out. For treatment, histological confirmation is mandatory, and efforts should be directed towards achieving this goal. The study of pleural, pericardial, and peritoneal fluid can provide a quick and non-invasive histological diagnosis, allowing for the initiation of treatment. In cases where there are no effusions, biopsies should be taken from the most representative and easily accessible lesions. Routine endoscopic studies should be avoided in patients without symptoms of gastrointestinal neoplasia, as well as tumor markers that are not accurate and may confuse the diagnostic process. Conclusion: a correct clinical approach that allows for a precise and timely diagnosis is indispensable.
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Hamilton W, Hajioff S, Graham J, Schmidt-Hansen M. Suspected cancer (part 2 - Adults): Visual overview of updated NICE guidance. Vol. 350, BMJ (Online). BMJ Publishing Group; 2015. p. 15–9. DOI: 10.1136/bmj.h3044.
Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. Vol. 112, British Journal of Cancer. Springer Nature; 2015. p. S92–107. DOI: 10.1038/bjc.2015.48.
Berrino, F., Gatta, G., Sant, M., & Capocaccia, R. (2001). The EUROCARE study of survival of cancer patients in Europe: Aims, current status, strengths and weaknesses. European Journal of Cancer, 37(6), 673-677. https://doi.org/10.1016/S0959-8049(01)00008-9
Fondo Colombiano de Enfermedades de Alto Costo, Cuenta de Alto Costo (CAC). Situación del cáncer en la población adulta atendida en el SGSSS de Colombia, 2021; Bogotá, D. C. 2022. Disponible en https://cuentadealtocosto.org/site/publicaciones/situacion-del-cancer-en-la-poblacion-adulta-atendida-en-el-sgsss-de-colombia-2021/
Marzo-Castillejo M, Vela-Vallespín C. Overdiagnosis in cancer. Aten Primaria. 2018 Nov 1;50:51–6. DOI: 10.1016/j.aprim.2018.08.002.
Pavlidis N, Pentheroudakis G. Cancer of unknown primary site: 20 questions to be answered. In: Annals of Oncology. 2010.
Gould Rothberg BE, Quest TE, Yeung SJ, Pelosof LC, Gerber DE, Seltzer JA, et al. Oncologic emergencies and urgencies: A comprehensive review. CA Cancer J Clin. 2022 Nov;72(6):570–93. DOI: 10.3322/caac.21727.
Klemencic S, Perkins J. Diagnosis and management of oncologic emergencies. Vol. 20, Western Journal of Emergency Medicine. eScholarship; 2019. p. 316–22. DOI: 10.5811/westjem.2018.12.37335.
Ayuso C, Rimola J, Vilana R, Burrel M, Darnell A, García-Criado Á, et al. Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines. Eur J Radiol. 2018 Apr 1;101:72–81. DOI: 10.1016/j.ejrad.2018.01.025.
Shroff GS, Guirguis MS, Ocazionez D, Oldham SAA, Restrepo CS, Chiles C. Beyond metastatic disease: A pictorial review of multinodular lung disease with computed tomographic pathologic correlation. Canadian Association of Radiologists Journal. 2015 Feb 1;66(1):16–23. DOI: 10.1016/j.carj.2014.05.007.
Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The Serum-Ascites Albumin Gradient Is Superior to the Exudate-Transudate Concept in the Differential Diagnosis of Ascites. Vol. 117, Annals of Internal Medicine. 1992. DOI: 10.7326/0003-4819-117-3-215.
Uehara T, Yoshida H, Fukuhara M, Yoshida M, Motoi N, Sugawara S, et al. Efficacy of ascitic fluid cell block for diagnosing primary ovarian, peritoneal, and tubal cancer in patients with peritoneal carcinomatosis with ascites. Gynecol Oncol. 2020 May 1;157(2):398–404. DOI: 10.1016/j.ygyno.2020.02.004.
Cavazzoni E, Bugiantella W, Graziosi L, Franceschini MS, Donini A. Malignant ascites: Pathophysiology and treatment. Vol. 18, International Journal of Clinical Oncology. 2013. p. 1–9. DOI: 10.1007/s10147-012-0396-6.
Song YJ. Prediction of optimal debulking surgery in ovarian cancer. Gland Surg. 2021;10(3):1173–81. DOI: 10.21037/gs-2019-ursoc-08.
Babu R, Lanjewar A, Jadhav U, Wagh P, Aurangabadkar G, Upadhyay P. A case series of malignant pericardial effusion. J Family Med Prim Care. 2022;11(10):6581. DOI: 10.4103/jfmpc.jfmpc_263_22.
Burazor I, Imazio M, Markel G, Adler Y. Malignant pericardial effusion. Vol. 124, Cardiology (Switzerland). 2013. p. 224–32. DOI: 10.1159/000348559.
Ferreiro L, Suárez-Antelo J, Álvarez-Dobaño JM, Toubes ME, Riveiro V, Valdés L. Malignant Pleural Effusion: Diagnosis and Management. Vol. 2020, Canadian Respiratory Journal. Hindawi Limited; 2020. DOI: 10.1155/2020/2950751.
Gayen S. Malignant Pleural Effusion: Presentation, Diagnosis, and Management. Vol. 135, American Journal of Medicine. Elsevier Inc.; 2022. p. 1188–92. DOI: 10.1016/j.amjmed.2022.04.017.
Blanc JF, Debaillon-Vesque A, Roth G, Barbare JC, Baumann AS, Boige V, et al. Hepatocellular carcinoma: French Intergroup Clinical Practice Guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, AFEF, SIAD, SFR/FRI). Clin Res Hepatol Gastroenterol. 2021 Mar 1;45(2). DOI: 10.1016/j.clinre.2020.101590.
Heilbrun ME, Yu J, Smith KJ, Dechet CB, Zagoria RJ, Roberts MS. The cost-effectiveness of immediate treatment, percutaneous biopsy and active surveillance for the diagnosis of the small solid renal mass: Evidence from a markov model. Journal of Urology. 2012 Jan;187(1):39–43. DOI: 10.1016/j.juro.2011.09.055.
Huang M, Yan C, Wei H, Lv Y, Ling R. Clinicopathological characteristics and prognosis of thyroid cancer in northwest China: A population-based retrospective study of 2490 patients. Thorac Cancer. 2018 Nov 1;9(11):1453–60. DOI: 10.1111/1759-7714.12858.
Lee MS, Sanoff HK. Cancer of unknown primary. Vol. 371, The BMJ. BMJ Publishing Group; 2020. DOI: 10.1136/bmj.m4050.
Losa F, Soler G, Casado A, Estival A, Fernández I, Giménez S, et al. SEOM clinical guideline on unknown primary cancer (2017). Clinical and Translational Oncology. 2018 Jan 1;20(1):89–96. DOI: 10.1007/s12094-017-1807-y.
Bochtler, T., Löffler, H., & Krämer, A. (2018). Diagnosis and management of metastatic neoplasms with unknown primary. Seminars in diagnostic pathology, 35(3), 199–206. https://doi.org/10.1053/j.semdp.2017.11.013
Shreenivas A v., Kato S, Hu J, Skefos C, Sicklick J, Kurzrock R. Carcinoma of unknown primary: Molecular tumor board‐based therapy. CA Cancer J Clin.2022 Nov;72(6): 510–23. DOI: 10.3322/caac.21748.
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