CUP — Types

C80—

Cancer of Unknown Primary

Prognosis

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🔬 Histological Types

📚 Latest Research

2026-09-09

Circulating tumor HPV DNA reappearance as an early indicator of recurrence after radiotherapy-based treatment for HPV-associated oropharyngeal cancer: analysis of more than 2000 assessments in 232 patients.

Jabłońska IA, et al

A prospective study of 232 patients with HPV-positive oropharyngeal squamous cell carcinoma or carcinoma of unknown primary demonstrated that serial blood-based ctHPV DNA monitoring via quantitative PCR detects disease recurrence with 90.3% sensitivity and 97.9% specificity, and preceded clinical confirmation of relapse in 58.1% of recurrent cases across 2,928 total assessments. ctHPV DNA positivity measured one month after completing radiotherapy-based treatment was a powerful independent predictor of outcomes, associated with a hazard ratio of 19.1 (95% CI 7.5–48.8) for overall survival and 15.4 (95% CI 6.7–35.4) for disease-free survival. The high negative predictive value of 98.4% means a negative test result reliably identifies patients at very low short-term risk of recurrence, supporting the potential integration of ctHPV DNA surveillance into routine post-treatment follow-up.

Oral oncology

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2026-09-04

A rare case of metastatic Merkel cell carcinoma presenting without a primary cutaneous lesion: A case report.

Luo N, et al

A 44-year-old male was diagnosed with metastatic Merkel cell carcinoma (MCC) presenting with no identifiable primary skin lesion, an uncommon and diagnostically challenging phenomenon known as occult-primary MCC. The diagnosis was confirmed through comprehensive immunohistochemical profiling, including positive CK20, pan-cytokeratin, synaptophysin, CD56, and Merkel cell polyomavirus staining, with imaging revealing widespread metastatic disease involving the right inguinal lymph nodes, pancreas, abdomen, and mediastinum. Despite surgical excision of the symptomatic groin mass and sequential chemo-immunotherapy regimens combining etoposide-cisplatin and then oxaliplatin-fluorouracil with the PD-1 inhibitor sintilimab, the disease progressed rapidly through both lines of treatment, and the patient died approximately 14 months after initial presentation. This case highlights that MCC must be considered in the differential diagnosis of metastatic neuroendocrine tumors even when no primary cutaneous lesion is present, and underscores the aggressive and often treatment-refractory nature of advanced MCC in young patients.

Medicine

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2026-09-03

[HPV-associated oropharyngeal carcinomas in the 9th edition of the TNM classification - Clinical classification and consequences].

Tribius S, et al

The 9th edition of the TNM classification (TNM-9) introduces a refined staging system for HPV-associated oropharyngeal carcinomas, placing greater emphasis on nodal disease characteristics — particularly extranodal extension — to achieve better prognostic discrimination within the HPV-positive subgroup than its predecessor TNM-8 could provide. This CME review examines the clinical implications of TNM-9, covering diagnostic work-up, the role of imaging, p16 immunohistochemistry as a surrogate marker for HPV status, and the prognostic weight of smoking and comorbidities. Cervical carcinoma of unknown primary and nasopharyngeal carcinoma are highlighted as paradigmatic models of biologically integrated staging, illustrating how molecular tumor biology can inform TNM classification beyond anatomical extent alone. The authors caution that correct application of TNM-9 requires standardized diagnostic procedures and interdisciplinary interpretation, and that therapeutic decisions must not be derived from TNM stage alone.

Laryngo- rhino- otologie

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