Metastatic Adenocarcinomas of Unknown Primary Site

METASTATIC adenocarcinoma from an unknown primary site (ACUP) is common in most general medical and oncology practices. We and others1 , 2 have suggested that the role of investigations intended to define the site of such primary tumors is limited. Despite extensive endoscopic and radiologic studies, a primary cancer site is seldom identified, and then only rarely does discovery influence subsequent management. The condition often presents such a diagnostic challenge that treatment assumes secondary importance.3 We report a randomized study of two combination-chemotherapy regimens with a broad spectrum of antitumor activity in symptomatic patients with metastatic ACUP. One regimen (CMF) combined cyclophosphamide, . . .