{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:29:30Z","timestamp":1787956170845,"version":"build-2784847793"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T00:00:00Z","timestamp":1621900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2021,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Umbilical metastases form a clinical challenge, especially when they represent the first sign of malignant disease and the primary tumor is unknown. Our study aims to generate insight into the origin and timing of umbilical metastasis, as well as patient survival, using population\u2010based data. A nationwide review of pathology records of patients diagnosed with an umbilical metastasis between 1979 and 2015 was performed. Data was collected from the Nationwide Network and Registry of Histopathology and Cytopathology (PALGA) and the Netherlands Cancer Registry. Kaplan\u2010Meier analyses and log\u2010rank testing were used to estimate overall survival and a Cox proportional hazard model was used to determine multivariable hazard ratios. A total of 806 patients with an umbilical metastasis were included. There were 210 male (26.1%) and 596 female (73.9%) patients. Distribution of umbilical metastases was different between male and female patients due to the high incidence of umbilical metastases originating from the ovaries in females. They most frequently originated from the ovaries in female patients (38.8%) and from the colon in male patients (43.8%). In 18% of cases no primary tumor could be identified. Prognosis after diagnosis of an umbilical metastasis was dismal with a median survival of 7.9\u00a0months (95% confidence interval 6.7\u20109.1). The origin of the primary tumor was an independent prognostic factor for overall survival. In conclusion, umbilical metastases relatively rare, mainly originating from intraabdominal primary tumors. Survival is dependent on the origin of the primary tumor and poor overall survival rates warrant early recognition.<\/jats:p>","DOI":"10.1002\/ijc.33684","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T04:19:25Z","timestamp":1621052365000},"page":"1266-1273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Umbilical metastases: Real\u2010world data shows abysmal outcome"],"prefix":"10.1002","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-1561","authenticated-orcid":false,"given":"Niek","family":"Hugen","sequence":"first","affiliation":[{"name":"Department of Surgery Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Surgery Rijnstate Hospital  Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heleen","family":"Kanne","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"Simmer","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlijn","family":"van de Water","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quirinus J.","family":"Voorham","sequence":"additional","affiliation":[{"name":"PALGA Foundation  Houten The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent K.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL)  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valery E.","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL)  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Simons","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris D.","family":"Nagtegaal","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"5","article-title":"Cases illustrative of obstetric disease","volume":"70","author":"Storer H","year":"1864","journal-title":"Boston Med Surg J"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.1998.00326.x"},{"key":"e_1_2_10_4_1","first-page":"19","article-title":"Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive","volume":"29","author":"Casparie M","year":"2007","journal-title":"Cell Oncol"},{"key":"e_1_2_10_5_1","unstructured":"Netherlands Cancer Registry. 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