Introduction: Carcinoma of unknown primary site (CUP) refers to 1–5% of all head and neck neoplasms. Very often, the primary site remains difficult to determine. Squamous cell carcinoma is the most frequent histopathological type diagnosed in the head and neck region. According to statistics, a primary site is usually located in the oropharynx. Study objective: The study presents diagnostic difficulties and the methods of diagnosing and the therapy of CUP and primary sites in patients treated in the region of Lower Silesia and Silesia. The aim of the study was to show a retrospective analysis of 233 CUP patients to assess how clinical features, diagnosis and treatment affect the survival of patients. Material and methods: The diagnostics of patients included panendoscopy with specimen collection (nasoendoscopy, laryngoscopy, esophagoscopy, brochoscopy), computed tomography examination of the neck, chest, abdomen and pelvis minor, as well as positron emission tomography examination. Tonsilletomy was performed in 37 patients. Neck dissection was carried out in 109 subjects and 165 patients were treated bt radiotherapy, and 135 by chemotherapy. Conclusions: Tonsillectomy is required in CUP patients with the negative results of biopsy and imaging tests. It gives a possibility of detecting the primary site and improves the results of treatment and survival of CUP patients.Combination therapy, including surgical treatment and chemoradiotherapy, gives the best therapeutic results in CUP patients. The general condition of patient and younger age have an impact on prognosis and survival.

Introductions: cancer of unknown primary site (CUP) is a heterogeneous group of cancers in which metastases are found, and the primary tumor is not detected with available diagnostic methods. CUP is a disease that has not been fully researched, and its biology is unclear. The clinical characteristics of CUP are variable, but the prognosis of patients is usually unfavorable, and the possibilities of radical treatment are limited. The microbiome is the genes and gene products of microorganisms residing in a human body. In recent years, thanks to the use of next-generation sequencing, it is possible to assess the impact of the microbiome on human body functions. Head and neck cancers, due to the rich microbiome of this area, are influenced by it, and dysbiosis may be a risk factor for the development of cancer. Objective of this work: the aim of this study was to evaluate prognostic factors, clinical features including the microbiome, and treatment outcomes in patients with cancer of unknown primary site. Results: in the study group, increased numbers of bacteria of the phyla Bacteroides, Fusobacteria, Bacillota, Actinomycetota, Actinobacteria, and Candidatus were detected, while Firmicutes and Proteobacteria were detected in smaller numbers. Independent predictors of CUP occurrence were the following: leukocyte count of at most 6.49 × 10³/mm, bacteria from the Proteobacteria phylum in the microbiome below 11.6%, Firmicutes below 22.1%, and Actinobacteria at least 11.0%. Increased numbers of Porphyromonas and Fusobacterium bacteria were associated with the risk of radiotherapy complications and shortened survival rate. Conclusions: clinical diagnosis and treatment of patients with CUP is complicated and difficult due to the lack of consensus on this issue. Treatment and prognosis of patients with CUP is unsatisfactory. The clinical value of the influence of the microbiome on the development, course, and treatment of cancer is becoming increasingly important. The microbiome may become a marker of response to anticancer treatment and the risk of its complications. Immunity modulation with the microbiome provides opportunities for further research on improving the effectiveness of oncological treatment. Fusobacterium and Porphyromonas seem to be the bacteria most important for the development of cancer, also worsening the prognosis of patients by increasing the risk of complications of radiotherapy and shortening the survival rate of patients. Streptococcus and Lactobacillus seem to be bacteria that reduce the risk of cancer, reduce the risk of complications, and improve the prognosis of patients. Total protein deficiency and elevated inflammatory markers are also important predictors of cancer risk.

Background: Currently, dementia is estimated to be the seventh most common cause of death and one of the leading causes of disability and dependency among older people worldwide. The main aim of this study is to analyze the association of presbycusis and cognitive impairment in the study population. Secondary aim is to identify the risk and prevalence of presbycusis taking into account bio- socio-demographic factors among the residents of Wrocław and surrounding villages.Methods: Data from 891 participants (559 women and 332 men; mean age: 60.7 years; range: 39–81) in the Polish cohort of the PURE study who met the inclusion criteria for the PURE MIND sub-study and who had a cognitive and functional assessment completed (MoCA test, DSST test, TMT parts A and B, CES-D, SAGE test).Results: Hearing loss was a significant risk factor for cognitive impairment as assessed using the MoCA, DSST, TMT A and TMT B tests. Mild cognitive impairment (MoCA < 26 score) was present in nearly half of those with hearing loss compared to 26.0 per cent of those without hearing loss (p = 0.036). Hearing loss increased the chance of MCI almost 1.5-fold [OR 1.34; CI 0.93–1.93]. Multivariate regression analysis showed that those with hearing loss, hypertension and diabetes scored significantly lower (worse) on the MoCA test (by −0.52 points [95% CI −0.99 to −0.06]; −0.48 points [95% CI −0.96 to −0.01] and −0.69 points [95% CI −1.16 to 0.23], respectively). Excessive body weight and diabetes increased the chance of developing hearing loss by more than 1.5-fold [OR 1.64; CI 1.03–2.68; OR 1.59; CI 1.04–2.41, respectively]. Hearing loss was significantly more common among men (22.3%), irrespective of level of education. The MCI was more common among rural residents (54.8% vs. 34.8%) and in participants with lower levels of education.Conclusion: Age-related hearing loss is a modifiable risk factor for dementia, emphasizing the importance of routine hearing assessments and timely interventions. Integrating hearing loss management with strategies targeting vascular and metabolic health can help mitigate cognitive decline.