Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty patients presenting to HGGM with non-Hodgkin's lymphomas between 1962 and 1986, were reviewed. Eighty-three per cent were of unfavorable histology; 72% had stages I-II. The control were obtained in 40% with radiotherapy alone (16% of the T3T4 when the disease were stages according to the TNM). The control rate was 78% with radiochemotherapy. Chemotherapy should be considered the elective therapy alone or combined with radiotherapy.
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PMID:[Lymphoma of primary extranodal localization in the otorhinolaryngologic region]. 263 87

Adequacy of applying Ann Arbor classification and TNM classification to evaluate extent of disease in extranodal lymphoma was assessed in patients with nasal and paranasal lymphoma. Ann Arbor classification proposed to evaluate extent of Hodgkin's disease was not considered to be good at assessing extranodal local lesions. TNM classification was superior to Ann Arbor classification in terms of the correspondence with survival. Patients with nasal and paranasal lymphoma of T3 and T4 stage (TNM classification) were prone to develop bone marrow and CNS spread.
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PMID:[Clinical studies on eleven patients with nasal and paranasal lymphoma, with special reference to staging evaluation]. 274 74

The clinical staging of malignant lymphomas not only includes histopathological classification but also non-invasive methods for assessing the stage and prognosis. In contrast to the TNM system of staging malignant epithelial tumors, in lymphomas the size is unimportant. Comparison is made between the invasive methods of staging Hodgkin's disease and Non-Hodgkin's lymphomas (splenectomy, laparotomy) and the non-invasive clinical radiological investigations (conventional X-rays, lymphography, sonography, CT, MR) and their statistical reliability. Whereas positive results in clinical staging are diagnostic, a negative result requires further correlation. A phased program for clinical staging is offered.
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PMID:[Clinical staging of malignant lymphoma]. 331 90

This is a population-based review of 153 cases of primary gastric lymphoma. Sixty-seven (43 per cent) were histologically reviewed using the Kiel classification. There were no significant differences between reviewed and unreviewed cases. Ninety-seven per cent of all cases were of the non-Hodgkin's type. The annual incidence was constant at 1.2 per cent of gastric malignancies. The mean age was 60 years and the male to female ratio 1:8. Presenting symptoms were similar to those of gastric cancer. Twenty-one per cent had a palpable mass but one-third of these were amenable to a potentially curative resection. Some 66 per cent were resectable and 58 per cent had a macroscopic clearance of tumour. TNM stage and absolute tumour size were significant prognostic factors (P less than 0.005 and P less than 0.05 respectively) but the Kiel classification was not. The overall 5 year survival was 24 per cent. Apart from 10 patients whose only anti-tumour treatment was radiotherapy (5 year survival 36.9 per cent) no patient who did not have curative surgery survived 5 years. The 5 year survival for curative resection was 34 per cent and for curative resection plus radiotherapy was 43.5 per cent (45 and 73.4 per cent for the node negative cases respectively). A laparotomy is essential; 'curative' surgery possibly with adjuvant radiotherapy offers the best hope for cure.
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PMID:Primary gastric lymphoma. 360 4

The initial staging, therapy and course of 156 patients with non-Hodgkin's lymphomas of head and neck extranodal sites were analyzed to determine whether they have a natural history which differs from primary nodal disease. The sites involved were: Waldeyer's ring-103 patients (tonsil-60, nasopharynx-25, base of tongue-18), and extralymphatic sites-53 patients (salivary gland-20, paranasal sinus-20, oral cavity-10, and larynx-3). Seventy-six percent had unfavorable histologies and 24% had favorable histologies. Fifty-three percent had pathologic Stages I-II and 47% had Stages III-IV. The 5-year survival was influenced by primary sites: salivary gland-61%, oral cavity-57%, tonsil-49%, base of tongue-47%, nasopharynx-36% and paranasal sinus-12%. The 5-year survival was also influenced by histology: unfavorable histologies-39%, favorable histologies-69%. The Ann Arbor staging system was more useful than TNM for determining outcome. For patients with Stage I-II unfavorable histologies treated with radiation alone, the 5-year survival was: involved field-24%, extended field-42%, total lymphoid irradiation-52%. The majority of patients who failed did so in extranodal sites. Forty-one patients with advanced disease received a variety of chemotherapy regimens as the sole treatment. There was a high percentage of CNS recurrence with paranasal sinus lymphoma, and CNS prophylaxis may be necessary. For head and neck extranodal lymphomas, limited radiation is inadequate, and combined modality programs should be considered.
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PMID:Non-Hodgkin's lymphomas of head and neck extranodal sites. 388 44

78 patients with histologically proven malignant tumors of the stomach (64 carcinomas, 10 non-Hodgkin lymphomas [NHL], 4 sarcomas) were investigated by endosonography (EUS), computed tomography (CT) and conventional ultrasound (US) during TN-staging (TNM-classification/UICC-1987 for carcinomas and NHL, TNMG-classification for sarcomas). In 60 patients (50 carcinomas, 6 NHL, 4 sarcomas) an operative resection was performed and the histological findings were compared with the results of preoperative staging. Demonstration of tumor was successful with EUS in 77 (99%), with CT in 33 (42%) and with US in 18 (23%) cases. The T-stage was correctly determined preoperatively by EUS in 50 (81%), by CT and US only in 15 (24%) and in 7 (11%) patients respectively. The accuracy of EUS in determining the T-stage of carcinomas and NHL amounted to 79% in T1-, 92% in T2-, 92% in T3- and 67% in T4-stage. In gastric sarcomas infiltrative destruction of the gastric wall could be demonstrated with EUS in all patients and with CT in 3 of 4 cases. With EUS and CT two smaller tumors were correctly delineated as submucous tumors while with US this was not possible in any case. In demonstrating local lymph node metastasis EUS achieved a sensitivity of 85%, CT of 29% and US of 13%. The specificity of EUS was 72%, of CT 79% and of US 100%. The overall accuracy for the pN-stage was 79.7% for EUS, 51.6% for CT and 42.2% for US. EUS proves to be an efficient method in the local TN-staging of gastric carcinomas an NHL.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endosonography in diagnosis and staging of malignant tumors of the stomach. A prospective comparative study between endosonography, computerized tomography and conventional ultrasonography]. 831 Jul 25

This survey describes potential clinical applications of the tumour markers CYFRA 21-1, SCC antigen, NSE, and CEA in patients with lung cancer. Due to the rather low prevalence of bronchogenic carcinoma in the general public and the limited diagnostic accuracy, currently available tumour markers are unsuitable for the screening of asymptomatic individuals. All studies performed so far in patients with histologically confirmed NSCLC, agree that the best performance characteristics, in terms of sensitivity and specificity, were obtained with the CYFRA 21-1 test (sensitivity: 40-66%, specificity: 95% versus patients with benign pulmonary disorders) while NSE was found to be the marker of first choice in patients with SCLC (sensitivity: 77-85%). For diagnostic purpose, the value of tumour markers must be compared with the efficiency of standard clinical methods including imaging techniques and cytopathological examinations (detection rates: sputum cytology: 40-70%, biopsy at bronchoscopy in central tumours: 95-98%, biopsy at bronchoscopy + bronchial washing + thin needle aspiration in peripheral tumours: 85%). These figures show that the diagnostic yield of cytopathological examinations by far exceeds that of tumour markers. In addition, these investigations supply with histology and give informations on the T-stage (bronchoscopy). Tumour markers, however, may be used for diagnosis in advanced stages in which patients are very often not eligible for extensive investigations due to their performance status. In the differential diagnosis between NSCLC and SCLC a combination of CYFRA 21-1 and NSE was claimed to be helpful. It was demonstrated that 97% of patients could be correctly classified. NSE was shown to be useful to distinguish SCLC from malignant lymphoma, both the Hodgkin's (rate of false-positive elevations: 6.5%) and the non-Hodgkin's (rate of false positive elevations: 22.4%) types. By applying a cut-off point of NSE assays of 21.9 ng/ml corresponding to a 95% specificity versus the lymphoma group, SCLC is still indicated by elevated NSE levels with a sensitivity of 57.7%. Although a positive correlation of marker concentrations with increasing anatomical tumour extent could be demonstrated, the markers cannot be used for staging purposes due to a considerable overlap of marker levels between the individual stages. CYFRA 21-1 was shown to be unable to differentiate between operable (TNM I-IIIa) and inoperable (TNM IIIb/IV) NSCLC patients. The latter were identified with a detection rate of only 17% by the CYFRA 21-1 test (specificity 95% versus operable patients, cut-off point 20 ng/ml). Pretreatment-measured tumour markers, in particular CYFRA 21-1, were shown to provide prognostic information for the overall survival. The negative prognostic effect of CYFRA-21-1 was independent of classical prognostic markers such as performance status and tumour extent. There are several potential applications of serially-assessed tumour markers for disease monitoring of patients under therapy. In SCLC, increasing NSE levels within the remission phase were demonstrated to be strongly suggestive of tumour recurrence. This finding should give rise to further diagnostic procedures. NSE, however, was not able to differentiate between partial and complete remission since, in both cases, NSE levels dropped to the normal range; thus, NSE cannot replace clinical response evaluations. In NSCLC, it was found that curative surgery resulted in a significant drop of preoperatively elevated CYFRA 21-1 or SCC antigen levels down to the normal range. Although rising SCC antigen levels in the postoperative surveillance of patients with squamous cell carcinoma indicated very early tumour relapse, these results are of minor clinical utility due to the absence of curative therapy. Serial measurement of CYFRA 21-1 during chemotherapy in patients with inoperable squamous cell carcinoma has shown that there is a concordance of 74% between the course of the m
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PMID:Does the assessment of serum markers in patients with lung cancer aid in the clinical decision making process? 869 37

In a retrospective multicentric analysis, 63 women treated between 1941 to 1988 for Hodgkin's disease (HD) subsequently developed 76 breast cancers (BC). The median age at diagnosis of HD was 26 years (range 7-67), and 22 women (35%) were 20 years old or less. Exclusive radiotherapy (RT) was used in 36 women (57%) and combined modalities with chemotherapy (CT) in 25 (39%). Breast cancer occurred after a median interval of 16 years (range 2-40) and the median age at diagnosis of the first BC was 42 years (range 25-73). TNM classification (UICC, 1978) showed 10 T0 (non-palpable lesions) (13%), 20 T1 (26%), 22 T2 (29%), 8 T3 (11%), 7 T4 (9%) and 9 Tx (12%), giving altogether a total of 76 tumours, including, respectively, 5 and 8 bilateral synchronous and metachronous lesions. Among the 68 tumours initially discovered, 53 ductal infiltrating, one lobular infiltrating and two medullary carcinomas were found. Moreover, two fibrosarcomas and 10 ductal carcinoma in situ (DCIS) were also found. Among 50 axillary dissections for invasive carcinomas, histological involvement was found in 31 cases (62%). 45 tumours were treated by mastectomy, without (n = 35) or with (n = 10) RT. 27 tumours had lumpectomy, without (n = 7) or with RT (n = 20). 2 others received RT only, and one only CT. 7 patients (11%) developed isolated local recurrence. 20 patients (32%) developed metastases and all died; 38 are in complete remission, whereas 5 died of intercurrent disease. The 5-year disease-specific survival rate by the Kaplan-Meier method was 61%. The 5-year disease-specific survival rate for pN0, pN1-3 and pN > or = 3 groups were 91%, 66% and 0%, respectively (P < 0.0001) and 100%, 88%, 64% and 23% for the T0, T1, T2 and T3T4 groups, respectively. These secondary BCs seem to be of two types: a large number of aggressive tumours with a very unfavourable prognosis (especially in the case of pN > 3 and/or T3T4); and many tumours with a 'slow development' such as DCIS and microinvasive lesions, especially in patients treated exclusively by RT. Moreover, a very unusual rate of bilateral tumours (21%) was observed. These secondary BC could be 'in field', in 'border of field' or 'out of field'. However, a complete analysis of doses delivered by supradiaphragmatic irradiation was often very difficult, due to large variations in several parameters. We conclude that young women and girls treated for HD should be carefully monitored by clinical examination, mammography and ultrasonography.
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PMID:Breast cancer in patients treated for Hodgkin's disease: clinical and pathological analysis of 76 cases in 63 patients. 961 68

On May 23, 2017, the FDA approved the first cancer treatment (pembrolizumab) for any solid tumor with a specific genetic biomarker: microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). For the first time in history, a solid cancer treatment was approved based on the genetic makeup of tumor not on the location in the body where the cancer originated, for example lung or breast cancer (TNM staging). This indication covers patients with solid tumors that have progressed following prior treatment and who have no satisfactory alternative treatment options and patients with colorectal cancer that has progressed following treatment with certain chemotherapeutics. All cancer drug approvals in the last 30 years were grounded on TNM staging independent of the therapy type (chemotherapy, monoclonal antibodies, TKI inhibitors, immune therapies or targeted therapies) and despite the huge and fast advances in understanding tumor biology. In fact, the FDA previously approved pembrolizumab taking into consideration the TNM staging, for the treatment of certain patients with metastatic melanoma, metastatic non-small cell lung cancer, recurrent or metastatic head and neck cancer, refractory classical Hodgkin lymphoma, and urothelial carcinoma. The archaic TNM staging will probably be changed under the disruptive wave of molecular biology. The recent FDA approval could be considered the certificate of birth for a truly new dimension of personalized medicine in cancer. We recommend European Union to follow the FDA approach of tissue-agnostic cancer drugs in order to speed up the development of next-generation oncologic therapies and to increase the access of patients to truly personalized medicine.
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PMID:The FDA Changed Everything. 3198 34