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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study describes the patterns of cervical and breast cancer among pregnant mothers who were treated at the NN Petrov Institute of Oncology in Russia during 1960-94. The sample included 476 patients admitted with invasive cervical cancer that was diagnosed during pregnancy or after birth or abortion. Findings were compared to a control group of 640 invasive cervical cancer patients and 240 breast cancer patients of reproductive age. 95.3% of cancers were malignant. 60.9% were tumors of the cervix, breast, and ovaries. The percentage of cervical cancer cases was 23.5% of reproductive age women. In 69% of the cervical cancer patients, the depth of tumor growth into the stroma exceeded 1 cm compared to only 32% in the control group. Cervical stage I cancer during pregnancy spread to the regional lymph nodes twice as frequently as in the control group. Lymphatic metastases were greatest in patients with regional metastases during the second and third trimester or after birth. 21.4% of pregnant patients and 15.5% of nonpregnant patients had stage III cervical cancer. 5-year survival rates after prompt treatment was 58.4% compared to 78.8% for controls. 2% of breast cancer patients were pregnant at the time of diagnosis, and most had the lobular form. Regional metastases were 1.5-2.0 times higher for breast cancer cases diagnosed during pregnancy compared to nonpregnant cases. The cancers diagnosed in the last two trimesters or during breast feeding tend to be aggravated. The 5-year survival rate is poor. The prognosis for the fetus is better if diagnosed in the third trimester, but better for the mother if diagnosed in the first trimester. Pregnancy does not increase the risk of malignant tumors and is not likely to accelerate tumor growth. IUD contraception should be used by breast cancer patients post-treatment. Cervical cancer patients should begin contraceptive use about 2 years after favorable prognosis.
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PMID:Fertility, pregnancy and cancer. 922 28

The only consistent factor influencing prognosis of primary melanoma in pregnancy has been the stage of disease at diagnosis, not the pregnancy. However, several studies suggest that pregnant women may have melanoma diagnosed at a later stage of disease. Thus, suspicious changes in nevi during pregnancy warrant prompt biopsy-not observation or deferral to the postpartum period. No hormonal factors in pregnancy that clearly influence melanoma development have been identified; there is no increased risk of recurrent disease with subsequent pregnancy. Thus, the decision for further childbearing should be a prognostic and personal one. Placental and/or fetal metastasis are limited to patients with hematogenous dissemination. Except possibly for this reason in women with distant metastases, there are no medical data to justify therapeutic abortion. Recommendations to the pregnant woman or the woman of reproductive age should not differ from that of other patients with melanoma.
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PMID:Melanoma and pregnancy. 1113 Apr 72

Germ cell tumors constitute a very complicated group of tumors of the ovary and their histogenesis is not yet clarified. Besides their histological heterogeneity, sarcomatous areas have also been described. A right ovarian mass was found in a 23-year-old female, who was being treated in the hospital for miscarriage. Disseminated omental metastases were detected during abdominal laparotomy. Pathological examination of the dissected material revealed the tumor to be a mixed germ cell tumor (immature teratoma and dysgerminoma) with sarcomatous component. Areas resembling granulosa cell tumor were also encountered. This ovarian tumor with many different histopathological features is presented with a review of the literature. The importance of thorough sampling in determining the type and extent of the malignant components is also emphasized due to their direct relation with the prognosis.
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PMID:Mixed germ cell tumor of the ovary with sarcomatous component. 1134 23

Placental site trophoblastic tumor (PSTT) is the least common form of gestational trophoblastic disease. The tumor represents a neoplastic transformation of intermediate trophoblastic cells that normally play a critical role in implantation. PSTT can occur after a normal pregnancy, spontaneous abortion, termination of pregnancy, ectopic pregnancy or molar pregnancy. It displays a wide spectrum of behavior, and when metastatic, can be difficult to control even with surgery and chemotherapy. Because of PSTT's rarity, limited information is known about its natural history. Several recent studies have indicated that mitotic index is an important prognostic indicator. Advances in chemotherapeutic regimens have also improved clinical response in metastatic disease.
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PMID:Advances in the understanding of placental site trophoblastic tumor. 1206 71

Placental site trophoblastic tumor (PSTT) is an uncommon form of gestational trophoblastic disease (GTD) with variable spectrum of clinical behavior. PSTT can occur after a normal pregnancy, spontaneous abortion, termination of pregnancy, ectopic pregnancy or molar pregnancy. Surgery is the primary treatment. Chemotherapy has an established role in loco-regionally advanced and metastatic disease. Many studies indicate that mitotic index is an important prognostic indicator. This article reviews the literature on this rare disease.
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PMID:Placental site trophoblastic tumor. 1283 40

Placental site trophoblastic tumour (PSTT) is a very rare and unique form of gestational trophoblastic disease (GTD). This tumour represents a neoplastic transformation of intermediate trophoblastic cells that normally play a critical role in implantation. PSTT can occur after a normal pregnancy, abortion, term delivery, ectopic pregnancy or molar pregnancy. It displays a wide clinical spectrum, and when metastatic, can be difficult to control even with surgery and chemotherapy. Unlike other forms of GTD, PSTT is characterized by low beta-hCG levels because it is a neoplastic proliferation of intermediate trophoblastic cells. Expression, however, of human placental lactogen (hPL) is increased on histologic section as well as in the serum. The most common presenting symptoms of PSTT are vaginal bleeding and amenorrhoea. Diagnosis is confirmed by dilatation and curettage (D and E) and hysterectomy but meticulous evaluation of metastasis is mandatory. Most cases are confined to the uterus but pelvic involvement, lung and other organ metastasis has been reported. Unlike other forms of GTD, the WHO prognostic score is of little help. For the PSTT patient, surgery is the primary treatment of choice. For patients desiring future childbearing, D and C and adjuvant chemotherapy is an option. Because these tumours tend to be less sensitive than other types of GTD to chemotherapy, the most successful regimen to date has been with EMA/CO or EMA/EP. Good prognosis is anticipated in cases localized to the uterus, and when the interval between antecedent pregnancy and treatment is less than 2 years. In cases with distant metastasis or delayed treatment, the outcome is dismal. Advances in chemotherapeutic regimens have improved clinical reponse in metastatic disease.
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PMID:Placental site trophoblastic tumour. 1461 93

Two women aged 34 and 32, were diagnosed with cancer during pregnancy. The 34-year-old woman with breast cancer diagnosed during the first trimester of pregnancy, had just undergone breast-conserving surgery. She chose to have an abortion before adjuvant chemotherapy was started. A year after chemotherapy ended she became pregnant again and gave birth to a healthy child. After 3 years there were no signs of metastases. In the 32-year-old woman with a malignant lymphoma diagnosed during the third trimester of pregnancy, chemotherapy had to be started because she developed V. cava superior syndrome. The dyspnoea disappeared and a week after the first treatment she gave birth to a healthy child. A year after completion of treatment she was in complete remission and her child was developing well. Pregnancy is not always a contraindication for starting chemotherapy. However, in order to reduce the risk to mother and child as much as possible, the duration of the pregnancy as well as different groups of cytostatic drugs have to be taken into consideration. A multidisciplinary approach to mother and child is essential.
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PMID:[Pregnancy and chemotherapy; an apparent contradiction]. 1518 44

The purpose of this study was to review patients with cancer during pregnancy, the effectiveness of the available methods of treatment, and their prognosis. A retrospective chart review was conducted of all women diagnosed with pregnancy-associated cancer between 1974 and 2002 at the University of Illinois at Chicago Medical Center. The demographics, clinical presentation, time and mode of diagnosis, treatment, pregnancy outcome, and maternal survival were noted. The incidence of carcinoma in pregnancy in the series was 0.32/1000 deliveries. The age ranged from 16 to 41 years (mean 30.5 years). No patient underwent a therapeutic abortion, and all patients delivered a healthy infant with no malformations. Metastases developed in three patients with median time of 44 months (range 13-96 months) to presentation of metastases from the time of initial diagnosis. Association of cancer with pregnancy is a rare occurrence. Rates of specific cancers in pregnant and nonpregnant women appear to be equivalent. Pregnant women with cancer are often diagnosed at a later stage compared to their nonpregnant counterparts. Though the cancer may be diagnosed at a more advanced stage, pregnant patients with cancer do not appear to have a more aggressive clinical course.
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PMID:Coexistence of pregnancy and cancer. 1558 20

The clinical outcome of patients with complete hydatidiform moles (CHM) is variable. The correlation between trophoblastic proliferation and development of persistent disease was evaluated. A hundred and fifty-one cases with the initial diagnosis of CHM were re-evaluated histopathologically. The need for chemotherapy and occurrence of metastatic disease was correlated with the histologic grade using a three-level score. Twelve out of 151 cases were re-evaluated as hydropic abortion, partial moles, or were insufficient for morphologic examination, representing a diagnostic agreement of 92%. A total of 63.4% of the CHM presented with low trophoblastic proliferation with focal areas of slight hyperplasia (grade 1), and 23.7% with moderate proliferation with slight anaplasia and medium-sized sheets of free trophoblast in between the villies (grade 2). In all, 12.9% of the cases showed marked hyperplasia with marked anaplasia and involvement of nearly all villies, as well as a large amount of intervillous trophoblastic sheets (grade 3). Twenty-six of the CHM (19%) required chemotherapy. Grade 3, on histology, showed a positive correlation with the necessity of chemotherapy (p=0.04), but not with the occurrence of metastatic disease. Histomorphology might predict the risk of persistent disease, indicating the necessity for closer a follow-up, but further studies are required.
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PMID:Prognostic value of trophoblastic proliferation in complete hydatidiform moles in predicting persistent disease. 1643 15

Although breast cancer (BC) affects patients at older age, it occurs more frequently in premenopausal women due to better diagnostic methods and an increasing trend towards delay in childbearing. The increasing population of women with BC delaying childbearing may be of concern regarding the effect of treatment on later pregnancy, as well as the influence of pregnancy on the prognosis of disease and survival. Radiotherapy has shown no adverse effects on the clinical outcome in the offspring except diminished lactation. The offspring of patients who became pregnant after chemotherapy have shown no congenital anomalies, although sometimes a high abortion rate (10-29%) has been demonstrated. Currently, several fertility-sparing options, including the use of endocrine therapy and assisted reproductive technologies, cryopreservation and ovarian tissue transplantation, are very promising. The survival of BC patients is not decreased by a subsequent pregnancy; compared with the non-pregnant group their survival rates are often the same or better, with favourable relative risks and lower recurrence of metastases.
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PMID:Breast cancer treatment--later pregnancy and survival. 1680 Feb 46


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