Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The success of cancer therapy depends on the destruction of all viable cancer cells in the primary site, as well as in metastatic areas. Surgery alone can do little for the patient whose tumor has produced distant involvement except in those situations where surgical excision, radiotherapy, chemotherapy, or immunotherapy can be relied on to eradicate metastatic disease. Because of the paucity of systemic therapy for renal cell carcinoma, an aggressive surgical approach to the primary tumor is justifiable when all metastatic lesions can be excised or otherwise definitively treated and in experimental protocols in which adjuvant therapy of possible benefit can be combined with palliative nephrectomy. There is no evidence, however, in reported studies to suggest that routine palliative nephrectomy in patients who will not be offered adjuvant systemic therapy or radiation is beneficial. Such practice is also associated with a higher incidence of complications and mortality than is expected for resection of localized renal cell carcinoma. For these reasons, it is reasonable to recommend adjunctive nephrectomy only in certain selected instances, which include (1) the control of a patient's current symptoms related to the primary disease, for example, flank pain, hematuria, fever and toxicity, anemia, erythrocytosis, and hypercalcemia; (2) nephrectomy with the excision of a solitary metastasis; and (3) the patient who is willing to undergo experimental therapy, part of which involves removal of the primary tumor.
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PMID:The failure of infarction and/or nephrectomy in stage IV renal cell cancer to influence survival or metastatic regression. 331 66

The toxic effects of protein A (Prosorba, IMRE Corporation, Seattle, WA) treatments given as part of an on-line plasmapheresis or off-line procedure were determined in a Phase I Study. Patients were randomized and treated 12 times either once per week or three times per week with a Prosorba column containing 50 or 200 mg protein A. Treated plasma volumes varied from 150 ml off-line to 2000 ml on-line. Seven patients having advanced metastatic breast adenocarcinoma patients were evaluated. All had advanced progressive disease that was resistant to chemotherapy and/or radiation therapy. Greater than 50% regression of measurable tumor volume occurred in four of seven patients; an additional patient responded with 33.5% regression. Two patients with only bony metastases demonstrated stable disease for a 60-day period. Side effects resulting from protein A treatments included transient fever, chills, rigors, and infrequently nausea, vomiting, diarrhea, episodic hyper and/or hypotension, bronchospasm, venospasm, headache, joint and tumor pain. Mild to moderate reactions were seen in all patients regardless of clinical response, but abated spontaneously or were controlled with pretreatment and/or post treatment with antipyretics and/or antihistaminics. The side effects decreased notably during the course of the week with the more intense reaction occurring during the first treatment of the week. Side effects occurred regardless of column size or volume of plasma treated. In the course of 12 treatments, anemia requiring transfusion developed in two of seven patients. Significant tumor regression was obtained in this group of patients with advanced disease. In light of the mild to moderate side effects and tumor regression in five of seven of the patients treated, protein A treatment merits further evaluation to determine the effectiveness of this treatment in breast adenocarcinoma.
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PMID:Toxicity following protein A treatment of metastatic breast adenocarcinoma. 334 17

Selective intraarterial administration of CDDP in combination with sodium thiosulfate (STS) was performed in a 39-year-old patient with a malignant ovarian tumor suspected of being a malignant granulosa cell tumor. The primary tumor was in the left ovary, and there were widespread metastases in the abdominal cavity. A total hysterectomy with bilateral adnectomy and partial omentectomy was performed. The tumor showed several different histologic patterns, including serous papillary cyst-adenocarcinoma and granulosa cell tumor of the microfollicular type with Call-Exner bodies in which bizarre nucleoli, deep indentations of the nuclear membrane, nuclear bodies, small mitochondria, lipid droplets, rER, and ribosomes were noted. Serum markers E1, E2, CA-125 and ferritin were elevated. CDDP (total 200 mg) was administered through the abdominal aorta, inferior mesenteric artery, and common hepatic artery in addition to STS, resulting in higher levels of plasma-free platin to the residual tumor. There were hardly any side effects due to this therapy, except for a slight upper digestive tract disturbance and anemia. The result of treatment in this patient was excellent, there is no sign of recurrence, and the serum level of CA-125 3 years after surgery is normal.
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PMID:[Selective intra-arterial administration of CDDP in a malignant ovarian tumor with peculiar ultrastructural findings]. 338 45

Zollinger-Ellison syndrome and myelofibrosis were diagnosed concurrently in a 10-year-old neutered female Brittany Spaniel. Documentation of gastric ulceration, hypergastrinemia, and gastrin-secreting islet cell tumor with splenic metastases facilitated the diagnosis of Zollinger-Ellison syndrome. Patchy long-bone medullary sclerosis, nonregenerative anemia and thrombocytopenia, multiple acellular bone marrow aspirates, marked splenic extramedullary hematopoiesis, and acellular core bone marrow biopsy with areas of necrosis and fibrosis supported the diagnosis of myelofibrosis. Despite the medical and surgical management attempted, the dog was euthanatized because of signs of severe intractable bone pain. Myelofibrosis has been documented in association with canine and human neoplastic disease. A direct causal relationship between gastrinoma and myelofibrosis was not clearly established in this instance.
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PMID:Zollinger-Ellison syndrome and myelofibrosis in a dog. 339 36

A retrospective analysis was carried out on 162 patients presenting to Wellington Hospital with renal cell carcinoma between 1958 and 1978, to evaluate factors that may influence prognosis. Following radical nephrectomy the five year survival was 70% for stages 1 and 2, 53% for stage 3A and 13% for stages 3B and 3C. No patient with distant metastases survived this period. Those with renal vein or caval involvement had a significantly worse prognosis than those with stage 1 or 2 disease, and a significantly better survival than those with nodal spread. Once the tumour stage had been assigned as a baseline the influence of clinical, haematological and biochemical variables on the prognosis was analysed using a proportional hazard model. The only factor showing a significant independent association with survival was the presentation of the renal cancer as an incidental finding (p less than 0.01). The presence of anaemia or a low peripheral lymphocyte count may be independently associated with survival (p = 0.02, 0.08 respectively). Weight loss, symptoms length, the ESR, abnormality of liver function and tumour size, although associated when considered alone, do not have an independent association and therefore offer little added prognostic information. The age and sex of the patient were not related to survival.
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PMID:Renal cell carcinoma: I. Clinical indicators of prognosis. 346 93

A phase II group study of cisplatin for cervical and endometrial carcinomas was carried out in 19 institutes throughout Japan. The patients entered consisted of 62 women with cervical and 7 with endometrial carcinoma of whom 39 and 4 were evaluable, respectively. Cisplatin was administered in either of two regimens; 10-20 mg/m2 i.v., on days 1-5, or 50-100 mg/m2 i.v., on day 1, every 3 to 4 weeks. The responders comprised 4 CRs and 10 PRs for cervical carcinoma and 1 CR and 2 PRs for endometrial carcinoma, and the response rates were 35.9% and 75.0%, respectively. The response rates by histological classification were 39.4% (13/33) for squamous cell carcinoma and 16.7% (1/6) for non-squamous cell carcinoma. Response rates analysed by lesion site were 33.3% for primary tumors, 36.8% for local lesions and 33.3% for metastases. Furthermore, the response rate among patients without any prior chemotherapy was 44.4% vs. 16.7% for those with prior chemotherapy. Adverse effects included nausea and vomiting (95.3%), anorexia (93%), anemia (72.1%), leucopenia (60.5%) and elevation of BUN (16.3%). Adverse effects were tolerable. We concluded from these results that cisplatin is among the most efficacious and useful drugs against cervical (and endometrial) carcinoma(s).
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PMID:[Phase II study of cisplatin in cervical and endometrial carcinomas]. 356 7

A prostatic adenocarcinoma with argyrophilia and many Paneth cell-like granules in a 91-year-old man is reported. The initial symptom was pollakisuria, and the laboratory data showed no significant abnormality except for moderate anemia. Through radiologic examinations a right hydronephrosis and metastatic cancer of the lumbar vertebra were suspected. Because prostatic cancer was suspected, a needle biopsy of the prostate was performed. Routine histologic examinations revealed a moderately differentiated adenocarcinoma of the prostate. By hematoxylin and eosin stain, eosinophilic large granules like those of Paneth cells were found in many cancer cells. In addition, argyrophilic cancer cells were seen by Grimelius' stain. Immunoperoxidase staining elucidated a definite reactivity for lysozyme in the granules like Paneth cells. Ultrastructurally, the granules of Paneth cell-like cancer cells were electron-dense spherical bodies with a medium diameter of 540 nm. Prostatic adenocarcinoma with argyrophilia is rare, and the argyrophilic adenocarcinoma with Paneth cell-like granules is very rare in the prostate.
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PMID:Argyrophilic adenocarcinoma of the prostate with Paneth cell-like granules. 363 Jun 97

Many patients with renal carcinoma have associated anaemia that is not related to the degree of their haematuria. We report our experience with 18 patients who were anaemic with low serum iron at the time of diagnosis. The serum iron was found to be useful as a tumour marker in following the course of the disease. In patients who had no evidence of metastases following radical nephrectomy, the serum iron returned to normal. In those who had residual disease or who developed recurrent disease, the serum iron was low. It was concluded that serum iron is a useful, inexpensive tumour marker in selected patients with renal carcinoma.
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PMID:Serum iron: a tumour marker in renal carcinoma. 380 17

The prospective controlled Phase III clinical trial tested the therapeutic value of the cis-platinum-adriamycin-cyclophosphamide combination (CAP), compared with the combination including cyclophosphamide, methotrexate, 5-fluorouracil, vincristine and prednisolone (CMFVP), in untreated metastatic breast cancer. One hundred and twenty-three patients (greater than 2 cycles) were evaluated: 61 on the CAP, and 62 on the CMFVP schedule. An objective response (CR + PR) to CAP combination chemotherapy was achieved in 72% of patients (43/61), with a high rate (36%) of complete remissions. In terms of metastatic site, the response rate appeared to be particularly high in soft tissue and visceral organ (lung, liver) metastases. In the CMFVP group, an objective response was noted in 26 of 62 patients (42%), with 16% complete remissions. The difference in overall therapeutic response - and in the complete remission rate as well - was statistically significant to the advantage of the CAP regimen (P less than 0.01). The duration of remissions was 6-28 + months (means = 14) for the CAP, and 4-15 + months (mean = 9) for the CMFVP schedule. Toxic side effects were more pronounced in the CAP group, particularly myelosuppression, with anemia prevailing. Side effects of CMFVP treatment were moderate. In 39 CMFVP previously treated cases, CAP was administered as second-line treatment, and an objective response was observed in 51% of cases (20/39). Results of this controlled trial showed the advantage of the CAP combination chemotherapy in the treatment of metastatic breast cancer.
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PMID:Cyclophosphamide, adriamycin and platinum (CAP) combination chemotherapy, a new effective approach in the treatment of disseminated breast cancer. Preliminary report. 389 Mar 7

In a prospective study of 402 colorectal cancer patients, 133 patients (46 men and 87 women) presented with right colon cancer. There was no significant difference between men and women in right colon cancer incidence. Common presenting features were abdominal pain, weight loss, and anemia. Ninety-one patients underwent resection with curative intent. There were significantly fewer Dukes' A tumors in the right colon cancer series (P less than 0.05). Significantly more women in the right colon cancer group were over 70 years old (P less than 0.05). The findings of peritoneal metastases and poorly differentiated lesions at initial surgery also were associated significantly with women who had right colon cancer (P less than 0.05). This study confirms previous reports of more advanced tumors in the right colon. The need for age, sex, and subsite differences to be taken into account when assessing treatment outcomes or survival is emphasized.
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PMID:Age and sex differences in right colon cancer. 394 13


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