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 results of treating 50 patients with bladder cancer with radiotherapy over a three-year period are evaluated. Ten cases (20 per cent) were treated for palliation. Sixteen of 40 patients treated with intent of cure are considered well with no evidence of disease. Six additional cases were salvaged by further surgery. Another 7 patients died because of natural causes or distant metastases with good local control of the primary cancer postradiotherapy. The remaining 11 cases were considered failures, all died except one living with disease. These patients could not be saved by further surgery primarily because they were not medically fit. Six of twelve cases (50 per cent) survived three years and 19 of 31 cases (61 per cent) survived for one year free of disease. Reasons for possible failures are discussed.
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PMID:Role of radiation therapy in cancer of bladder. 6 39

Single-drug chemotherapy was employed in a multicentric co-operative trial. Adriamycin was given to 18 patients, VM-26 to 30 and Bleomycin to 33. Almost all patients were suffering from a T3 or T4 bladder cancer with known metastases in almost 40% of cases. The vast majority of patients had already received previous treatment either chemotherapy, surgery of irradiation. Complete regression was obtained in 5% of cases; partial objective regression in 11.1% of patients treated with Adriamycin, 26.6% with VM-26 and 33.3% with Bleomycin. The results were uniformly better when high dosages of drug were employed. No clear-cut superiority of one drug over the others can be demonstrated.
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PMID:Single-drug chemotherapy of bladder cancer with adriamycin, VM-26 or bleomycin. A phase II multicentric, co-operative study. 7 Mar 52

Results of disease-oriented phase II trials with cis-dichlorodiammineplatinum(II) (cis-platinum) in 135 adequately treated patients with advanced urothelial tumors at Memorial Sloan-Kettering Cancer Center are presented. In four protocols which used cis-platinum alone or in combination with Adriamycin and/or cyclophosphamide in 95 patients with bladder cancer, no significant difference (46%--54%) in the number of partial remissions (PRs) in previously untreated patients was noted. The median duration of response in three of the four protocols was 5--7 months. A review of the literature indicates that cis-platinum used singly produced remissions in 45% of 67 patients (95% confidence limit, 12%--57%). In the treatment of superficial bladder tumors, intravesically administered cis-platinum induced few complete or sustained remissions. The difficulties in evaluating response with intravesical therapy are discussed. The importance of patient selection, particularly the need to include patients with objectively measurable disease parameters, in phase II trials is stressed. Differences in patient characteristics and response criteria will necessitate prospective randomized trials of cis-platinum alone versus cis-platinum combination regimens in the treatment of metastatic disease. cis-Platinum was inactive (12% PRs) in 25 patients with prostatic cancer who had objectively measurable parameters. It is of interest that PRs were obtained in three of six patients (50%) with penile cancer. A review of the literature and the data in the present series indicates that cis-platinum has no value in the treatment of metastatic hypernephroma.
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PMID:Phase II trials with cis-dichlorodiammineplatinum(II) in the treatment of urothelial cancer. 38 26

In this review of the management of invasive carcinoma of the bladder the results of primary and systemic therapies are evaluated in the light of the natural history of the disease. The clinical and pathological causes of treatment failure are assessed in an attempt to identify new approaches that may be used in the future management of patients with bladder cancer. To improve survival in this disease requires different approaches to both the control of local disease and the early control of metastatic disease.
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PMID:Chemotherapy in the management of invasive bladder cancer. A review. 38 80

Our experience with the preoperative staging of bladder cancer by bilateral selective hypogastric arteriography has been accumulated since 1968. More than 150 patients have been studied by selective angiography before radical cystectomy. Our latest series of 52 patients (1972 to 1976) compares to our previous experience demonstrating angiographic staging accuracy to detect bladder invasion and occult metastases at a rate exceeding that of clinical staging alone. Arteriographic staging of D lesions, when supplemented with lymphography, approaches 100 per cent accuracy. Falsely negative lymphograms currently are extremely uncommon (1.9 per cent). In several illustrated instances angiographic staging was proved to be even more accurate than the pathologic staging of a limited cystectomy specimen. The over-all angiographic and lymphangiographic staging accuracy in our most recent series of cystectomy patients was 78.8 per cent. The techniques and reliability of the data are discussed in detail, including the factors that interfere with the exact arteriographic staging of bladder cancer. However, these factors are more troublesome in early stage lesions. These studies demonstrate the role and value as well as areas of limitation of preoperative arteriography and lymphography in the evaluation of invasive bladder cancer.
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PMID:Eight years of experience with preoperative angiographic and lymphographic staging of bladder cancer. 61 18

We have found that routine bilateral selective angiographic studies for patients considered candidates for radical cystectomy is a useful technique. Our experiences since 1968 to present have indicated that early bladder invasion and occult metastases can be detected at a rate exceeding that of clinical staging alone. Angiographic staging in D lesions, when supplemented by lymphangiogram, can approach 100 per cent accuracy. Our current false negative lymphangiogram rate is relatively low, that is, 1.9 per cent. The over-all angiographic and lymphangiographic staging accuracy prior to surgery in our most recent series of cystectomy patients was nearly 79 per cent. Such techniques and reliability of data are discussed in detail including the factors which interfere with the exact angiographic staging of bladder cancer. These techniques in no way are meant to surplant routine preoperative clinical evaluations which are appropriately used with additional accuracy and success.
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PMID:Developments in preoperative staging of bladder tumors. 62 85

We examined 76 bladder tumors of various stages and grades for the presence of the ABO (H) cell surface antigen, using the specific red cell adherence technique. Of the grade I lesions studied 70 per cent were positive for the cell surface antigen and none of the 26 grade III tumors retained the antigens. When correlated with clinical stage the tumors showed no antigens for those of stages B1 to D, while 12 of 16 stage A lesions were positive for the antigen. When stage A lesions were studied and the findings were correlated with recurrence and metastasis/invasion rates the cell surface antigen was present on the initial tumor in only 1 lesion that recurred at an invasive stage. The findings of this study show that the specific red cell adherence technique may be valuable for predicting malignant potential in low grade, low stage cancer of the bladder. If supported by further investigation this technique may offer the capability of selecting low grade, low stage bladder tumors that are destined to invade or metastasize while they are at curable stages.
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PMID:Correlation of the cell surface antigens with stage and grade in cancer of the bladder. 75 41

228 bilateral pedal lymphograms in patients with bladder cancer have been correlated with the features of the primary bladder tumour and patient survival. In 70 cases, radiographic findings were correlated with operative node histology. The results show that it is not possible to predict accurately which cases have lymphatic spread without this investigation. Positive lymphograms were found in 91 cases, and were associated with a very poor prognosis. Only 6% of patients with unilaterally involved iliac nodes survived 5 years, and all patients with bilateral iliac or para-aortic disease died within 3 years. Histological correlation was found in 90% of cases, and the results indicate that this investigation slightly underestimates the incidence and extent of microscopic lymphatic metastases. It is concluded that this investigation is essential in planning the treatment of infiltrating bladder tumours.
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PMID:The value of lymphography in the management of bladder cancer. 101 31

Charcteristics of urethral transitional cell carcinoma in patients who have undergone cystectomy for bladder cancer have been reviewed. The retained urethra was the site of urothelial malignancy in 7 per cent of 348 patients who underwent cystectomy alone. Urethras removed during prophylactic cystourethrectomy in 110 patients showed unsuspected carcinoma in situ and marked atypic in 12.5 per cent. Patients with urethral cancer were at greater risk for meatal and upper tract tumors, a reflection of multicentric tumor neogenesis, and at greater risk for perineal tumors and inguinal metastases, a reflection of direct invasion. Cytology is advocated for examining the retained urethra. However, urethrectomy to include a fossa navicularis and glandular meatus at the time of cystectomy seems justified as a definitive means of guarding against the often asymptomatic and potentially lethal urethral occurrences of transitional cell carcinoma. Furthermore, incontinuity removal of the bladder and urethra more nearly satisfies the requirements for cancer surgery by avoiding transection of a tumor containing viscus.
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PMID:Transitional cell carcinoma of the urethra in men having cystectomy for bladder cancer. 124 14

The regional lymph nodes from 47 patients with carcinoma of the bladder who had undergone radical cystectomy and bilateral pelvic lymphadenectomy were classified into 3 histologic patterns that correlated with immunologic function. Lymph nodes were designated as stimulated if they exhibited prominent germinal centers (B cell proliferation) and expansion of the deep cortex (T cell proliferation), depleted if they appeared markedly hypocellular and fibrotic, and unstimulated if they resembled a normal resting lymph node. Correlation of the histologic pattern with the extent of disease revealed that patients whose nodes appeared stimulated had fewer metastases (p less than 0.05) than those with either unstimulated or unstimulated combined with a depleted pattern. A markedly improved 5-year survival rate was seen in patients with a stimulated pattern (p less than 0.0001) compared to those patients who exhibited a depleted and/or unstimulated lymph node pattern. The survival advantage related to the stimulated pattern was observed primarily among patients with advanced disease. It is suggested that stimulated nodes reflect proliferation of T and B lymphocytes engaged in cell-mediated and humoral immune responses to the bladder tumor and that this favorably influenced survival in those patients. Patients whose lymph nodes showed a depleted pattern fared poorly despite the extent of the disease and those with an unstimulated pattern were intermediate in survival. A depleted pattern may represent a state of local immune paralysis, exhaustion of the draining lymph nodes as a result of exposure to excess tumor-derived products such as antigen or toxic substances or simply an atrophic node incapable of response. In the absence of a local immune response such patients might be expected to do poorly. These results suggest that morphologic evaluation of the lymph nodes regional to bladder cancer may provide a clue to their immunologic function and a more accurate guide to prognosis of patients with this neoplasm.
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PMID:Prognostic significance of regional lymph node histology in cancer of the bladder. 125 85


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