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)

Improvement in survival of patients with bladder cancer has despite much effort in optimizing treatment schedules been limited (21). Patients seem to present with a bladder tumour that has a biological potential which it is difficult to alter by treatment. Bladder tumours seem either to possess or lack the biological potential for invasion. Non-invasive (Ta) bladder tumours do not kill the patient, and survival of patients with invasive tumours is localized to the bladder or present with regional and/or distant metastases (26).
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PMID:Rationals for optimizing bladder cancer treatment and control. 269 70

After cystoprostatectomy for cancer of the bladder 43 men were provided with a detubularized, low pressure ileal reservoir (Kock pouch) connected to the urethra. Reflux was prevented by an intussusception valve. There was no operative mortality and few early complications. At followup the mean postoperative observation time was 13 months, with a range of 5 to 20 months. Late complications included manifestations of local tumor recurrence or distant metastases in 9 patients within 6 months postoperatively, which made adequate functional evaluation impossible. In 18 patients reflux to the upper urinary tract due to eversion or sliding of the antireflux valve occurred at various postoperative intervals. In 16 of these patients incontinence developed as a consequence of the reflux. Surgical correction of the failing antireflux valve restored reflux prevention and continence. Within 3 to 6 months the capacity of the reservoirs had reached an ultimate volume of approximately 600 ml. Pressure waves exceeding 40 cm. water seldom occurred in the mature reservoirs and then only at high filling volumes. The mean urethral resting resistance to flow was 64 cm. water. The configuration and function of the upper urinary tract improved or stabilized postoperatively. Of 34 evaluable patients 30 were continent during the day with a voiding frequency of 3 to 5 times and dry at night with a frequency of 0 to 2.
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PMID:Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features. 270 96

To evaluate the diagnostic value of preoperative staging of bladder cancer and cancer of the prostate, CT and NMR scans of 45 histologically defined tumors of the bladder and the scans of 24 patients with radical prostatectomy were compared. Lack of extravesical spread was imaged correctly by NMR in all cases of urothelial cancer (pT1-pT3a). CT diagnosis failed in 39%. False-negative results were obtained in 2 of 5 invading tumors (pT3b) by NMR and in 3 of 5 by CT. Extraglandular spread of cancer of the prostate was diagnosed with an accuracy rate of 79% by NMR and of 46% by CT. The diagnostic value for detection of pelvic lymph node metastases had a low-sensitivity rate of 26% in NMR and of 22% in CT.
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PMID:[The clinical value of preoperative staging of bladder and prostatic cancers with nuclear magnetic resonance and computerized tomography]. 271 95

From 1979 through 1988, 64 men and 16 women (age range 36-82; mean 63 years) with bladder cancer underwent pelvic lymph node dissection and radical cystectomy with urinary diversion. Bilateral common iliac, external iliac, internal iliac, obturator and presacral nodes were removed and examined. The frequency of involvement of each nodal group was the highest at the common iliac and the external iliac nodes followed by the obturator, presacral and internal iliac nodes. The incidence of lymph node metastasis increased with the tumor grade and pathological stage. The incidence of positive nodes is 3.7% in patients with P1 tumors, 10% in P2, and 17% in P3 tumors. Of these patients, 9 were with nodal metastasis; seven died of metastatic cancer 3 to 37 months post-operatively, two were alive for 4 to 41 months without evidence of recurrence. The mean survival time was significantly longer than that of the historical control group (1975-1978 total cystectomy without node dissection).
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PMID:[Pelvic lymph node dissection for invasive bladder cancer]. 273 2

Three patients who underwent surgical resection for pulmonary metastases were reviewed. The primary lesion was testicular tumor, bladder cancer and renal cell carcinoma. One of these patients is alive without disease at 30 months after the pulmonary resection, while the others died of recurrence at 3 and 7 months after the surgical resection, respectively. As a factor affecting prognosis, characteristics of the primary lesion, especially its chemosensitivity, was thought to be important. The surgical resection of pulmonary metastasis may be effective, if the indication is assessed carefully.
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PMID:[Surgical resection of pulmonary metastasis from genitourinary cancers]. 273 33

Thirty patients with bulky T3 or T4 transitional cell carcinoma of the bladder, clinically determined to be without nodal or distant metastases, were treated with a 48-hour hypogastric artery infusion of cisplatin (CDDP) 75-150 mg/m2 1 month before tumor resection. Complications of the CDDP infusions were milder than those with intravenous (IV) infusion or rapid intraarterial (IA) infusion, although three lower extremity neuropathies were seen. The CDDP infusions reduced the primary bladder mass effectively, and seven of 16 cystectomy specimens were rendered PO. However, patient survival was clearly predicted by the nodal status. Of 15 T3-4N + MO patients, 11 died at 15 +/- 3 months. Methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) chemotherapy was given if residual transitional cell carcinoma was found after IA CDDP. Of 12 P3NOMO patients undergoing cystectomy, eight are alive with no evidence of disease (NED) at 28 +/- 8 months and no patient has died of transitional cell carcinoma. IA CDDP can effectively reduce bulky bladder cancer masses, but has no demonstrable effect on survival in N+ disease. It appears that adjuvant IA CDDP favorably affects survival in T3NOMO transitional cell carcinoma of the bladder.
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PMID:Intraarterial cisplatin infusion in the management of transitional cell carcinoma of the bladder. 273 84

The authors report the cases of 8 patients who had been, or were being, treated for pharyngo-laryngeal carcinoma (n = 7) or cancer of the bladder (n = 1). Because of the finding of one or several peripheral pulmonary opacities, these patients underwent exploratory thoracotomy which showed that these opacities corresponded to benign lesions instead of metastases of these cancers. This leads to a reappraisal of the diagnostic approach of pulmonary opacities in patients with known cancer, since benign lesions unrelated to the malignancy cannot be excluded. The need for an accurate diagnosis of these intrapulmonary lesions is emphasized, using various exploratory methods including thoracotomy if required.
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PMID:[False pulmonary metastases. Apropos of 8 cases]. 274 Jul 4

We treated 41 patients with transitional cell carcinoma with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy. Median patient age was 56 years. Of the patients 33 had either distant metastases or locoregional disease that could not be cured by an operation or radiation. Of these patients 30 had measurable disease and 12 responded (4 complete and 8 partial responses, response rate 40 per cent, 95 per cent confidence limits 23 to 59 per cent). Only 2 of these patients remain with an unmaintained complete response at 34 and 52 months. Of 5 patients 3 responded who were treated with neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin for locally advanced bladder cancer before radiation or cystectomy, and only 1 of these patients is free of disease. The remaining 3 patients were treated postoperatively because they were at high risk for recurrence and all are well. Toxicity of the regimen was severe: 41 per cent of the patients experienced neutropenic sepsis and 54 per cent required hospitalization for management of toxic complications. Three patients experienced pulmonary embolism and 1 had deep vein thrombosis. There was 1 drug-related death of sepsis. Although a patient occasionally may have long-term benefit from this chemotherapy our results suggest caution in the widespread application of this protocol.
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PMID:M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for transitional cell carcinoma: the Princess Margaret Hospital experience. 274 45

The cisplatin-based combination chemotherapy regimens of M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) or MVC (methotrexate, vincristine, cisplatin) were given to 25 patients with metastatic urothelial carcinoma, 13 with locally advanced bladder cancer, and 10 as adjuvant therapy after radical surgery. Toxicity was significant with two deaths. Forty-eight percent of the patients with metastatic disease had a complete (20%) or partial (28%) response. Survival was only improved if a CR was achieved. Nine of 13 patients given M-VAC/MVC as neoadjuvant therapy underwent cystectomy and six are free of disease (mean 31 months). Three of the four patients who did not have radical surgery are also free of disease. These regimens appear to be superior to cisplatin alone. In the overall response evaluation, however, toxicity is greater.
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PMID:M-VAC or MVC for the treatment of advanced transitional cell carcinoma: metastatic, induction, and adjuvant. 276 94

A series of 71 patients with muscle invasive bladder cancer received a median of 3 cycles (range 1-6) of methotrexate, vinblastine, Adriamycin and cisplatin (M-VAC). Efficacy assessed by transurethral resection alone showed that 48% of patients were TO, 13% Tis and 54% had normalisation of initially positive urinary cytology after treatment. However, when considering transurethral resection of the bladder (TURB), cytology and non-invasive procedures (CT scan and/or ultrasound), only 21% had a clinical complete remission (cCR); 48 patients (68%) had pathological evaluation and 13 (27%) were PO after treatment. Non-responding patients had a poor prognosis: 14/30 (47%) developed metastatic disease and 13 died. In assessing the primary lesions, clinical understaging was significant. Of 15 patients who were TO cystoscopically prior to surgery, 6 (40%) had residual disease in the pathological specimen, including 4 with muscle infiltration; 23 patients (32%) remained clinically staged, only 8 of whom remain disease-free. With a median follow-up of 24 months (range 2-42+), 41 patients are alive and disease-free, including 20 with a functional bladder. The large staging error raises questions concerning studies using clinical rather than pathological endpoints as the sole criteria of efficacy.
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PMID:Neo-adjuvant chemotherapy for invasive bladder cancer. Experience with the M-VAC regimen. 280 61


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