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

The problem of the malignant potential of neoplastic colonic polyps is being, in large measure, resolved by newly derived techniques. Now most polyps may be removed endoscopically using the fiberoptic colonoscope. The largest world experience is at the Beth Israel Medical Center in New York, where over 2000 polyps have been endoscopically removed without a single death and with but one complication requiring operative intervention. Laparotomy is now reserved for polyps not suitable for endoscopic resection or where a question of residual cancer exists. Experience with endoscopic resection has called for: 1) re-assessment of colonic polyps in terms of their malignant potential; and 2) clarification of the indications for laparotomy and bowel resection subsequent to or instead of endoscopic removal. Among all polypoid lesions 0.5 cm or greater in size in the Beth Israel series, a variety of pathologic types was encountered. If only the neoplastic polyps were considered, the incidence of "malignant change" was 10.5% for 855 polyps analyzed. There is, however, a need to clarify terminology and to differentiate between carcinoma in situ and invasive cancer whenever possible. Superficial cancers (carcinomas in situ) do not recur or metastasize and require no treatment other than polyp removal. When "invasive" cancer is present (4.5% of neoplastic polyps) or the lesion is a "polypoid carcinoma" each case must be individually evaluted. Criteria for diagnosis, gross morphological features suggesting cancerous change, and current management of "malignant" polyps are discussed. Colonoscopy is an important component of the followup program whether malignant polyps are resected endoscopically or by the transabdominal route.
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PMID:Endoscopic polypectomy. Therapeutic and clinicopathologic aspects. 115 28

Report on 2309 vaginal hysterectomies. The leading indication for vaginal hysterectomy was benign disease of the uterus (54.4%). Utero-vaginal prolapse was the indication in approximately 32% of the patients. In 71.1% of the hysterectomies, the vaginal approach for removal of the uterus was selected in malignant and pre-malignant diseases. Of these cases 11.9% had carcinoma in situ and 2.7% had micro-invasive carcinoma of the cervix. 2.6% of these cases had carcinoma of the endometrium. In 69.9% of the cases the vaginal hysterectomy was combined with a colporrhaphy. Previous genital operations or laparotomies where no contra-indication to vaginal hysterectomy. Trauma to the urinary tract or the rectum occurred in 26 cases (1.02%). Post-operatively 3 urinary tract fistulas and 3 rectovaginal fistulas developed. The mortality was 0.51%. Among 272 cases of carcinoma in situ and 62 cases of micro-invasive carcinoma of the cervix treated by vaginal hysterectomy, one case developed a recurrent carcinoma in situ of the vaginal vault eight years after vaginal hysterectomy for carcinoma in situ. One patient treated for micro-invasive carcinoma of the cervix died four years following vaginal hysterectomy in another hospital of suspected pulmonary metastases. The diagnosis was not confirmed by autopsy. Simple total hysterectomy whenever possible by the vaginal approach is at present the maximal treatment in the University Department in Graz for carcinoma in situ and micro-invasive carcinoma of the uterine cervix.
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PMID:[Vaginal hysterectomy at the department of gynecology of the university of Graz from 1955 to 1970 (author's transl)]. 118 93

The management of 63 carcinomas in situ of the breast is reviewed. These 63 carcinomas in situ occurred among 575 carcinomas of the breast from 1969 to 1973. The treatment consisted of simple mastectomy. In cases of early invasion the axilla was explored by palpation of the adipose tissue for enlarged lymph nodes. None were found and no extirpation of the axillary nodes was carried out. Of 59 patients with carcinoma in situ of the breast, 3 later had a local recurrence. Two patients later died of distant metastases. In view of these inadequate results of simple mastectomy it is recommended that a modified radical mastectomy should also be done in all cases of carcinoma in situ of the breast.
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PMID:[The treatment of carcinoma in situ of the breast (author's transl)]. 119 54

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

Lung cancer arises after a series of morphological changes, which take several years to progress from normal epithelium to invasive cancer. The morphological changes progress from hyperplasia, to metaplasia, to dysplasia, to carcinoma in situ, to invasive cancer and finally to metastatic cancer. Multiple molecular changes have been documented in lung cancers, both small cell (SCLC) and non-small cell (NSCLC) types. The number of changes has been estimated to be in double digits. These changes include activation of dominant oncogenes myc family, (K-ras and neu genes), as well as loss of recessive growth regulatory genes or anti-oncogenes (p53, and RB as well as unidentified gene or genes on chromosome 3). However, cytogenetic and molecular genetic studies indicate that multiple other specific sites of actual or potential DNA loss may be present in lung cancers. Other changes may include development of drug resistance, and production of growth factors and their receptors. It is tempting to associate specific molecular changes with specific morphological changes, as has been attempted in the colon. However, because of the difficulties in serially sampling the respiratory tract, such studies have not been performed to date. Documentation of molecular changes in premalignant lesions and prospective studies of their prognostic effects will be necessary for the design of rational chemoprevention trials.
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PMID:The molecular biology of lung cancer. 130 9

Previous studies have shown that patients with nonpalpable invasive breast cancer have a favorable prognosis. These studies, however, have not analyzed pathologic features of mammographically detected tumors according to tumor size. We describe the histopathologic features of 77 nonpalpable invasive breast cancers, comparing neoplasms less than or equal to 1 cm with larger clinically occult tumors. Forty-seven lesions (61%) were less than or equal to 1 cm (group A) and 30 (39%) were greater than 1 cm (group B). In group A, there were 30 infiltrating ductal carcinomas (IDC); seven infiltrating lobular carcinomas (ILC); and two cases each of mixed ILC and IDC, mixed tubular carcinoma and ILC, and infiltrating cribriform carcinoma. There was one case each of mucinous carcinoma, apocrine carcinoma, tubular carcinoma, and mixed mucinous and IDC. In group B, there were 23 (77%) IDC, five (17%) ILC, and two mixed IDC and ILC. Tumors in group B were more frequently grade 3 (22% versus 7%), but this was not statistically significant (p = 0.21). There were no important differences in the frequency, subtypes and location of carcinoma in situ, or other histopathologic parameters evaluated in the biopsy specimens. Mastectomy specimens with axillary lymph node dissections were available for review in 64 cases (83%). Group B patients had a higher rate of residual invasive carcinoma (31% versus 13%) and lymph node metastases (31% versus 16%), but these differences were not statistically significant. Residual carcinoma in situ was more frequent in group B (54%) compared with group A (26%) (p = .036). Of seven group B cases with negative biopsy margins, residual invasive carcinoma was present in five (71%). We conclude that small nonpalpable invasive breast cancers differ from larger nonpalpable tumors primarily in size. The finding of negative biopsy margins should not be construed as conclusive evidence for the absence of residual infiltrating disease.
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PMID:Pathologic findings in nonpalpable invasive breast cancer. 130 12

Among the various factors reported as having significant prognostic value in primary breast cancers, the author discusses the value of well established "classical" prognostic factors used routinely and "new" prognostic factors developed over recent years as a result of progress in cell and molecular biology. The presence of axillary lymph node metastases remains the most important prognostic factor of recurrence, justifying post-surgical adjuvant therapy. However, in patients with negative axillary nodes (N-), the size of the tumour, Scarff-Bloom-Richardson (SBR and MSBR) histological grade, certain particular histological types (carcinoma in situ and tubular, colloid or pure papillary cancer) and hormone receptors (ER and PR) appear to be well established prognostic factors allowing the identification, within this group of N- patients who generally have a good prognosis, those patients with a low risk of recurrence and therefore not requiring adjuvant therapy. In contrast, the proliferative activity (ploidy and S phase, Thymidine Labeling Index, antibody Ki67), cathepsin D, thymidine kinase, EGF receptors, several genes including oncogene HER-2/neu, are recently developed prognostic factors whose significance needs to be confirmed by further studies.
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PMID:[Prognostic factors in breast cancer]. 134 Jan 64

Prostatic specific antigen (PSA) can be detected in normal and benign hypertrophic prostates, as well as in prostatic cancer and its metastases. Since it appears in the serum, this glycoprotein has become an established marker for the detection and monitoring of prostate cancer. Using a radioimmunoassay (CIS--Biointernational, France), we found serum PSA levels higher than 4 ng/ml in 55 of 58 patients with prostatic cancer. The concentrations were proportional to tumor stage: significantly higher in stages C and D than in stages A and B (p less than 0.002). In all 6 cases with occult prostatic carcinoma (stage A), levels were higher than 15 ng/ml. PSA was found to be a good indicator of response to therapy, as well as a marker of tumor progression during follow-up. After radical prostatectomy serum PSA levels decreased to below 1 ng/ml. Following radiotherapy levels returned to normal within 1-6 months in 8 of 11 patients. In 21 of 23 with metastases serum PSA decreased during hormonal treatment. In 3 who responded initially to hormonal therapy, levels increased before clinical manifestation of tumor progression. We conclude that PSA is a sensitive serum marker for the diagnosis of prostatic cancer in cases of metastatic disease of unknown origin, as well as for monitoring the response to treatment of prostatic carcinoma. The use of PSA serum levels for screening for prostatic cancer is still controversial.
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PMID:[Prostatic specific antigen for detection and monitoring of prostatic cancer]. 137 29

The purpose of the present study was to compare the effectiveness of MRI, CT and radioimmunoscintigraphy in the staging and detection of bladder cancers in 28 patients. We distinguish two groups: Group I included the tumour stages CIS-T3A and the second group the deep infiltrative tumours T3B-T4. MRI was slightly superior to CT in respect of tumour staging (75% correct results as compared to 63%). No understaging occurred with MRI, whereas in 22% of the cases the stage of the tumour was underestimated using CT diagnostics. Overstaging occurred in 25% of the MRI and 15% of the CT-diagnostics, respectively. RIS cannot distinguish the tumour groups, and hence this method is useful only for the detection of the primary tumour and metastases. In 77% of cases the tumour was detected and in 15% the tumour could be safely excluded.
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PMID:[The demonstration and staging of bladder carcinoma. A comparative study between magnetic resonance tomography, computed tomography and radioimmunoscintigraphy]. 139 37

Between January 1975 and December 1985, 45 patients with carcinoma in situ or invasive squamous cell carcinoma of the glottic larynx received radiation therapy at the Mayo Clinic. Local control in the entire group of 45 patients was 84% (in 6 of 6 with carcinoma in situ and in 32 of 39 with invasive cancers). Three of seven patients (43%) with local recurrences underwent successful larynx-preserving surgical procedures; thus, the rate of laryngeal preservation was 91%. In our study of several treatment factors, including the duration of treatment, type of treatment (continuous course versus split course), photon energy (60Co versus 4-MV photons versus 6-MV photons), total dose, and dose per fraction, we found that only total dose of 6,300 cGy or more was associated with significantly improved local control (in 35 of 38 patients [92%]). Two patients (4%) died of uncontrolled delayed nodal metastases, one of which was preceded by a local recurrence. Severe laryngeal edema developed in two patients, associated with recurrent glottic carcinoma in one of them. No larynx was lost because of complications. In our current treatment recommendations, patients receive a total dose of 6,300 cGy in 28 fractions of 225 cGy each, administered in a continuous course with use of 6-MV photons.
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PMID:Early-stage squamous cell carcinoma of the glottic larynx managed with radiation therapy. 143 95


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