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

There have been major advances in the diagnosis and treatment of bladder cancer in the last several years. Flexible cystoscopy and DNA analysis have combined to increase both comfort for the patient and detection rates of early disease. The laser has become an established alternative to transurethral resection of superficial tumors, providing identical cure rates, but with more comfort and less expense. Intravesical installation of BCG has become not only an alternative treatment for recurrent superficial bladder cancer, but the first line of treatment for diffuse carcinoma in situ of the bladder which previously had been best treated with radical cystectomy. There are now numerous alternatives to the ileal conduit, when radical cystectomy is the preferred treatment. Herein we describe the "Providence Pouch," our own variation on the theme. Lastly, metastatic disease, once universally fatal, is now responding to a new combination of chemotherapy agents based on a combination of cisplatinum and methotrexate.
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PMID:Advances in the diagnosis and treatment of bladder cancer. 267 73

Recent studies have demonstrated that epidermal growth factor receptor (EGF-R) shows great homology with the v-erbB transforming protein and the amplified expression of EGF-R accompanies the malignant transformation of squamous epithelium of the uterine cervix. In this study, the tissue localization of EGF-R in the oncogenesis of uterine cervical cancer was examined by the avidin/biotin immunoperoxidase technique using anti-EGF-R monoclonal antibody. Normal squamous and columnar epithelium was almost negative for EGF-R. The positive rate of EGF-R increased in the precancerous lesions, whereas it decreased in invasive and metastatic cancer (mild dysplasia: 36%, moderate dysplasia: 57%, severe dysplasia: 77%, carcinoma in situ: 82%, microinvasive carcinoma: 80%, squamous cell carcinoma: 24%, glandular dysplasia: 67%, adenocarcinoma in situ: 75%, adenocarcinoma: 8%, adenosquamous carcinoma: 33%, metastatic carcinoma of the pelvic lymph node: 21%). The positive rate of dysplasia in follow up cases was high in the progressive group (regressive group: 0%, persistent group: 62%, progressive group: 80%). These results suggest that EGF-R may play an important role in the early stage of carcinogenesis of uterine cervical cancer, and it will be used as one of the markers in the prognosis of precancerous lesions of the uterine cervix.
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PMID:[Immunohistochemical studies on epidermal growth factor receptor in oncogenesis of uterine cervical cancer]. 268 40

To determine the extent of lymphadenectomy necessary to cure early gastric cancer, the relationship between the frequency of nodal involvements and the extent of the primary invasion was examined in 274 patients with primary cancer of the stomach. We also evaluated the relationship between the number of metastatic lymph nodes, the pattern of metastases to the nodes, and the histologic type of the primary tumor. In early gastric cancer, lymph node metastasis was more frequent in protruded-type cancer with invasion into the submucosa more than 3 cm in diameter and located in the lower third of the stomach, but was limited to the group 1 lymph nodes, which were defined as being anatomically located nearest to the cancer. In cancer invading into the muscularis propria, metastasis to the group 2 or 3 lymph nodes, which were defined as being anatomically located farther from the cancer than group 1, was found. The number of lymph nodes involved and extent of cancer metastasis in these lymph nodes metastasis, differentiated early gastric cancer had more lymph node involvement and wider extent of metastases than undifferentiated cancers. The cancer cells sometimes replaced most of the node and invaded the perinodal fatty tissue, even in early gastric cancer. In addition, it is occasionally difficult to distinguish macroscopically early gastric cancer with submucosal invasion from cancer invaded into the muscle layer. In conclusion, group 1 and 2 lymph nodes, including perinodal fatty tissue, should be removed completely, even in early gastric cancer, except for carcinoma in situ, particularly when the cancer is of the differentiated type.
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PMID:Strategy for lymphadenectomy of gastric cancer. 270 96

Incidence and survival rates were estimated for all white and black women in metropolitan Atlanta with a new diagnosis of in situ or invasive cervical carcinoma between 1975 and 1986. During this period, the average annual age-adjusted incidence (per 100,000) of in situ lesions declined from 51.4 to 25.6 among whites and from 102.2 to 34.6 among blacks. The average annual age-adjusted incidence rate of invasive cervical cancer decreased from 11.8 to 8.2 for whites and from 33.0 to 26.7 for blacks. Although the black-to-white ratio of carcinoma in situ incidence rates declined progressively over time, the excess of invasive cancer among blacks did not decrease. The five-year cumulative survival percentages by stage for whites and blacks, respectively, were 99.1 and 99.1 for in situ carcinoma, 92.2 and 80.5 for locally invasive carcinoma, 49.2 and 40.5 for regionally invasive carcinoma and 3.1 and 3.4 for cases with distant metastases. No improvements in stage at diagnosis of invasive cancer or stage-specific survival rates were observed during this period.
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PMID:Recent trends in the epidemiology of cervical neoplasia. 275 Apr 36

We reviewed a total of 119 resected esophagi with intraepithelial neoplasias of low grade (including slight or moderate dysplasias), high grade (including severe dysplasia and carcinoma in situ), or microinvasive squamous carcinoma (i.e., not invasive beyond the submucosa and without metastases in regional lymph nodes). Epithelial buds bulging into the stroma were noted in noninvasive intraepithelial lesions. The most severe degree of histological alteration was used to characterize each case. Of the 119 cases, five were low-grade, 38 were high-grade, and the remaining 76 specimens contained microinvasive squamous carcinoma. Of these, 23 invaded only the lamina propria. Nine invaded the muscularis mucosae, 16 invaded the inner half of the submucosa, and the remaining 28 invaded the outer half of the submucosa. Epithelial buds were divided according to their configuration into types I, II, and III. Grade I was characterized by regular epithelial buds of the same size, grade II had regular buds that varied in size, and grade III had irregular buds (i.e., buds of varying length and width with irregular contours). Our study of 66 specimens with microinvasive squamous carcinoma showed that one of the two specimens that had low grade dysplasia also had type III buds, while 56 of the remaining 64 (87.7%) with high grade dysplasia also had type III buds. Microinvasion originated at the tip of the type III epithelial buds in 12 specimens. Similar results have been demonstrated in experimental animals. We conclude that in the esophageal mucosa, there is a close relationship among the degree of squamous cellular atypia, the formation of epithelial buds, and the progression toward invasive carcinoma.
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PMID:Histological classification of intraepithelial neoplasias and microinvasive squamous carcinoma of the esophagus. 275 Oct 41

By radioimmunoassay the concentration of the CA 19-9 antigen was determined in the serum of 68 patients with large bowel cancer, while the CA 125 antigen was determined in 26 patients with this disease. Both markers were determined with CIS kits. In all, 127 determinations were done. The results were as follows: 1) CA 19-9 concentration increased with disease progression from 21% (in grade I of local-regional progression, A, B, C according to Dukes), through 41% above-normal results in group II (with metastases--Dukes' grade D), to 67% in case of recurrence of the tumor, and to 0% in group IV--with absent recurrence sign after radical surgical intervention. 2) CA 125 is without clinical value in large bowel cancer.
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PMID:[CA 19-9 and CA 125 antigens in the sera of patients with cancer of the large intestine in relation to its clinical progress]. 278 2

The sera of 563 patients who underwent colonoscopy were assayed for glycolipid antigen CA 19-9 and CEA. These patients represented a broad spectrum of clinical diseases ranging from advanced metastatic cancer of the colon, pancreas, or stomach to those with negative colonoscopic examination. Sensitivity and specificity for CA 19-9 and CEA were calculated using the following clinical definitions. Malignant or pre-malignant disease was defined as colon, pancreatic or stomach carcinoma, stomach dysplasia, atypical adenomatous polyp, atypical villous adenoma, carcinoma in situ and carcinoma in an adenomatous polyp. When the normal group included patients with adenomatous polyp, hyperplastic adenoma, inflammatory disease and patients with no disease apparent, the sensitivity and specificity for CA 19-9 was 23% and 96%, and for CEA, 23% and 95%, respectively. When adenomatous polyp patients were placed in the malignant or pre-malignant disease group, the sensitivity and specificity for CA 19-9 was 8% and 96%, and for CEA, 11% and 95%, respectively. When comparing CA 19-9 and CEA in colorectal carcinoma, the percent positivity of the CEA assay was equal to, or better than, CA 19-9 in all Dukes' stages. In pancreatic carcinomas CA 19-9 showed better diagnostic performance than CEA.
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PMID:Comparison of serum CA 19-9 and CEA levels in a population at high risk for colorectal cancer. 280 13

The significance of various radiographic signs in 183 patients with clinically occult breast disease is described. 30.6% had a carcinoma of the breast or a carcinoma in situ. The radiological features have varying predictive values and there is variation in the incidence of lymph node metastases. It is considered useful to classify the radiological appearances under the headings of round foci, star-shaped opacities, diffuse opacities, opacities with calcification and groups of micro-calcification. Despite the early diagnosis, 24% of patients already had lymph node metastases.
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PMID:[The significance of mammographic symptoms in clinically occult findings]. 282 67

Between 1979 and 1985 surgical resections from 680 cases of primary breast cancer were examined histologically. The patients were divided into four groups: (i) patients aged between 45 and 69 years who had been screened (n = 316); (ii) those younger than 45 who had not been screened (n = 55); (iii) those aged between 45 and 69 who had not been screened (n = 104); and (iv) those older than 69 who had not been screened (n = 205). The material was compared in terms of the association between in situ and invasive carcinoma. There was a low incidence of lobular carcinoma in situ (LCIS) in all groups and a high incidence of ductal carcinoma in situ (DCIS) which declined with age. Ninety nine group i patients had in situ carcinoma or early invasive carcinoma (less than 1 cm in diameter) compared with 19 of group iii cases. Screened patients had fewer multicentric cancers and a lower incidence of large invasive cancer compared with unscreened patients. Group ii patients had a higher incidence of whole quadrant in situ carcinoma, multiple cancer, and lymph node metastases. Group iv patients had a lower incidence of in situ cancer, and more low grade cancer than the other groups. Cases were divided into four types on the basis of this analysis.
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PMID:Topographical and histological presentation of mammographic pathology in breast cancer. 283 Mar 18

After presensitization with IV hematoporphyrin derivative (HpD), neoplasms in the tracheobronchial tree of 18 patients were treated by photodynamic therapy (PDT) with 630-nm light from a tunable dye argon laser system delivered through quartz fibers passed through the biopsy channel of a flexible bronchoscope under local anesthesia. Tumor effect was measured by complete response (CR)--no visible tumor in area treated, partial response (PR)--tumor size or degree of obstruction reduced by more than 50% and some response (SR)--tumor or degree of obstruction reduced by more than 20% but less than 50%. One month or less after 30 treatments to 26 areas in 18 patients, there was 40% CR, 57% PR, and 3% SR. All tumors showed at least some response. Since many of these patients had end-stage disease, the effect on the clinical condition and symptoms were evaluated using the Karnofsky Performance Status (KPS), oxygen requirements, and the presence or absence of respiratory symptoms. One month after treatment, 61% were clinically improved, with an increase of the average KPS from 48 to 61. Three patients with stage III primary lung cancer improved from being severely disabled requiring hospitalization to normal activity with effort and lived an average of 3.5 months. One patient with metastatic colon cancer was palliated from bedrest with continuous oxygen to normal activity with no oxygen for 12 months. A patient with hemoptysis and carcinoma in situ remains biopsy- and symptom-free for 34 months. A patient with hemoptysis and cough from breast cancer metastases maintained CR, biopsy- and symptom-free for 7 months. A patient with hemoptysis from recurrence at the bronchial stump maintained CR, biopsy- and symptom-free for 13 months. Six patients with Stage III primary lung cancer with average KPS of 27 (severe) died in the hospital and lived an average of 5 weeks (two CR, two PR, two SR). One patient with atelectasis of the right lower lobe re-expanded 14 days after treatments began.
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PMID:Photodynamic therapy of endobronchial tumors. 294 45


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