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)

Of 299 patients who presented with superficial bladder cancer (Ta, T1), 60 were treated by intravesical chemotherapy (Epodyl, methotrexate or mitomycin C). The rate of tumour progression to muscle invasion or metastases was identical for each intravesical regime. There was no evidence that mitomycin C promoted tumour progression. Carcinoma in situ in non-tumour-bearing urothelium was the most significant predictive factor for progression to muscle invasion or metastases.
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PMID:Superficial bladder cancer: intravesical chemotherapy and tumour progression to muscle invasion or metastases. 309 81

Recent reports of disease progression in patients being treated with intravesical agents for carcinoma in situ of the bladder led us to examine our 5-year experience with 26 consecutive patients with carcinoma in situ treated with intravesical therapy for this lesion. Nine patients with isolated carcinoma in situ and 17 with carcinoma in situ associated with papillary lesions were treated intravesically with a variety of agents in a closely monitored program for a mean of 22 months. All patients wished to exhaust conservative options before accepting cystectomy. Of 26 patients treated 9 (35 per cent) have no evidence of disease with a functional bladder after 27 months, 13 (50 per cent) are treatment failures and 4 (15 per cent) maintain an equivocal status to date. Successful treatment results with each drug were 6 of 24 thiotepa, 0 of 7 mitomycin, 0 of 6 doxorubicin and 3 of 8 bacillus Calmette-Guerin. Treatment failure was associated with disease progression to muscle invasion, adjacent organ invasion or metastases in 7 patients (27 per cent). Significant reduction in bladder capacity after prolonged therapy occurred in 3 patients. Our results suggest that persistent, intensive, "conservative" intravesical therapy in the face of recurrent or persistent disease is associated with substantial patient risk.
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PMID:5-year experience with intravesical therapy of carcinoma in situ: an inquiry into the risks of "conservative" management. 311 55

Squamous cell carcinoma (SCC) antigen levels in sera and several tissues were estimated in patients with oral and maxillary cancer. The normal value of serum SCC antigen level was 1.7 ng/ml in this experiment, and 43.3% of squamous cell carcinoma was positively higher than 1.7 ng/ml as a whole, including cases of carcinoma in situ and of recurrence and metastasis in the oral region. In relation to the clinical staging of tumors, 20.0% in stage I, 14.3% in stage II, 42.9% in stage III, and 77.8% in stage IV were positive for SCC antigen. In the group with definite regional lymph node metastases, 80% of patients revealed a higher value than the normal cut-off value. Patients with recurrent SCC demonstrated elevated SCC antigen values in sera except 1 case with an early condition of recurrence. Serum SCC antigen also presented good responses to various cancer treatments. The measurement of SCC antigen does not appear to be useful for the detection of early stage oral and maxillary SCC; however, for detection of recurrence and for lymphatic and/or remote metastases in the follow-up period, it would appear that SCC antigen level would be some value.
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PMID:Squamous cell carcinoma antigen in the serum of oromaxillary cancer. 312 92

The estrogen receptor (ER) content of 31 surgically removed breast tumors (26 duct carcinomas, one lobular carcinoma, one papillary carcinoma, one colloid carcinoma, one duct carcinoma in situ, and one atypical fibroadenoma) was determined by a commercially available immunocytochemical method (Abbott Laboratories, ER-ICA) on cytologic material obtained by fine needle aspiration biopsy (FNAB) of surgical specimens. Immunocytochemical staining of cells by a peroxidase-antiperoxidase technique was evaluated on the basis of the percentage of positive cells and the intensity of staining. An immuno-staining score for cytologic (IS-CYTO) and histologic (IS-HISTO) material was defined and a threshold of positivity determined to facilitate the semi-quantitation of results and the comparison of cases. The results of immunostaining of cytologic material were compared with the evaluation of ER in corresponding tissue samples as determined by the radioligand binding assay using the dextran-coated charcoal procedure (ER-DCC) and by ER-ICA using cryostat sections of frozen tissue. The sensitivity, specificity, predictive value of a positive test, and test efficiency of ER-ICA in cytologic material as compared to ER-DCC was 96%, 83%, 96% and 93%, respectively. The IS-CYTO was significantly correlated with the IS-HISTO in corresponding histologic material (r = 0.72, P less than 0.001). In conclusion, the combination of ER-ICA with FNAB represents a useful new technique for the evaluation of ER which may be applied to small primary tumors, tumor recurrences, and metastases.
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PMID:Evaluation of estrogen receptors by immunocytochemistry on fine-needle aspiration biopsy specimens from breast tumors. 330 9

Although interstitial implantation of invasive carcinoma of the bladder has been shown to be an effective treatment in Europe, there has been little experience with this method in the U.S. During the past 6 years, 14 patients at the Hospital of the University of Pennsylvania with single bladder tumors less than 5 cm and no evidence of carcinoma in situ on random bladder biopsies have been treated by a combination of external beam radiation and iridium wire implant. The iridium wire is inserted by an afterloading technique following tumor exposure via suprapubic cystotomy. Following delivery of the prescribed dose, the sources are removed percutaneously. Three patients with recurrent or high grade T1 lesions and 11 patients with T2-T3A lesions have been treated. With a median follow-up of 22 months (range 17 to 65 months), 9 patients are currently NED, 4 patients have died of disease, and 1 patient has died of intercurrent disease. There have been two isolated bladder recurrences, both non-invasive, one having been treated with cystectomy and one being treated locally. In addition, one patient developed regional failure, two developed distant metastases only, and one developed local recurrence following distant failure. The 2-year actuarial local control rate is 84%, with an overall 2-year actuarial survival of 66%. Complications have been minimal. Bladder implantation by this method is technically simple and produces excellent local control with acceptable morbidity.
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PMID:Treatment of bladder cancer with interstitial iridium-192 implantation and external beam irradiation. 333 48

Cancer of the urinary bladder, renal pelvis and ureter is usually transitional cell carcinoma. One third of cases of urethral cancer are also transitional cell carcinoma. In planning the treatment for these urothelial cancers, the anatomic stage (Ta-T4), the histologic grade (1-3), tumor multiplicity and tumor size are generally taken into account. Superficial and low-grade tumors can usually be treated by transurethral resection. However, such patients run the risk of subsequent tumor recurrence in the bladder. This risk may be reduced by intravesical administration of anti-neoplastic agents and BCG. Diffuse carcinoma in situ (CIS) should be treated intravesically before deciding on surgical extirpation of the bladder. Patients with tumors showing deep muscle invasion are usually managed by surgery. The role of adjuvant chemotherapy and/or radiation therapy is currently under investigation. Patients with unresectable cancer and/or metastases are candidates for systemic chemotherapy. This form of therapy is now resulting in an increased number of complete and partial remissions. However, there is still no evidence that systemic chemotherapy prolongs the duration of survival, especially in patients showing partial remission.
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PMID:[Current status of the treatment of urothelial tumors]. 334 82

Twenty-three men who underwent radical cystoprostatectomy between March 1, 1983, and October 1, 1986, were found to have not only multifocal carcinoma in situ (CIS) of the bladder but also transitional cell carcinoma (TCC) of the prostatic ducts. In 18 patients TCC was limited to the epithelium lining the prostatic ducts (CIS of prostatic ducts), but in 5 patients TCC also invaded the prostatic stroma (invasive TCC of prostatic ducts). During follow-up (mean, 26 months), in 2 of the 18 patients (11%) with CIS of the prostatic ducts metastases developed. By comparison, metastatic TCC developed in 5 of 5 patients (100%) who had invasion into the prostatic stroma. Evidence indicates that patients with multifocal CIS of the bladder should be evaluated very closely for the presence of TCC of the prostatic ducts. When TCC is present in the ducts, radical cystoprostatectomy is necessary to control this lesion before it progresses to invasion. When invasion has occurred, however, radical cystoprostatectomy alone is not sufficient therapy. Since metastatic TCC develops in 100 percent of these patients, we believe that chemotherapy (either adjuvant or neoadjuvant) should be used in addition to radical cystoprostatectomy.
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PMID:Importance of early treatment of transitional cell carcinoma of prostatic ducts. 338 55

A retrospective study of the incidence and clinical course of transitional cell carcinoma of the urethra is reported. Of 110 consecutive male patients who underwent cystectomy during a 9-year period, 9 had or developed a urethral tumour. Five patients undergoing radical cystectomy had known or suspected urethral involvement which was confirmed at urethrectomy. All 5 had deeply invasive (T3 or T4) transitional cell carcinomas of the bladder and subsequently died of metastatic disease. Four patients underwent urethrectomy because of signs or symptoms of urethral recurrence at an average interval of 2.5 years after cystectomy. There were two deaths in this group, neither of which appeared to be due to urethral recurrence. Six additional patients had undergone prophylactic urethrectomy because of prostatic urethral involvement or diffuse carcinoma in situ in the cystectomy specimen, and none had identifiable tumour in the anterior urethra. The residual urethra is a potential focus for recurrent tumour and this necessitates careful follow-up with serial cytology, but the low incidence of urethral recurrence (3.5% in this series) does not appear to warrant routine urethrectomy at the time of cystectomy.
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PMID:Transitional cell carcinoma of the urethra in men after radical cystectomy for bladder cancer. Is prophylactic urethrectomy indicated? 340 61

Previous investigations into the association between oral/oropharyngeal carcinoma and clinical white patches (leukoplakia) have noted that the latter lesion is found adjacent to malignancies in 10% to 100% of all carcinomas of this site. This is an unacceptable variation in results and probably relates more to the referral biases inherent in hospital-based studies than to any other factor. The present population-based study, which is relatively free of selection bias, demonstrates that 62%, 36%, and 18% of invasive carcinomas of the labial vermilion, oral cavity proper, and oropharynx, respectively, have leukoplakia lesions of immediately adjacent mucosal surfaces. Only 7% of invasive carcinomas have juxtaposed carcinoma in situ, whereas another 2% have severe epithelial dysplasia. Mucosal carcinomas associated with leukoplakias appear to be smaller, more mature histologically, and more likely to be only superficially invasive; such carcinomas present with fewer metastases at diagnosis and provide a better prognosis than similar carcinomas not associated with leukoplakia.
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PMID:Leukoplakia and carcinoma in situ synchronously associated with invasive oral/oropharyngeal carcinoma in Rochester, Minn., 1935-1984. 342 24

One hundred human female breasts surgically removed by radical mastectomy for clinical cancer were analyzed under a dissecting microscope to search for other submacroscopic (less than 0.5 cm) foci collateral to and independent from the clinical one. These foci were found in 36 percent of cases, either in situ (17 percent), or infiltrating (12 percent), or both in situ and infiltrating (7 percent). This high percentage of multiple cancer confirms previous data, suggesting the wide intramammary distribution of breast cancer disease. Multicentricity appears to be significantly associated with the incidence of familial breast cancer (p less than 0.05) and advanced patient age in the range between 71 and 80 years (p less than 0.005). Axillary lymph node metastases are significantly associated with collateral foci of in situ cancer (p less than 0.025), but not with submacroscopic foci of infiltrating cancer and the general character of the mammary glandular parenchyma, tumor size or histologic type of the clinical neoplasm. The critical question is whether multicentricity makes a difference clinically and especially to women who do not have their entire breast removed. Radical mastectomy results in a severe cosmetic and functional problem for patients. According to many authors, the goal of the treatment should be the removal of breast cancer by conservative surgical techniques (lumpectomy, subcutaneous mastectomy, quadrantectomy), using adjuvant radiotherapy and/or chemotherapy. The use of radiotherapy as primary treatment of early breast cancer has been also suggested. There is disagreement about surgical management of breast cancer. In fact, some investigators emphasize that the natural biologic history of multicentric cancers has not been documented by any adequate follow-up series in women who do not have their entire breast removed. Thus far, no difference has been seen in disease-free or overall survival between groups of patients with early breast cancer treated by an alternative therapeutic procedure and patients treated by radical mastectomy. However, Veronesi et al. (1981) refer to 4 second primary tumors of the ipsilateral breast in the 352 cases of small cancers treated by quadrantectomy, axillary dissection, and adjuvant radiotherapy. Moreover, Hellman et al. (1980), using radiation therapy without mastectomy for the primary treatment of 176 patients with early breast cancer, found 1 case of new cancer in a separate quadrant. Further evaluation is necessary to establish the long-term results of the alternative treatments of breast cancer and for the understanding of the clinical significance of microscopic multifocal tumor in the mammary gland.
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PMID:Multicentricity in breast cancer: a submacroscopic study. 351 Apr 13


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