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 purpose of this study is to find out the biological feature of laryngeal cancer and metastatic lymph nodes with DNA Image Analysis, Argyrophilic Nucleolar Organizer Region (AgNOR), Carcinoembryonic Antigen (EA) and Estrogen Receptor (ER) 30 patients were included in this study. It was found that carcinomatous tissues showed a statistically significantly higher DNA content, AgNOR content, and positive reaction of CEA and ER than those of normal tissue (P < 0.01). Paired comparisons were performed in primary tumor and metastases and didn't show statistical difference (P > 0.05). The group with survival time over 5 years had a significantly lower DNA content, AgNOR content, CEA positive reaction of metastases and higher ER positive reaction of metastases than those with less than 5 years survival (P < 0.01). But there no was consistant relationship between primary tumor CEA or ER positive reaction and survival time (P > 0.05). The patients who accepted radiotheraphy had better prognosis than those who didn't (P < 0.05). The above results indicate that the combined analysis of metastases and primary tumor will provide a good feature for biological activity. In addition, radiotherapy before and after operation will be beneficial.
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PMID:[Biological study on prognosis of laryngeal carcinoma with regional metastatic lymph nodes]. 780 26

In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.
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PMID:[The latest results of the advanced hypopharyngeal cancer surgery with immediate reconstruction using the free jejunal autograft]. 797 Jul 59

Laryngectomy has been performed as first-line treatment in 23 patients with laryngeal cancer stage III-IV. The author has modified the final stage of the surgery: laryngeal defect suturing with a continuous suture and the wound drainage. Two patients were operated on radically. Five-year follow-up covered 3, 3-year one 15 patients. None of them had recurrence or metastases. Healing by first intention was observed in 74% of the patients. It is inferred that laryngectomy is effective as an initial stage of combined treatment of laryngeal cancer stage III-IV. The modification of the surgery final stage reduces the frequency of postoperative complications in the absence of inflammation in the tissues adjacent to tracheostoma.
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PMID:[Experience with radical resection of the larynx in stage III - IV cancer]. 800 69

Abnormal DNA content of cancer cells in a primary tumor is thought to reflect the altered proliferative capacity of that cancer and overall patient prognosis. Recently, increased DNA content has been associated with early tumor recurrence in patients with advanced laryngeal cancer. To determine if DNA content correlates with a tumor's metastatic behavior, 94 previously untreated patients with stage III (n = 54) or stage IV (n = 40) squamous carcinoma of the larynx were prospectively studied. The adjusted DNA index (aDI) of the primary tumor was measured by computerized cytomorphometry, and correlations with regional metastases, number of positive nodes, extracapsular spread, and pattern of relapse were determined. Median follow-up was 35 months. Of 94 patients, 73 underwent neck dissection. Positive nodes were found in 51 patients (70%) and three or more positive nodes were found in 31 patients (42%). High aDI (> .024) was significantly associated with the presence and number of histologically positive nodes (P = .016). Among patients with high aDI, 19 (50%) of 38 had three or more nodes positive compared to 12 (21%) of 56 of those with low aDI. Median aDI levels in patients with three or more nodes were significantly higher than in patients with 1 or 2 nodes (P = .003). Time to recurrence was shorter in patients with high aDI (P = .0078). These findings provide further evidence that increased DNA content is associated with more aggressive laryngeal cancers having high rates of multiple lymph node metastases and worse overall prognosis.
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PMID:DNA content and regional metastases in patients with advanced laryngeal squamous carcinoma. Department of Veterans Affairs Laryngeal Study Group. 816 89

During the past year, several areas of head and neck surgery have had notable refinements and advancements. In the area of early laryngeal cancer, the complementary roles of radiation therapy and surgery have been discussed, as well as refinements in endoscopic laser techniques. Issues of the incidence of nodal metastasis and the role of in-continuity versus discontinuous neck dissection in oral and pharyngeal carcinoma have been considered. Rehabilitation techniques following treatment of oral cancer using free microvascular sensate flap reconstructions have been presented. The role of free jejunal interposition and gastric pull-up for reconstruction in hypopharyngeal cancer have been discussed, as well as their compatibility with postoperative radiotherapy. Finally, the concepts for treatment of neck nodal metastases have been discussed in relation to the roles of radiotherapy, radical neck dissection, and modified neck dissection.
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PMID:Surgery for head and neck cancer. 849 11

Three cases of postoperative laryngopharyngeal edema following nonsimultaneous radical neck dissection are presented. Case 1 was a 65-year-old male with tongue cancer and left cervical lymph node metastases. Hemiglossectomy, reconstruction of the floor of the mouth with a free rectus abdominis flap, and left radical neck dissection had been performed. Postoperatively, the tongue and left upper neck were irradiated. Seven months later, right cervical lymph node metastases were observed. Right radical neck dissection was performed, and immediately after extubation, upper airway stenosis due to severe laryngopharyngeal edema occurred. Emergent tracheostomy saved his life. Case 2 was a 55-year-old female with tongue cancer and right cervical lymph node metastases. Radium needles had been implanted in the tongue, and right radical neck dissection was performed. Three months later, left cervical lymph node metastases were found. Left radical neck dissection was performed and, as in Case 1, upper airway stenosis revealed immediately after extubation. Since the situation was anticipated, an immediate tracheostomy was done. Case 3 was a 43-year-old male with laryngeal cancer and left cervical lymph node metastasis. Irradiation of the larynx and the bilateral upper neck followed by left radical neck dissection and partial laryngohypopharyngectomy had been performed. Five years later, right cervical lymph node metastasis was observed. Right radical neck dissection was performed, and laryngoscopic examination before extubation revealed severe laryngopharyngeal edema. In this case, tracheostomy was performed before extubation. To our knowledge, there have been only five cases of postoperative laryngopharyngeal edema, following nonsimultaneous radical neck dissection, reported in the literature.
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PMID:[Three cases of postoperative laryngopharyngeal edema following nonsimultaneous bilateral radical neck dissection]. 855 80

Laryngeal cancer is a relatively common cancer in Hong Kong when compared with other cities over the world. The purpose of this study is to characterize and identify the clinico-pathological features of patients with laryngeal cancer being resected or autopsied in our hospital for the years 1973 to 1992. The peak age at presentation of 451 patients (408 males, 43 females) with primary laryngeal cancer resected was 62 years old and 1.6% of patients were under 40. The incidence increased with age in both sexes. The patients were noted to be ageing steadily in the 20-year study period. Most patients (30%) had tumours involving both the supra-glottis and glottis. Histological examination revealed that the cancers comprised squamous cell carcinomas (98.3%), spindle cell carcinoma (0.7%), adenoid cystic carcinoma (0.2%), mucoepidermoid carcinoma (0.2%), atypical carcinoid (0.2%) and chondrosarcoma (0.4%). Most cases of squamous cell carcinoma were moderately differentiated (67.3%). Poorly differentiated squamous cell carcinomas were more often noted in females. Forty-six laryngeal cancers were noted in the study period giving an autopsy incidence of laryngeal cancers of 0.46%. Distant metastases were found in 50% of these autopsied cases. The metastatic lesions were found in the lung (43%), liver (18%), diaphragm/pleura (18%), kidney (9%), bone (7%), heart (5%), spleen (2%), nostril (2%) and small intestine (2%). The results indicate that there are different histological subtypes of laryngeal cancer in Hong Kong Chinese and they share similar epidemiological characteristics with those reported in other studies.
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PMID:Cancer of the larynx in Hong Kong: a clinico-pathological study. 860 35

Sixty-three patients with primary laryngeal squamous-cell carcinoma were followed up for a median of 33 months after surgery. Cathepsin D (Cath D) concentration was assayed using a solid phase 2-site immunoradiometric assay in which the first monoclonal antibody (MAb) was coated on the ELISA solid phase and the second one, MIG8 radiolabeled with 1125-EGF, was used as the tracer. The median value of Cath D (13.8 pM/mg protein) was chosen as cut-off. Cath D > or = median value was closely related to neck lymph node involvement at presentation and to a short metastasis-free survival (MFS) and actual overall survival (OS). The 5-year MFS was 71% for patients with Cath D < median value tumors as compared with 0% for patients with Cath D > or = median value tumors. Lymph node status at presentation was not related to a short MFS and OS. Cox's univariate regression analysis using Cath D as a continuous variable showed that Cath D levels are correlated with neck lymph node metastasis. On multivariate analysis, Cath D status proved to be an independent factor for predicting a short MFS. Cath D assay may prove to be particularly useful in identifying laryngeal cancer patients who, with or without neck lymph node involvement at presentation, are at high risk of metastatic disease and poor outcome.
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PMID:Cathepsin D concentration in primary laryngeal cancer: correlation with clinico-pathological parameters, EGFR status and prognosis. 860 76

In this study of 22 patients with laryngeal cancer, computed tomographic (CT) scans in the axial plane were compared with histopathological sections prepared in the same plane. The value of the preoperative CT for evaluating tumor invasion, location and size was then investigated. Findings demonstrated that CT was most sensitive in determining tumor invasion to the paralaryngeal and preepiglottic spaces, anterior and posterior commissures and subglottis. In contrast, CT was less sensitive in determining actual tumor invasion to the laryngeal cartilages, extralaryngeal tissues and metastases to cervical lymph nodes.
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PMID:Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal cancers. 867 49

Laryngeal cancer is one of the most curable malignancies. One of the reasons is that most of them are in the early stage. However, the prognosis of advanced bilateral neck metastases is still poor. Based on loco-regional failure and cause of death, the effective procedure of neck dissection and the efficacy of postoperative irradiation were investigated retrospectively. A total of 1022 patients with laryngeal squamous cell carcinoma were registered in our hospital between 1979 and 1991, 58 of them (5.7%) had bilateral neck metastases. Clinical N2c cases accounted for 52% (32/58). In the other patients, the metastatic nodes were revealed by elective neck dissection for a clinically negative neck. The T stages of the 58 cases were as follows; T2 in 14 cases, T3 in 22 and T4 in 22. Forty-nine of the patients treated curatively by bilateral neck dissection were analyzed, 48 with total laryngectomy and 1 with partial laryngectomy. The remaining 9 patients were excluded because of radical irradiation in 3, distant metastases found the diagnosis in 3, unresectable recurrent neck metastases treated in other hospitals in 2 and no treatment because of severe myocardial infarction in 1. Cumulative crude and cause-specific 5-year survival rates for the 49 patients were 32.2% and 52.2%, respectively. Nineteen patients died of their disease; 10 of them of an uncontrolled neck lesion. From a comparison of the surgery alone group (28 cases) with a surgery plus irradiation group (21 cases) which consisted of preoperative irradiation in 2 and postoperative in 19, addition of irradiation may be effective for loco-regional control. Eight patients died of an uncontrolled neck lesion in the surgery alone group, while there were only 2 deaths in the postoperative irradiation group. Nevertheless there were no significant differences in survival: the cumulative crude and cause-specific 5-year survival rates in the surgery alone group were 34.4% and 56.2%, respectively, while those in the surgery plus irradiation group were 28.6% and 46.3%, respectively. It is obvious that the procedure of neck dissection influenced the loco-regional control. Excluding the recurrence-free patients who died of intercurrent diseases within 2 years, recurrence in the ipsilateral neck was found in 1 of 12 patients with radical neck dissection (RND), in 1 of 3 with modified radical neck dissection (MRND), in 2 of 15 with lateral neck dissection (lateral ND) and in 9 of 11 with regional neck dissection (regional ND). Recurrence is the contralateral neck were found in none of 2 with RND, of 3 with MRND and of 20 with lateral ND, but in 6 of 16 with regional ND. These results suggest that regional ND was insufficient to accomplish loco-regional control in those patients and that lateral ND or MRND or RND may be required bilaterally. Since 1986, all patients except 1 were treated by more extensive maneuvers than lateral ND bilaterally, so that loco-regional recurrence was found in only 1 case, in spite of the fact that the surgery alone group accounted for 73% (19/26). Cumulative crude and cause-specific 5-year survival rates for the patients prior to 1985 (23 cases) were 26.1% and 32.6%, respectively, while those for the patients since 1986 (26 cases) were 38.5% and 76.9%, respectively. There was no significant difference (p = 0.73) in cumulative crude 5-year survival rates between the 2 groups, but the difference in their cause-specific 5-year survival rates was statistically highly significant (p = 0.0032). It was concluded that lateral ND, MRND or RND should be required bilaterally for the patients with bilateral neck metastases and that addition of irradiation is not always indispensable for patients treated by curative neck dissection, such as lateral ND, MRND or RND.
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PMID:[Treatment of bilateral neck metastases in laryngeal cancer]. 869 3


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