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

Metastatic frequency to various organ sites in 137 autopsy cases with histologically confirmed prostatic adenocarcinoma was examined retrospectively. Bone lymph node metastases were observed in 81% and 82.5% of the cases, respectively. Lung and liver metastases were noted in 46.7% and 30.7% of the cases respectively. Statistical analysis of the inter-relation among metastases to the bones, lymph nodes, lungs and liver revealed that 83.2% of cases with lymph node metastasis also had bone metastasis. Sixty out of 64 cases with lung metastasis also presented with bone metastasis. There was a significant correlation of metastases between bones and lymph nodes, bones and lungs, and lymph nodes and lungs. Although approximately 88% of cases with liver metastasis also had bone metastasis, this relationship was not statistically significant. there was a statistically significant relationship between lung metastasis and specific sites of bone metastases, i.e. vertebrae, ribs, and sternum. Using the Cochran-Mantel-Haenszel statistical method, we found that the metastatic combination between lung and bone was significantly related in cases with or without lymph node metastasis. These observations suggest that the Batson's vertebral system might play an important role in the metastatic spread of prostatic adenocarcinoma either to the bones or lungs.
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PMID:Analysis of bone metastasis of prostatic adenocarcinoma in 137 autopsy cases. 149 15

Clinically, prostate cancer (prostatic adenocarcinoma) is now the most frequently diagnosed cancer in males and the second leading cause of mortality due to cancer in the United States. However, because 75% of histologic prostate cancers remain functionally benign (will not metastasize and kill the patient), mass screening of the male population for the disease has become a hotly debated issue among urologists. The real challenge in the upcoming decade for geriatricians, though, will be to diagnose earlier in their course the prostate cancers which, if not treated, will metastasize and kill the patient and thus allow this subgroup of patients the opportunity to be treated more effectively. This review briefly discusses the etiology of prostate cancer, ways the disease may present, current treatments, depending on disease stage, screening in the diagnosis of prostate cancer, and quality of life issues important to patients confronted with the disease.
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PMID:Prostate cancer. 158 84

Retrospective analysis of outcome in 137 patients who underwent radical perineal prostatectomy and bilateral injection of gold-198 implants into the periprostatic tissues and/or neurovascular pedicles as treatment for prostatic adenocarcinoma was performed. Patients had undergone treatment between 1975 and 1985. Local recurrence developed in 22 patients (16.1%) and distant metastases developed in 33 (24.1%). Clinical and surgical staging of disease and Gleason grading of pathologic specimens were performed retrospectively. Kaplan-Meier local recurrence, freedom from relapse (FFR), and survival rates decreased with increasing stage and pathologic grade. With clinical staging, these rates were not statistically different from previous rates achieved with external beam radiation therapy, and with pathologic staging, they were not statistically different from previous rates achieved with prostatectomy. The authors conclude that (a) 5-year follow-up is inadequate to determine local control rates after prostatectomy; (b) use of implants did not improve local control, FFR, or survival rates of 10 years; and (c) method of staging probably has more effect on local control, FFR, and survival rates than does treatment modality.
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PMID:Results of radical perineal prostatectomy with adjuvant brachytherapy. 162 Aug 24

Between 1977 and 1991, 20 patients with radical prostatectomy for adenocarcinoma of the prostate and palpable, biopsy-proven local recurrence without evidence of metastases underwent radiotherapy. Of these patients 16 were treated with orchiectomy combined with irradiation and four patients underwent irradiation alone. Local control, as determined by rectal palpation was achieved in 19/20 patients. Eleven patients are still alive without disease. Disease-free survival (determined since 1987 including PSA) was 68% for five years and 41% for ten years. 6/9 patients have died with cancer, three patients died intercurrent free of disease. Overall survival remained 51% for five years and 31% for ten years. Prevention of local recurrence is of great importance and these data support the adjuvant post-operative irradiation in defined patients at risk.
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PMID:Radiotherapy of local recurrence following radical prostatectomy. 162 Dec 11

Strontium-89 has been used for the treatment of painful bony metastases in patients suffering from disseminated adenocarcinoma of the prostate, with a variable proportion of patients obtaining clinically significant reductions in analgesic requirements. Based on data revealing enhancement of continuous low-dose rate irradiation by low-dose cisplatin in murine models, a protocol using 148 MBq (4 mCi) of 89Sr and 35 mg/m2 of cisplatin infused over 2 days, 1 and 4 wk after administration of the radioisotope was undertaken. Preliminary data suggest good pain relief with 55% of 18 patients entered thus far obtaining at least a 50% reduction in analgesic requirements. Improvements in total alkaline phosphatase and serum lactate dehydrogenase have consistently been seen, with some patients exhibiting improvements in hemoglobin, tumor markers and bone scans. Toxicity appears to be mild, with no life-threatening complications. In particular, myelosuppression after one course of treatment was modest, but retreatments in two patients has resulted in grade 3 hematologic toxicity. Two patients developed a "pain flare" after administration of cisplatin. Further accrual to this study will allow more accurate determination of pain response rate, and improved evaluation of parameters of objective response.
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PMID:Strontium-89 and low-dose infusion cisplatin for patients with hormone refractory prostate carcinoma metastatic to bone: a preliminary report. 163 33

The records of 107 patients with newly diagnosed adenocarcinoma of the prostate irradiated with curative intent at Duke University Medical Center from 1970 through 1983 were reviewed. Forty patients (37%) underwent standard bilateral pelvic lymph node dissection (PLND) prior to beginning irradiation. Twenty-four patients (22%) were found to have pelvic nodal metastases (Stage D1). Those found to have a single microscopically positive node at PLND may be curable with irradiation. In contrast, those with more extensive nodal metastases appear to be incurable with radiotherapy. Additional studies are needed to confirm or refute these findings.
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PMID:Prognostic significance of extent of nodal involvement in stage D1 prostate cancer treated with radiotherapy. 155 59

The presence of periacinar and pericellular basement membranes (BMs) has been reported recently in common prostatic adenocarcinomas. In this study we extended our investigations of BMs on lymph node and hematogenous metastases, primary prostatic cancer with unusual histologic features, and posttreatment tumors. In contrast to prostatic malignancies that derive from the transitional epithelium (squamous cell carcinoma, prostatic transitional cell carcinoma) and prostatic involvement by bladder cancer, inconspicuous stromal changes and distinct BM formations at the site of tumor invasion were observed in carcinomas deriving from the secretory epithelium (papillary ductal carcinoma) and from the basal cell (basal cell carcinoma). Even highly malignant anaplastic and small cell carcinomas, as well as irradiated and/or hormonally treated tumors, showed distinct BM formations in contact with the stroma. The same observations could be made in lymphatic and hematogenous metastases of different anatomic sites. These findings indicate that prostatic malignancies may retain BMs even in high-grade lesions, metastases, posttreatment tumors, and variants of prostatic adenocarcinoma.
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PMID:Distribution of basement membranes in primary and metastatic carcinomas of the prostate. 164 38

Forty-one patients with adenocarcinoma of the prostate localized in the pelvis (stage A2, NX; 3, A2, pN0; 5, B, NX; 5, B, pN0; 1, C, NX; 13, C, pN0; 7, C, pN1; 7) underwent curative external radiotherapy. Thirty-two cases were treated by fast neutron combined with or without Liniac X-ray and 9 cases were treated by Liniac X-ray. Twenty-six cases were well controlled by radiotherapy, but 15 cases recurred and were followed by endocrine therapy. The types of recurrence were local growth in 3, distant metastases in 11, and both in 1. These recurrences occurred in the cases of large prostatic carcinoma, small radiation field in NX cases or low radiation dose. The five-year disease-free survival rates of stage A2, B, C were 86, 66, and 47%, respectively and the five-year overall survival rates were 100, 100, and 53%, respectively. The cases with well differentiated carcinoma had better prognosis than those with poorly differentiated carcinoma (p less than 0.05). As 58% of the cases which were given concomitant endocrine therapy were controlled for over 2 years, endocrine therapy seems to be effective in the cases of failure after radiotherapy. Most of the complications were slight and only one case with complication of sacral decubitus needed surgical treatment. It was concluded that external radiotherapy was a good modality for prostatic carcinoma localized in the pelvis.
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PMID:[Radiotherapy of prostatic carcinoma]. 165 78

Both the polyclonal anti-c-erbB-2 peptide antiserum pAB 60 and the monoclonal anti-c-erbB-2 protein antibody mAB-1 detect the c-erbB-2 protein in human breast adenocarcinomas. We investigated c-erbB-2 expression in adult human benign hyperplastic and neoplastic prostates, using the avidin-biotin complex immunoperoxidase method. Formalin-fixed, paraffin-embedded specimens of benign hyperplastic prostate (13), prostatic adenocarcinoma (22), and prostatic adenocarcinoma lymph node metastases (two) were tested with pAB 60. Ten formalin-fixed, paraffin-embedded specimens of prostate adenocarcinoma, 11 frozen sections of benign hyperplastic specimens, and eight frozen sections of prostate adenocarcinoma were tested with mAB-1. Our results demonstrated consistent detection of c-erbB-2 immunohistochemically in frozen sections of both benign and malignant prostate. Preincubation of pAB 60 with the immunizing peptide blocked subsequent reactivity with prostatic tumor tissue, indicating specificity. However, fixation and processing protocols significantly affected the reactivity of the antigenic determinants detected by these antibodies, as mAB-1 was nonreactive with formalin-fixed, paraffin-embedded prostatic tissues. Differential reactivity of pAB 60 with malignant rather than benign glands was maximized by exposure of the specimen to the antibody at 4 degrees C rather than 22 degrees C. The most frequently observed staining pattern with both antibodies was cytoplasmic. However, mAB-1 produced distinctly membranous staining in two frozen specimens of benign hyperplasia and one specimen of prostate cancer.
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PMID:Immunohistochemical detection of c-erbB-2 protein in human benign and neoplastic prostate. 167 81

Serum prostate-specific antigen (PSA) levels were determined in four groups of patients with prostatic carcinoma: 230 untreated patients with adenocarcinoma of the prostate after careful clinical staging; in 102 patients with localized prostatic carcinoma who were treated by radical prostatectomy; in 183 patients after radiation therapy for adenocarcinoma of the prostate; and in 45 antiandrogen-treated patients with documented metastatic disease. Within each treatment modality PSA proved to be a powerful tool in predicting stage and prognosis of each patient. In the untreated group the PSA level was directly proportional to advancing clinical stage and Gleason score. The rate of increase of PSA in clinical stage A and B cancer patients suggested a doubling time of at least 2 years. In the group of patients who underwent radical prostatectomy, PSA correlated extremely well with the tumor volume and had a high predictive value for pelvic lymph node metastasis. No patient with pelvic lymph node metastasis achieved an undetectable PSA level following radical prostatectomy without adjunctive therapy. Both anti-androgen and radiation treatment were followed initially by dramatic falls in serum PSA concentrations, but the majority of patients soon experienced a reversal of this initial response, signifying early failure and again providing new information unavailable from any other source.
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PMID:[The role of prostate-specific antigen in the diagnosis and treatment of prostatic adenocarcinoma]. 169 83


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