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)

Forty patients out of 273 who had undergone radical surgery for adenocarcinoma of the prostate at Duke University Medical Center between 1970 and 1983 developed palpable, biopsy-proven local recurrence without evidence of distant metastases. Of these 40 patients, 16 were treated with irradiation alone (Group I) and 16 patients were treated with hormonal therapy only (Group II). The remaining eight patients received either no therapy (4 patients) or both radiotherapy and hormonal therapy (4 patients) and are not further analyzed. Local control, as determined by palpation, was achieved in 14/16 patients in Group I versus only 7/16 patients in Group II (p less than 0.05). Subsequently, six patients in each group have relapsed, all with distant metastases. Thus, 8/16 patients in Group I remain alive without disease versus only 1/16 patients in Group II (p less than 0.05). There was no difference in survival between Groups I and II. No patient in either group has died free of disease. In Group I, 4/16 patients have died with cancer. Six of 16 in Group II have died with cancer. Severe complications occurred more frequently following irradiation compared to hormonal therapy. Irradiation appears to be superior to hormonal therapy in achieving local control and prolonging disease-free survival. Neither therapy conveys an advantage over the other in terms of survival. Thus, even if local control is achieved, distant failure may be an inevitable consequence of locally recurrent prostate cancer. Therefore, prevention of local recurrence after radical prostatectomy is of paramount importance. These findings support the use of adjuvant post-operative irradiation in patients at high risk for local recurrence.
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PMID:Radiotherapy vs. hormonal therapy for the management of locally recurrent prostate cancer following radical prostatectomy. 280 57

Metastatic disease to the ureter is rare. Although it is not often diagnosed during life metastasis to the ureter should be suspected when malignancy and symptoms of ureteral disease are present. We report the thirteenth case of adenocarcinoma of the prostate metastatic to the ureter, which also was associated with a ureteral calculus.
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PMID:Adenocarcinoma of the prostate metastatic to the ureter with an associated ureteral stone. 281 May 18

Tumor-to-tumor metastases are uncommon despite the fact that the presence of two or more malignancies in a single patient is not a rare occurrence. The most frequent donor tumors are the lung, prostate, and thyroid gland, whereas renal cell carcinoma is by far the most common recipient. In this report we describe a patient dying of metastatic malignant melanoma and locally advanced prostate cancer in which the melanoma metastasized to the prostatic adenocarcinoma. The prostatic primary was well differentiated and stained positively with prostate-specific antigen and prostatic acid phosphatase, whereas the melanoma contained abundant melanin pigment and stained positively for S-100 protein. This is the second reported instance of prostatic carcinoma as the recipient in a case of tumor-to-tumor metastases and the first in the English language literature.
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PMID:Malignant melanoma with metastasis to adenocarcinoma of the prostate. 291 Apr 17

We examined the relationship between age and pathological stage in 444 consecutive patients who underwent pelvic lymphadenectomy and radical retropubic prostatectomy for clinically localized adenocarcinoma of the prostate. Pathological stage of cancer was determined postoperatively as organ-confined, capsular penetration (cancer through prostatic capsule), seminal vesicle involvement or lymph node metastases. Patient age ranged from 34 to 75 years. The majority of the patients had clinical stage B1 disease with induration confined to less than 1 lobe of the gland. In this group a statistically significant (p equals 0.001, chi-square test for trend) correlation between increased age and higher pathological stage was found. We also found that older men with clinical stage B1 disease had a statistically significant trend toward higher Gleason grade. An explanation for our findings might be the masking of prostatic induration by benign prostatic hypertrophy, clearly a disease of aging men. We suggest that increased age is a relative risk factor for advanced pathological findings in men with clinical stage B1 prostatic cancer.
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PMID:Pathological stage is higher in older men with clinical stage B1 adenocarcinoma of the prostate. 234 16

Many treatment modalities are available to patients with disseminated adenocarcinoma of the prostate. Although no single therapeutic approach can be advocated for all patients at the present time, delay of endocrine manipulation until the onset of symptoms is the recommended approach because it maintains the most normal lifestyle in these patients. With the onset of symptoms such as bone pain or urinary retention, or perhaps as disease progression becomes apparent, orchiectomy is recommended to patients with increased cardiovascular risks as well as to those patients who are judged irresponsible in taking oral estrogens. A dose of 1 mg of diethylstilbestrol three times daily achieves a castrate level of serum testosterone and may not increase cardiovascular mortality. Because of the relative safety and lack of side effects, GnRH analogues represent an alternative treatment in selected patients, particularly in those who refuse orchiectomy or have an increased risk of developing cardiovascular complications. Hormonal manipulation with androgen deprivation remains the cornerstone of treatment and provides clinical remission in the majority of patients with advanced prostate cancer. The prognosis is poor once tumor has recurred. Several secondary forms of endocrine therapy are available, but it would help to be able to select those patients with hormonally sensitive tumors that would respond favorably to these modalities. Transurethral surgery and radiotherapy are effective in palliating patients with bladder outlet obstruction and bony metastases unresponsive to hormonal therapy. Nonhormonal cytotoxic agents are available, but well-controlled studies are required to determine the value of specific agents, whether used alone or in combination.
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PMID:Treatment of advanced prostatic cancer. 295

The authors review 55 cases of adenocarcinoma of the prostate, from July 1982 to June 1983. The mean age of these patients was 61.5 years. None of them underwent orchiectomy. They were all treated with an LH-RH analogue: Decapeptyl. In 74.5% of the patients a consistent decrease of tumour mass in the prostate to about half its original size was observed, in association with a shrinking of the metastases. The Karnofsky index improved in 89% of the patients. The authors believe that Decapeptyl is preferable to surgical castration because it allows an improvement in pain symptoms, a regression of the primary tumour and metastases and achieves a better balance of serum levels of testosterone, FSH and LH.
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PMID:[Contribution to studies on the treatment of cancer of the prostate with D-Trp6-LH-RH]. 296 23

The best treatment for adenocarcinoma of the prostate depends on the patient's age, general medical condition, life expectancy, and willingness to accept such side effects as impotence. Radical prostatectomy or full-dose radiation therapy are usually curative when cancer is confined to the gland. The technique of prostatectomy has been improved and potency often can be preserved. Once the tumor extends beyond the gland, treatment alternatives are radiation or endocrine therapy. If lymph nodes are negative, radiation therapy may result in a long period without progression. If lymph nodes are positive, the expense and morbidity of radiation therapy may not be worthwhile because the likelihood of cure is low. Androgen deprivation, or endocrine manipulation, is preferred for metastatic disease. Response is varied and may depend on the patient's testosterone level when therapy is initiated. Survival is shorter in those with levels below normal.
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PMID:Adenocarcinoma of the prostate. Stage-by-stage treatment alternatives. 305 50

Between 1970 and 1983, 477 consecutive patients with clinically localized prostatic adenocarcinoma were treated with primary external-beam radiotherapy. With a minimum follow-up period of 60 months, the five- and 10-year survival rates were 59% and 33%, respectively. The five-year survival rate was 89% for patients with stage-A disease, 59% for stage-B disease and 25% for stage-C disease; it was 79% for patients with well-differentiated carcinomas, but only 37% for patients with high-grade tumours. The over-all local in-field control rate was 88%. Local failure occurred in 6% of patients with stage-A disease, 11% with stage-B disease, and 18% with stage-C disease. All patients experienced some radiation-induced reactions, but these were significant in only 14.2% of cases. The role of local- versus extended-field radiotherapy for curative treatment of prostatic cancer is discussed in some detail. Our unexpectedly low over-all survival figures emphasize the need to exclude the presence of distant metastases as fully as possible before commencing radical radiotherapy. High-dose radiotherapy to localized prostatic cancer offers significant advantages over radical surgery and is associated with an excellent local control rate, which can be achieved with an acceptable degree of early morbidity.
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PMID:High-dose radiotherapy for localized prostatic cancer. An analysis of treatment results and early complications. 308 80

Since the beginning of 1981, 32 patients at an age of 52 to 72 years who suffered from a locally confined adenocarcinoma of the prostate were treated by permanent implantation of iodine-125 seeds at the Urologic and Radiotherapeutic Hospital of the University of Erlangen. 25 patients were evaluated after a median observation period of 30 months. The first group consisting of 19 patients was submitted to a combined percutaneous and interstitial treatment, the other six patients were initially treated only by interstitial therapy because of severe complications observed in the meantime. After bilateral pelvic staging lymphadenectomy, permanent iodine-125 seeds were implanted into the patients of stage T1, T2, early T3, and pN0-1, in case of microscopic lymph node manifestation without capsular perforation also into patients of stage pN2 and pN4. Eight weeks later the patients received a moving beam irradiation with 10 MV photons at the linear accelerator. The centre of the prostate was faded out by a specially constructed H absorber in such a way that the prescribed target dose of 36 Gy in four weeks to the 90%-isodose was only applied to a spherical surface around the implant. One patient died perioperatively from an embolism due to phlebothrombosis of the thigh. 22 out of the other 24 patients are in complete remission, one patient had a local recurrence in the right seminal vesicle which appeared 28 months after primary therapy, and one patient developed skeletal metastases. The objective side effects and late complications of our combined treatment are considerable with respect to their incidence as well as their severity: a slight or medium radioproctitis was found after a latent period of one to two years in 28% (5/18) of cases, after a latent time of about 1 1/2 to two years another 28% (5/18) developed subsequently to a proctitis an urethral stricture and an ulcer situated on the anterior rectum wall facing the prostate, and four patients presented finally a prostato-rectal fistula.
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PMID:[Combination of bilateral pelvic lymphadenectomy, permanent iodine-125 implantation and percutaneous irradiation of localized prostate carcinoma. 1: Methods and results]. 310 1

Between 1980 and 1987, 54 patients with prostatic adenocarcinoma in stages T0 to T3, M0, underwent staging by pelvic lymphadenectomy, 16 with associated radical prostatectomy. Lymph node metastases were present in 28 cases (52%). In this study, the presence of pelvic lymph node metastases was better correlated to clinical stage than to histological grade.
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PMID:Pelvic lymphadenectomy as staging before definitive treatment of prostatic carcinoma. 314 34


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