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

Lung cancer is the most common cause of cancer death in both men and women now. Limited resections have proven to be safe and effective in high-risk patients. Sleeve resection now offers both conservation of pulmonary function and enhanced resectability to select patients. Chest wall resections in association with pulmonary resection offer worthwhile survival if the mediastinal lymph nodes are not involved. Solitary cerebral metastases can now be resected with favorable results in carefully selected patients. New treatment strategies, such as neoadjuvant therapy, are on the horizon for advanced stage patients. Operative mortality has declined significantly compared to past decades. While the prognosis for most patients with non-small cell lung cancer remains grim, surgery is now possible in select subgroups with relatively good results.
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PMID:New trends in the surgical treatment of non-small cell lung cancer. 216 56

The highest incidence of remote neuromuscular disorders in cancer has previously been reported in lung carcinoma. The clinical incidence of neuromuscular disorder was estimated and correlated with muscle histology and the histological type of lung tumour in 100 patients with lung carcinoma who were studied prospectively. Thirty-five patients had small cell carcinoma and 65 patients non-small cell lung cancer. Clinically, 33 patients had a polymyopathy, of whom 18 had a cachectic myopathy and 15 had a proximal myopathy (two patients had Lambert-Eaton myasthenic syndrome, one presented with dermatomyositis and one had evidence of ectopic ACTH production). Cachexia was more common in non-small cell cancer; proximal myopathy was more common in small cell cancer. Ninety-nine patients had abnormal muscle histology; 74 had type II atrophy, 12 had type I and II atrophy, one had type I atrophy and 12 had necrosis. The majority of patients were affected sub-clinically and the clinical entities of cachectic and proximal myopathy did not correspond to previous pathological classifications. Atrophy was not related to the duration of tumour symptoms, ageing, clinical type of myopathy or histological type of lung tumour, and was statistically different from that seen in controls. Qualitatively, the presence of weight loss, muscle wasting and metastatic disease were not factors in the development of atrophy. Similarly, necrosis was not related to the type of lung tumour, the presence of metastases, ageing, weight loss, muscle wasting, duration of tumour symptoms or the clinical form of myopathy. This study demonstrates that lung carcinoma has a direct effect on the motor unit, including atrophy, a necrobiotic myopathy and Lambert-Eaton myasthenic syndrome. Clinical assessment does not accurately assess the 'remote' neuromuscular effects of cancer on the motor unit.
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PMID:A clinicopathological study of the paraneoplastic neuromuscular syndromes associated with lung cancer. 217 Oct 9

Computed tomographic (CT) and chest radiographic findings were retrospectively correlated with those found at fiberoptic bronchoscopy (FOB) in 58 patients presenting with hemoptysis. Abnormalities involving the airways were depicted by CT in a total of 28 cases (48%). In 18 of these (31% of the total group of 58), focal abnormalities involving the central airways were identified (17 were subsequently proved to be malignant) and in 10 (17% of the total), CT showed bronchiectasis. Focal airway abnormality was shown by FOB in 18 cases (31%); all of these were depicted with CT. Malignancy was diagnosed in 24 patients, including three in whom results of FOB were normal but malignant cells were identified at transbronchial biopsy. CT abnormalities were identified in all cases of malignancy. In 10 of 21 cases (48%) of non-small cell lung cancer, CT allowed definitive staging by documenting either direct mediastinal invasion and/or metastatic disease, while FOB allowed definitive staging in only three cases. CT studies provided no false-negative results. It is concluded that when carefully performed, CT may be an effective modality for evaluating patients presenting with hemoptysis.
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PMID:Hemoptysis: CT-bronchoscopic correlations in 58 cases. 221 69

Tumour associated monoclonal antibodies HMFG1, HMFG2, H17E2, AUA1, EGFR1, labelled with 123-Iodine or 111-Indium, were used to detect primary and metastatic cancer by external body scintigraphy in patients with ovarian, breast and non-small cell lung cancer (NSCC). Successful localisation was seen in all patients with primary and 80% of the metastatic NSCC, 50% of primary and 70% of metastatic breast cancer lesions and in 80% of patients with metastatic ovarian cancer. On the other hand, imaging carried with a radiolabelled non-specific monoclonal antibody produced positive results in 3 out of 5 cases with primary NSCC. Therefore non-specific imaging should be further studied in clinical research for the evaluation of the specificity of radioimmunodetection. In our therapeutic trials we have so far treated 29 patients with resistant ovarian cancer, with intraperitoneal 131I-labelled antibodies (HMFG1, HMFG2, AUA1, H17E2), 11 patients with recurrent pleural and pericardial effusions by intracavitary 131I-labelled antibodies, 10 patients with brain gliomas by intravenous or intracarotid infusion of 131I-EGFR1 and two patients with hepatic metastases from colon carcinoma by intrahepatic infusion of 131I-anti-CEA antibodies. The preliminary results from these therapeutic studies seem to be encouraging and are discussed in detail in this review.
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PMID:Radiolabelled monoclonal antibodies in tumour diagnosis and therapy. 240 91

Hematogenous metastases to the limb skeletal muscles are extremely rare. Better understanding of the mechanisms resulting in the relative resistance of skeletal muscle to metastases could have bearing on therapeutic interventions for prevention of metastases. Three patients with non-small cell lung cancer and metastases in the proximal limb muscles are presented. Skeletal muscle metastases may present as painful masses in the proximal skeletal muscles. Subcutaneous and osseous metastases which are more frequent must be excluded by careful physical examination, bone scan and x-rays. Computed tomography (CT) can confirm the location of the tumor within the fascial planes of skeletal muscles and may help in the accurate delineation of the radiation portal. The tumor can be diagnosed and more common causes, such as hematoma or abscess, can be excluded by thin needle aspiration with cytologic examination. Clinical recognition of metastases in this unusual site is important based on our report that total tumor dose of 3600 to 4200 cGy of radiation in fractions of 300 cGy, 5 days a week, is effective in palliation of swelling and pain.
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PMID:Skeletal muscle metastases from lung cancer. 243 11

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.
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PMID:Yield of total body GA-67 scintigraphy in the staging of non-small cell lung cancer. 254 May 80

One hundred forty-four patients with non-small cell lung cancer, the majority (72%) of whom had received previous chemotherapy, were evaluable in this randomized phase II study of N-methylformamide (N-MF), spirogermanium, and 4-demethoxydaunorubicin. There were two partial responses, one each with spirogermanium and 4-demethoxydaunorubicin. There were eight life-threatening complications (mostly hematologic) and two lethal complications (N-MF, hematologic; 4-demethoxydaunorubicin, gastrointestinal). The overall survival ranged from 9 days to 533 days with a median of 17.6 weeks. The following factors were associated with poor survival: Poor initial performance status, prior weight loss, presence of liver or subcutaneous metastases.
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PMID:Phase II study of N-methylformamide, spirogermanium, and 4-demethoxydaunorubicin in the treatment of non-small cell lung cancer (EST 3583): an Eastern Cooperative Oncology Group study. 254 26

To examine a potential contribution of protooncogene abnormalities other than point-mutational activation of the K-ras protooncogene in the classification of non-small cell lung cancer, amplification of cellular protooncogenes was studied in 47 lung tumour specimens obtained at thoracotomy and in four lung tumour cell lines. The primary tumours included 21 adenocarcinomas, nine large-cell carcinomas, 13 epidermoid carcinomas, one carcinoid and three metastases of primaries outside the lung. The copy numbers per haploid genome of 11 protooncogenes in every tumour sample were determined: H-ras, K-ras, N-ras, c-myc, N-myc, L-myc, erbB, mos, myb, ncu (erbB-2) and ral amplifications. The c-myc gene was amplified 5-7-fold in two adenocarcinomas, the H-ras gene 3 5-fold in one adenocarcinoma, while the K-ras and the neu gene were amplified in lung metastases from a colorectal and a breast cancer primary respectively. None of the tumours with an amplified protooncogene simultaneously harboured a mutationally activated K-ras gene. We conclude that amplification of the investigated protooncogenes is a rare event in non-small cell lung cancer. In view of the two c-myc amplifications detected, a systematic study of c-myc expression levels in non-small cell lung cancers appears worthwhile.
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PMID:Cellular protoonocogenes are infrequently amplified in untreated non-small cell lung cancer. 254 15

Thirty patients with Stage III non-small cell lung cancer were entered on a trial to evaluate the feasibility of combined radiation and concomitant 5-fluorouracil infusion. Patients had received prior debulking surgery (nine), induction chemotherapy (16), or no therapy (five). Radiation employed standard fractionation (180-200 rad/day) administered to a median cumulative dose of 5500 rad (range, 4500-6200 rad). 5-Fluorouracil was infused 24 hours per day throughout the period of radiation at a dose of 300 mg/m2/day for a median of 42 days (range, 28-56 days). Radiation complications included pneumonitis three of 30 (10%) and esophagitis (27%). Chemotherapy complications included stomatitis, two of 27 (7%), and hand-foot syndrome, three of 30 (10%). Treatment interruptions were necessary in six of 30 (20%) and four of 30 required parenteral nutrition. At a median follow-up of 12 months 26/30 (87%) maintained local control and eight had distant metastases (three of whom presented with Stage IV disease). 5-Fluorouracil delivered continuously throughout standard fractionation radiation to high cumulative doses is feasible and practical. Comparative clinical trials of the various combined radiation and chemotherapy schedules employed are in order. One additional clinical observation was the identification of six of 30 (20%) with brain metastases at presentation or after 12 months, all of whom had adenocarcinoma histologic subtype.
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PMID:Concomitant 5-fluorouracil infusion and high-dose radiation for stage III non-small cell lung cancer. 254 5

Small cell lung cancers are neuroendocrine tumours and therefore produce a lot of peptide hormones (calcitonin, ACTH, ADH), as well as the neuropeptide chromogranin A, which are all useful tumour markers. Furthermore, the tumour-associated antigens CEA and TPA, as well as the enzymes neuron specific enolase (NSE) and creatine kinase BB are used as markers in small cell lung cancer. At present, NSE appears to be the best marker for small cell lung cancer; elevated serum NSE levels are found in 65 to 85% of the patients. The serum level of the tumour markers is related to the stage of the tumour. When tumour regression occurs following therapy, elevated pretreatment levels decrease to the normal range. If the marker level increases again, tumour progression is indicated and this can be an early and sensitive sign denoting recurrence. Metastases in the central nervous system can be detected early by marker determination in the cerebrospinal fluid. At present, CEA appears to be the most valuable tumour marker for non-small cell lung cancer, but TPA may also be a useful marker.
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PMID:[Tumor markers in bronchus cancer]. 254 31


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