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

Statistical analyses have been made by the Liver Cancer Study Group of Japan of 4031 cases of primary liver cancers diagnosed at 155 institutes during the period of Jan. 1, 1968-Dec. 31, 1977, based on the questionnaire in the form of individual file. They comprised 2411 cases of hepatocellular carcinoma, 268 of cholangiocellular carcinoma, 58 of the mixed type, 69 of hepatoblastoma, 23 of others, and 1202 cases with only clinical diagnosis. The survey and analyses mostly based on the histology-proven cases included gross anatomical and histological features of tumors, grades of anaplasia and growth patterns of tumor cells, pathology of noncancerous liver portion, frequency of accompanying cirrhosis or fibrosis, distant metastases, past history, frequency of hepatitis in the past history, frequency of positive HBsAg and anti-HBs, familial clustering of positive HBsAg tests, age distribution, subjective symptoms, objective signs, serum alpha-fetoprotein, celiac angiography findings, number of operations performed, kinds of surgical approaches made, extents of hepatic resection, prognosis in terms of survival in relation to various surgical treatments, chemotherapeutic agents used and routes of administration, prognosis as related to the accompanying parenchymal liver disease, and overall survival.
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PMID:Primary liver cancers in Japan. 615 97

Six autopsy cases of the rare, diffuse type of hepatocellular carcinoma (HCC), as classified gross anatomically according to the strict definition, have been studied. The prominent clinical feature was the rapid deterioration of the patient's general condition, terminating in hepatic failure. The liver size enlarged quickly, at a perceptible speed, often accompanied by abdominal pain. Diagnosis of this particular type of HCC was difficult, and celiac angiography and scintiscan of the liver were only suggestive when considered together with other laboratory data. Hepatitis B surface antigen was positive in all three patients in whom it was tested. The entire liver was studded with minute, uniformly sized tumor nodules, evenly distributed throughout. Some of them were grossly indistinguishable from cirrhotic nodules. All livers had an underlying cirrhosis which was characterized by relatively small regenerative nodules with thin stromas. Large portal branches at the hilum contained tumor thrombi in all patients, except for one case in which left lobectomy was followed by intraportal dissemination. Histologically, all tumor nodules represented intrahepatic metastases via the portal vein system. Tumor cells were poorly differentiated. These findings suggest that the diffuse type of HCC most frequently, if not always, represents intrahepatic, widespread portal metastases which have occurred within a short period of time.
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PMID:A clinical and pathological study of diffuse type hepatocellular carcinoma. 629 41

The pathologic findings of 232 consecutive cases of hepatocellular carcinoma (HCC) autopsied during the past ten years at Kurume, Japan, were analyzed from the point of view of global epidemiology, in relation to clinical feature, and in regard to incidence, age, sex, etiologic factors, size of liver, changes in noncancer parenchyma, gross type of tumor, extrahepatic metastases, intravascular and intraductal growths, cancer cell histology, hepatitis B surface antigen (HBsAg) in hepatocytes and cancer cells, liver cell dysplasia, and frequency and clinicopathologic characteristics of minute HCC. Furthermore, postmortem hepatic arteriography and portography were done in 152 livers for comparison with gross anatomy and celiac angiograms. It was found that: (1) epidemiologically, HCC in Japan is distinct from that in the West that it is frequently encapsulated, livers are generally small because of frequent and advanced cirrhosis and small cancer, minute HCC, is not uncommon at autopsy, cirrhosis most commonly associated is the one with thin stroma and medium size nodules, and micronodular cirrhosis is very rare despite frequent alcohol abuse; (2) HCC is increasing in incidence; (3) HBsAg is frequently found in parenchyma; (4) liver cell dysplasia is indirectly related to HBsAg with no evidence for premalignancy; (5) the lung is the most frequent site of metastasis but peritoneal dissemination is unusual; (6) intraportal tumor growth is very common and the hepatic vein is less frequently affected; (7) growth in the major bile duct is frequently associated with intraportal growth and clinically presents as obstructive jaundice; and (8) tumor is supplied solely by arteries and celiac arteriograms are closely correlated with gross pathologic findings.
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PMID:Pathology of hepatocellular carcinoma in Japan. 232 Consecutive cases autopsied in ten years. 629 17

We performed angiotension-induced hypertension cancer chemotherapy in a patient with unresectable gastric cancer with invasion to the pancreatic head and lymphatic metastases along the common hepatic and celiac arteries. At re-operation, the tumor size was remarkably decreased and we were able to perform curative subtotal gastrectomy without invasion and metastases. The pathological specimen showed no malignant cells at postoperation.
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PMID:[A gastric cancer patient who underwent curative resection by angiotension-induced hypertension cancer chemotherapy]. 642 2

One hundred and seventeen patients with colorectal hepatic metastases had insertion of catheters for infusional chemotherapy. The two-year survival estimate of patients with less than 50% hepatic replacement and no other adverse factors was 37%. Nine of 39 patients in this group are alive at 24 months. The catheters were placed into the hepatic artery (HA), 23; into the portal venous system (PV), 18; into both HA and PV, 64; or into an accessory HA following ligation, 12. Fifty-nine patients had ligation of the common HA also. The 30-day postoperative mortality rate was 1.7% (2/117) and morbidity was 37.6%. The majority of complications were related to fever (61%, 27/44). Over the past 2 years, 87% of patients have been discharged within 10 days following surgery. Preoperative CEA ranged from 0.5-12,150 ng/ml (median 165 ng/ml); 93% (78/84) had plasma CEA levels exceeding 5 ng/ml. All patients had careful intraoperative staging: per cent hepatic replacement (PHR) ranged from 5-95% (median 60%); portal, celiac, or periaortic lymph node metastases were observed in 31% (36/117). Initial intrahepatic chemotherapy programs consisted of either CAMF (9 patients), MAFL (60 patients), BFS (22 patients), continuous infusion FUDR (14 patients), or miscellaneous drugs (4 patients). Median survival time of 109 evaluable patients was 11.5 months. The effect of 20 variables on the observed survival time was analyzed using a multivariate proportional hazard model. Three variables were found to have influenced survival: PHR emerged as the most significant, p = 0.000001. Increased PHR was associated with decreased survival time. Lymph node metastases and prior chemotherapy were prognostic factors also, p = 0.0006 and p = 0.03, respectively. No patient with PHR greater than 80% lived more than 8 months. Utilization of these variables would appear to be necessary for accurate stratification and evaluation of future chemotherapy trials in patients with colorectal hepatic metastases.
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PMID:Multivariate analysis of a personal series of 247 patients with liver metastases from colorectal cancer. II. Treatment by intrahepatic chemotherapy. 670 93

Extension of tumor into the vena cava occurs in 5 to 10 per cent of the cases of renal cell carcinomas. Of these cases 14 to 39 per cent may extend to or into the right atrium. Acceptable techniques for dealing with this situation include cross-clamping the atrium, using positive pressure ventilation and extracting the thrombus with a Fogarty or Foley catheter, and extracorporeal circulation or a cardiopulmonary bypass with open excision of the tumor extension. Since 1974 we have seen 2 men and 2 women, mean age 56 years, with clear cell renal carcinomas and supradiaphragmatic vena caval tumor extension (1 with additional pulmonary embolism). None had other evidence of metastatic disease determined on staging evaluation by celiac and renal angiography, liver scan, bone scan and chest tomography. Each patient was explored with the planned use of extracorporeal circulation or cardiopulmonary bypass, Greenfield vena caval filter insertion and standard radical nephrectomy. Resection was not done in 1 patient with biopsy proved tumor eroding through the right atrial wall. He died of disease in 8 months. Of the remaining 3 patients who had the tumors completely resected 1 is alive with recurrent disease in the retroperitoneum at 44 months, 1 died of metastatic disease to the bones and liver at 39 months, and 1 died 1 day postoperatively of technical complications with no evidence of residual disease at autopsy. In the absence of metastatic disease it seems reasonable to pursue a radical surgical approach in patients with renal cell carcinoma and supradiaphragmatic tumor thrombus. The use of extracorporeal circulation and post-extraction insertion of the Greenfield vena caval filter offers the surgeon the advantage of direct visualization and better vascular control in removing the thrombus, as well as protection from the possibility of post-extraction pulmonary embolism. With the combined use of these techniques, the previously hopeless situation for these patients has been improved.
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PMID:Extracorporeal circulation for renal cell carcinoma with supradiaphragmatic vena caval thrombi. 670 18

Resected specimens from 41 cases of carcinoma of the head of the pancreas or the periampullary region and autopsy specimens from 16 patients with recurrence were examined for lymph node metastasis. Evidence demonstrating the need for dissection and removal of specific lymph node groups in pancreatoduodenectomy or total pancreatectomy was discussed. These include the common hepatic and celiac groups, the superior mesenteric group, the jejunal group located in the mesentery of the proximal portion of the jejunum, and the retropancreatic group located behind the uncinate process. Metastasis to these groups was found even in cases where the carcinoma was considered small. In carcinoma of the head of the pancreas, metastasis to the peripancreatic lymph nodes was seen more widely. Therefore, total pancreatectomy with lymph node dissection is desirable for this disease.
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PMID:Lymph node dissection in radical resection for carcinoma of the head of the pancreas and periampullary region. 688 57

Endocrine manifestations were absent in a patient presenting with pain in the left peri-umbilical region from a paraganglioma of the organs of Zuckerkandl. The authors describe the embryology of paragangliomas and review the published literature concerning the noradrenaline-secreting forms of these tumors. Only 86 references to those of Zuckerkandl, situated on the side of the aorta in relation to the inferior mesenteric artery, were found. Diagnosis of non-secreting forms is confirmed by arteriography which in this present case demonstrated three pedicles arising from the inferior mesenteric, celiac, and one of the lumbar arteries respectively. The only evidence of malignancy is the presence of metastases. Their diagnosis is therefore difficult but essential as one-third of the localisations of malignant pheochromocytomas (10 p. cent of pheochromocytomas) outside of the adrenals affect the organs of Zuckerkandl.
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PMID:[Paraganglioma of the organs of Zuckerkandl. A case report (author's transl)]. 720 15

Two patient-materials with esophageal carcinoma are analyzed: a group of 22 patients who, during the period 1971-1974, were treated with esophageal resection followed by esophagogastrostomy or colonic interpolation; a second group of 28 patients from 1975-1978, who were treated in the same way, but also given either preoperative or postoperative radiation therapy, or both. Surgical mortality was about the same in the two groups: 25-32%. The group given radiation therapy had a one-year survival rate of 50%, as compared with 23% in the group treated solely with surgery. All 24 patients given combined therapy, with all or part of the absorbed dose of 24-47 Gy given preoperatively, showed vital cancer in resected specimens. Vital cancer was found in the periesophageal nodes in only six patients (25%), however; patients given no preoperative radiation therapy had tumor in 20 of 26 cases (77%; P less than 0.01). Celiac nodes were resected at laparotomy; when malignancy was found, the celiac region was irradiated postoperatively. This finding does not appear to exclude long-term survival, as two patients with metastases to the celiac nodes at operation are alive 16 and 20.5 months following surgery. Simple compared to troublesome dissection gives a better rate of survival. The spleen was unintentionally injured in 21 patients at laparotomy and had to be removed. One-year survival was better in patients with intact spleen, especially in those who also had radiation therapy. Patients with resected spleen succumbed from metastases more often than from mediastinal recurrence, as compared with the patients with intact spleen.
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PMID:Surgery alone or combined with radiation therapy in esophageal carcinoma. 723 93

Twelve patients with malignant thyroid lymphomas seen over a 12-year period were reviewed. Two of these patients developed intra-abdominal lymphoma and a third, adult coeliac disease. Treatment by radiotherapy and thyroxine was effective, with thyroid excision mainly reserved for obstructing lesions. Prognosis was not affected by local metastases. A plea is made for open thyroid biopsy and accurate clinical staging of patients with this disease.
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PMID:The natural history of malignant thyroid lymphomas. 741 48


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