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)

Between 1970 and 1983, 66 patients with adenocarcinoma of the cardia underwent resection in our institute. Hospital mortality within 30 days of surgery was 18.2%. Overall hospital mortality irrespective of time was 27.3%. The 4-year survival rate for all patients excluding overall hospital mortality was 29%. There was a significant difference in cumulative survival between T2 (n = 29) and T3 tumours (n = 15) (P = 0.035). Comparison in this 44-patient group of cumulative survival of patients with negative nodes (N0, n = 13) and positive nodes (N+, n = 31) was also significant (P = 0.01). The application of tumor invasion and lymph node involvement as peri-operative parameters for the selection of patients for resection was evaluated in a retrospective study. Forty-four patients were found eligible to be rearranged in a system using the following clinicopathological parameters: T = 3 versus T = 2 and N+ (positive nodes in N1 and/or N2 groups) versus N0. This system revealed no distinct group of patients who should be withheld from resection according to the criteria held in our institute. Resection provided excellent relief of dysphagia in most patients. The various findings are discussed, and further prospective studies will be needed. At present, in the absence of haematogenous metastases, we prefer surgical resection for all patients whose general condition allows major surgery.
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PMID:Significance of tumor invasion and lymph node involvement on the prognosis and selection for surgery of adenocarcinoma of the cardia. 279

Precise 5-FU intra-arterial infusion and simultaneous irradiation are considered to reduce most tumors, with no functional disturbance occurring as a rule. We performed this therapy in 2 patients. One patient had lower esophageal cancer (T2N0M0) and the other had metastatic cancer of both lungs. We inserted a catheter into the lower periphery of the aortic arch via the left superficial temporal artery in the former patient, and into the upper thoracic aorta via the thyrocervical trunk in the latter patient, before infusing 5-FU together with simultaneous irradiation. Dysphagia disappeared and there was significant improvement of the esophagram, X-ray appearance, and endoscopic appearance in the former patient, who remains under observation. The latter patient showed remarkable regression of the tumor but died after a recurrence. Good efficacy is observed with the use of radiotherapy for the treatment of esophageal cancer at first. However, recurrences occur which carry a bad prognosis. The temporary favorable effect of radiotherapy suggests a promising future for this new therapy, since 5-FU is a strong radiosensitizer. We have a favorable impression of this mode of therapy in comparison with radiotherapy alone, though we have experience with only one patient. There was also a better response than expected when we used it for the treatment of metastatic lung cancer.
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PMID:[5-FU intra-arterial infusion and simultaneous irradiation in the treatment of esophageal cancer and metastatic lung cancer]. 278 81

Three cases of oat cell carcinoma of the oesophagus are presented and published reports reviewed. This is mainly a disease of older age with a 3:2 predominance of men. Of all published cases, 43 (47.3%) occurred in the middle third, 41 (45.1%) in the lower third, and four (4.4%) in the upper third. In one case it was multifocal and in two the location was not stated. Dysphagia was the most common symptom and was found in 82.5% of cases. Overall survival was 4.7 months. The longest survival in a patient treated by resection was 24 months and in a patient treated by chemotherapy 11 months. All but one of the patients had widely disseminated metastatic disease at death. It is concluded that surgery, possibly with adjuvant chemotherapy, holds out the best prospect for such patients.
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PMID:Primary oat cell carcinoma of the oesophagus. 301 39

In order to study the usefulness of treatment with vinblastine (VLB) in the prevention of cancer metastasis in squamous cell lung cancer, 50 patients with locoregional disease were randomized to receive either locoregional RT alone (group A) or a weekly intravenous bolus injection of VLB (6 mg/m2) concurrently with and after locoregional radiotherapy (RT) (55 Gy in 6 weeks) until the appearance of metastases (group B). Neither the incidence of death with metastases, metastasis-free survival (MFS) nor overall survival (S) were significantly affected by treatment with the drug. However, due to the limited number of patients in each group, the power of the statistical test was such to allow only the detection of differences in MFS and S to or more than 80 per cent at the P = 0.05 level. Local tumor response was significantly superior in group B (P less than 0.05). Acute toxicity (dysphagia, myelosuppression) during RT was significantly worse in group B. During long-term therapy with VLB, mild polyneuropathy developed in the majority of patients in group B. Furthermore, seven patients discontinued treatment with VLB during maintenance due to compliance (4) and excessive neurotoxicity (3). This treatment schedule with VLB is not recommended for patients with locoregional squamous cell lung cancer as significant toxicity is present during and after RT and significant increase in MFS and S is lacking. Because of an apparent increase in local response, the combination of VLB and RT merits further investigation in those tumors where local tumor control is crucial.
Clin Exp Metastasis
PMID:Is adjuvant treatment with vinblastine effective in reducing the occurrence of distant metastasis in limited squamous cell lung cancer? A randomized study. 333 80

During the period 1978 to 1986, 13 children aged 2-15 years underwent surgical resection of malignant thoracic tumours. Five children with neuroblastomas presented with chest pain and infections, pleural effusions, dysphagia, lymphadenopathy and paraplegia. Chemo- and radiotherapy were given preoperatively to previously diagnosed cases and postoperatively to all survivors. At operation, complete tumour clearance was possible in only two cases. Two children remain alive with no sign of recurrence at 6 and 7 1/2 years. Eight children with pulmonary metastases had undergone resection of the primary tumour and systemic chemotherapy. All were asymptomatic and were detected by chest radiographs. Wedge resection or lobectomy was performed. Two required contralateral resections at 4 months. Two children remain alive with no evidence of recurrence at 2 and 6 1/2 years. We conclude that aggressive surgical resection of childhood thoracic malignancy is worthwhile, but cooperation with a paediatric oncology team is essential.
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PMID:Surgical management of thoracic malignancy in childhood: eight years' experience in Leeds. 340 50

Thirteen patients with esophageal or gastroesophageal tumors with regional disease only were treated with sequential combined therapy. Weeks 1 to 6 continuous (24 hours) infusion 5-fluorouracil (5-FU) 300 mg/m2/d; weeks 6 to 10 or 12 infusional 5-FU administered concomitantly with radiation to the primary tumor site using standard fractionation with a cumulative median dose of 5000 rad; range 4400 to 6900 rad. Surgery was performed in five patients. All patients were evaluable for assessing response to the initial 5-FU infusion and 11/13 patients demonstrated tumor regression. Of 12 evaluable patients subsequently receiving combined infusional 5-FU and concomitant radiation, all 12 achieved complete clinical (10) or pathologic (two) tumor regression. Two of five patients having surgical resection had no pathologic evidence of tumor. All patients had relief of dysphagia within 1 week of initiating chemotherapy. Acute complications of therapy included stomatitis (two patients); hand-foot syndrome (two patients), and subclavian vein thrombosis (two patients). Stricture requiring periodic dilation occurred in three patients, and one patient developed a tracheoesophageal fistula at 36 months. Local control was maintained in 12/13 evaluable patients. Four of 13 patients were alive and without disease at 12 to 46 months. Nine patients died of distant metastases at 6 to 40 months. Median survival for the whole group was 16 months. Ten of the 13 patients (77%) survived for more than 1 year and 3/13 (22%) survived more than 3 years. This pilot study demonstrates the activity of 5-FU administered on an infusion schedule in both squamous and adenocarcinoma of the esophagus and the capacity to deliver infusional 5-FU throughout standard fractionation radiation. The local control and survival data may provide a basis for expanded Phase II trials, and a comparative trial against surgery alone might also be justified.
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PMID:Sequential infusional 5-fluorouracil followed by concomitant radiation for tumors of the esophagus and gastroesophageal junction. 359 64

We report a very rare case of adenocarcinoma metastatic to the epiglottis and cervical lymph nodes that presented clinically with symptoms of dysphagia. The method of diagnosis, including recent advances in the evaluation of head and neck metastases, is discussed.
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PMID:A rare manifestation of metastatic adenocarcinoma. 371 15

Autopsy findings for 231 cases of carcinoma of the esophagus are presented. Cases with tumour resection constituted 57% of the series. Residual malignancy was present in 81% of all cases. Local residual or recurrent tumour was found in 53%, lymph node metastases in 65% and visceral metastases in 54% of cases. Intrathoracic lymph node metastases were present in 41% of patients after tumour resection and were probably significant in the failure of radical surgery. Adequate clearance of intrathoracic lymph nodes during radical surgery may reduce the incidence of tumour recurrence in this group of patients. Survival was poor in patients with or without resection of the primary tumour. Less than 12% were alive 1 yr after presentation. The average duration of dysphagia at presentation was 2.5 mth. The poor survival of our patients suggests that, by the time they presented clinically, the disease was already advanced. Early disease detection is important for a chance of cure in patients with esophageal cancer.
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PMID:Carcinoma of the esophagus. An autopsy study of 231 cases. 382 18

Nodal metastases from occult head and neck primaries presenting as a pharyngeal space mass are unusual. In this report, a patient with dysphagia and a large parapharyngeal mass was found to have metastases papillary thyroid carcinoma. Although it is common for such tumors to metastasize to regional lymph nodes, to our knowledge, this is the only reported case of a thyroid neoplasm masquerading as a primary parapharyngeal space tumor. It indicates upward lymphatic spread of tumor to involve the lateral retropharyngeal nodes. This pattern of spread is in keeping with Rouviere's description of a direct lymphatic pathway from the posterior surface of the superior thyroid lobe to the lateral retropharyngeal nodes. The case presentation is intended to alert the reader of this possibility and to emphasize the inclusion of regional metastatic nodal disease as a possible cause of parapharyngeal space masses.
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PMID:Thyroid carcinoma presenting as a parapharyngeal mass. 387 Aug 19

Cutaneous malignant melanoma sometimes metastasizes to the upper respiratory and digestive tracts. It may cause significant local symptoms such as airway obstruction and dysphagia, and, in some cases, may represent the initial manifestation of disseminated disease. Of the 8,823 patients with cutaneous malignant melanoma seen at The University of Texas-M.D. Anderson Hospital and Tumor Institute at Houston between 1944 and 1983, metastases to this region developed in 54 patients. The most common sites involved were the tonsil, tongue, nasopharynx, larynx, and lip. Five of ten cases in which an autopsy was performed were noted to have previously undiagnosed metastatic mucosal lesions. We conclude that metastases to the upper aerodigestive tract in patients with cutaneous malignant melanoma is a distinct possibility. Melanoma patients who manifest symptoms localized to this region should be carefully examined to exclude the possibility of metastatic tumor, since alternative treatment may be required. Local endoscopic treatment may be necessary to relieve airway or digestive tract obstruction.
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PMID:Upper aerodigestive tract metastases in disseminated malignant melanoma. 396 53


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