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)

Esophageal, rectal, tympanic, and central blood temperature, i.e., pulmonary artery and aortic arch, were recorded in three patients during iatrogenic whole-body hyperthermia for the treatment of advanced malignant metastatic cancer. Aortic temperature closely followed changes in pulmonary arterial temperature, with an average delay time of 27 s. Esophageal temperature reflected quantitatively and more quickly (avg lag time, 80 s) the temperature changes in the pulmonary artery than tympanic membrane temperature. Tympanic temperature was consistently lower than the blood temperature of the heart during steady state. Therefore it is suggested that esophageal temperature is a preferable index of central blood temperature. Additionally, measurement of esophageal temperature can be made more easily and safely than tympanic membrane temperature.
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PMID:Esophageal and tympanic temperature responses to core blood temperature changes during hyperthermia. 373 33

Based on the analysis of the lymph nodes dissected during resection of 234 esophageal carcinomas and the long-term results of the patient, lymph nodes of the esophagus were grouped into 3 categories, n1, n2 and n3. The lymph nodes of n1 group were frequently involved in metastases and the long-term results of the patients with these lymph nodes metastases were excellent. The n2 lymph nodes were frequently involved in metastases but the survival rates of the patients were low. The n3 lymph nodes were rarely involved and the prognoses of the patients were poor. In comparison with the classification of lymph nodes for surgical dissection as described by the Japanese Society for Esophageal Disease, some problems in this category are discussed. However, this category was revealed to have close relation to the long-term results of the patients with carcinoma of the esophagus and was considered to be of clinical use.
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PMID:[Lymph node involvement in carcinoma of the esophagus--re-evaluation for the grouping of lymph nodes]. 402 88

Among 4,184 patients with cancer of the esophagus, 55 second primary cancers were observed, whereas 64 were expected [relative risk (RR) = 0.86]. The absence of an excess risk of alcohol- and tobacco-related cancers was not anticipated. A significant 19% deficit of second cancers was found among 30,843 patients with stomach cancer. Cancer of the rectum, kidney, and lung all occurred significantly below expectation. An excess risk of ovarian cancer (RR = 1.9) was seen in women. Reasons for these findings are not entirely clear. Cancer of the small intestine is rare, and despite a relatively short survival expectation, a moderate excess of second cancers was seen among 868 patients (36 vs. 26.8). Only cancers of the liver and gallbladder were significantly elevated, and the possibility of misclassified metastases is discussed. Colon cancer is one of the most common cancers in Denmark, and 29,490 patients with this disease were at slightly lower risk for development of second cancer (RR = 0.96; 95% confidence interval = 0.9-1.0) than the general Danish population, excluding secondary colon cancers. Esophageal, stomach, and liver cancers occurred less frequently than expected. That cancers of the uterine corpus and ovary were significantly increased supports the notion that common risk factors, such as diet and endogenous hormones, influence the development of these cancers. A significant 23% deficit of second cancers was also found among 26,597 patients with cancer of the rectum, excluding secondary rectal cancer. Significant deficits were seen for cancers of the stomach (RR = 0.5), lung (RR = 0.8), and brain (RR = 0.5), and for multiple myeloma (RR = 0.4). The likelihood of underreporting of second cancers, especially of the digestive system, is discussed. However, cancer of sites previously reported to be associated with rectal cancer, e.g., the colon, breast, and uterus, did not occur below expectation. Cancers of the liver and biliary tract occurred in 4,453 patients; their average survival was only 1 year. Except for a slight excess of cancer of the ovary (5 vs. 1.6), the risk of second cancer development for all sites was consistent with unity (RR = 0.90). The risk of second cancers among 7,752 persons with cancer of the pancreas was not greater than expected (88 vs. 85.2). Males were at significant risk of kidney cancer (RR = 3.2), whereas females showed elevated rates of cancers of the uterine corpus (RR = 3.2) and ovary (RR = 3.1). No site occurred significantly below expectation.
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PMID:Second cancer following cancer of the digestive system in Denmark, 1943-80. 408 3

A 54-yr-old man was admitted to Hokkaido University Hospital, complaining of fever, multiple arthralgia, edematous erythema and face and muscular weakness of extremities during the last 2 months. He was diagnosed as dermatomyositis by acceleration of ESR, elevation of GOT, GPT, CPK, aldolase, moderate increases of collagen fibers in biopsy specimen of skin and his clinical signs. Although stools were positive for occult blood, the routine radiographic examination failed to detect the bleeding site in the upper GI. tract. However, in the double contrast picture of the stomach, a very fine abnormal linear shadow was observed at the upper corpus of the lesser curvature. This linear shadow was a margin of the tumor, retrospectively. About 4 months later, abnormal pain occurred and a mass was palpable in the left lumbar region, suggesting a pancreatic tumor. He was operated on excising the tumor, but was performed only exploratory laparotomy because of the presence of intra-abdominal metastases. Death occurred 40 days after the operation and necropsy was done. The gross anatomical findings of the abdomen showed a stomach tumor as large as an infant's head and its metastases to pancreas, lymph nodes, and greater and lesser omentum. Esophageal mucosa including esophagocardiac junction was intact. Histological examination of the intragastric tumor revealed a typical squamous cell carcinoma with keratinization. According to the absence of the components of adenocarcinoma and squamous metaplastic gastric mucosa of non-cancerous areas in the stomach, it seemed likely to be a heterotopic squamous cell carcinoma. It was unknown about the precedence between the stomach cancer and dermatomyositis. There have been 11 cases of primary pure squamous cell carcinoma in the world literature since 1968, but this is the first case report of coexistence of these two diseases.
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PMID:[A case report of a primary pure squamous cell carcinoma of the stomach associated with dermatomyositis (author's transl)]. 726 22

A multicenter retrospective statistical study of 2,400 patients with tumors of the esophagus and cardia was undertaken. Study of individual sites revealed the operability of certain carcinomas of the upper third of the esophagus with a reasonable five-year survival rate despite macroscopic invasion seen in more than half the patients. For the middle third of the esophagus, intrathoracic colonic esophagoplasty with esophageal resection extending as high as possible appeared to offer the best long-term results, particularly if the anastomosis was performed in the neck. Tumors of the lower third of the esophagus were also associated with better results when the esophageal anastomosis was made at a level above the aortic arch, resulting in an improved survival rate for patients undergoing intrathoracic colonic esophagoplasties. For carcinomas of the cardia, use of total gastrectomy was superior to the use of upper polar gastrectomy, but the results were better when gastric excision was also associated with esophageal excision. The finding of normal lymph nodes did not preclude recurrence of the tumor in approximately one-fourth of the patients. Esophageal sections at a distance from the tumor was not necessarily synonymous with section in a healthy area, since the sites of sections studied were either invaded (29%) or areas of neoplastic repermeation (40%). Existence of a histologically normal esophageal section site did not preclude recurrences in 27% of patients with more than one-third in the esophagus. Undifferentiated or poorly differentiated squamous cell carcinomas paradoxically appeared to have a somewhat better long-term prognosis than well differentiated forms, but the increased number of metastases associated with them confirms their unfavorable prognosis. The importance of the T/N classification was confirmed for tumors in classes T1 and T2. From Stage T3, the N criterion was not important. Incidence of postoperative mortality from fistulas appeared to decrease progressively, chiefly due to appropriate medical treatment. Cervical fistulas were associated with a mortality rate of 21%. After esophageal anastomosis above the aortic arch was performed, more than 10% of the recurrences were seen in the neck, indicating the need for extension of the incision as high as possible. Metastases to the bone were present in 15% of the patients. Preoperative radiotherapy did not lessen the number of lymph nodes found to be invaded at the time of excision; the tumors considered to be histologically "sterilized" by irradiation were nevertheless associated with a high incidence of lymph node involvement (approximately one-third) and with more than a 40% rate of distant metastases. Excisions considered to be "palliative" by the surgeon nevertheless were of definite value. The mean survival rate at five years was 12%, and one-third of these patients showed no recurrence of neoplasm.
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PMID:Treatment of carcinoma of the esophagus. Retrospective study of 2,400 patients. 740 63

We studied 40 formalin-fixed, paraffin-embedded esophageal squamous cell carcinomas from a high risk region for this tumor for the presence of human papillomavirus (HPV) DNA by the polymerase chain reaction (PCR). We used two general consensus primers from a highly conserved E1 region of HPV types 6, 11, 16, and 18. Human papillomavirus DNA was detected in 60% (24 of 40) of the cases without relation to the tumor grade. Two lymph node metastases had the same HPV types as the primary tumor. Human papillomavirus types were determined in the 24 HPV-positive cases by Southern blot analysis of amplified DNA. Human papillomavirus type 6 was detected in 50% (12 of 24) of the cases, HPV type 16 in 8% (two of 24), and HPV types 6 and 16 in 17% (four of 24); in 25% (six of 24) of the cases the type was unknown. Human papillomavirus types 11 and 18 were not detected. Esophageal mucosa adjacent to the tumor was studied for morphological changes of HPV effect in 27 cases. Adjacent esophageal mucosa in 16 HPV-positive tumors showed statistically significant (P < .05) koilocytosis in six cases. Papillomatosis was the next most frequent finding in four cases. This study supports the role of HPV in the causation of esophageal squamous cell carcinomas, especially in high risk regions for this tumor.
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PMID:Detection of human papillomavirus DNA in esophageal squamous cell carcinomas by the polymerase chain reaction using general consensus primers. 775 Sep 44

The role of surgery in patients with Barrett's esophagus and high-grade dysplasia is controversial. The aims of this study were to determine the prevalence of unsuspected early cancer and to evaluate surgical outcome in a cohort of patients with high-grade dysplasia. Records of all 16 patients who underwent esophagectomy for high-grade dysplasia from 1986 to 1991 were reviewed. All had preoperative endoscopy with no gross evidence of carcinoma, and none had a preoperative diagnosis of intramucosal or invasive carcinoma. Intramucosal carcinoma was found in six (38%) resection specimens. There were no cases of invasive carcinoma or lymph node metastases. One patient (6%) died 3 months postoperatively. The remaining patients are alive without evidence of recurrent cancer (range of follow-up, 2-68 months). Early postoperative complications occurred in seven patients (44%). Late complications occurred in 11 patients (73%). Anastomotic strictures accounted for seven of the 11 (64%) late complications. Complications were successfully managed conservatively in all but two patients. One required laryngectomy for chronic aspiration and another required a gastrojejunostomy for gastric outlet obstruction. Intramucosal carcinoma that had been unsuspected is frequently found in patients with Barrett's esophagus and high-grade dysplasia. Mortality associated with esophagectomy is low, and perioperative complications can usually be managed conservatively. Esophageal resection is indicated in appropriately selected patients with Barrett's esophagus and high-grade dysplasia.
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PMID:Surgical management of high-grade dysplasia in Barrett's esophagus. 823 24

Oral cavity. Most carcinomas in situ of the oral cavity present as red or pink lesions that do not have a keratinized surface. Scrapings of such lesions readily disclose abnormal squamous cells diagnostic of cancer. Scrapings of the keratinized white lesions (so-called leukoplakia) are of no diagnostic value. Dentists, who are most likely to uncover precancerous lesions, are apparently not aware of the diagnostic options based on simple scrape smears. The method is also applicable to follow-up of patients with treated cancer of the oral cavity. Esophagus. Cytologic evaluation of esophageal cancer, initially by washings and subsequently by brushings under endoscopic control, is an established method of diagnosis. The diagnostic results are very good in symptomatic cancer patients and have an accuracy reaching 85-90%. Unfortunately the results of treatment of advanced lesions are very poor, with 5-year survival of only about 5%. Serious efforts at detection of early esophageal cancer started in China in the 1960s, using an abrasive balloon technique which was applied to asymptomatic populations in high risk areas such as Linxian in the Henan province of Central China. The Chinese investigators reported the finding of numerous precancerous lesions of the esophagus classified as carcinoma in situ and as dysplasia. Surgical resection of some of the precursor lesions apparently resulted in a significant drop in the rate of invasive carcinoma, although the statistical results were not convincingly presented. The balloon technique has been tested by us and by others in South Africa and in Transkei, confirming its efficacy in the diagnosis of early esophageal cancer. Peripheral lung. Sputum and bronchial brush cytology may uncover bronchogenic carcinoma in situ and early invasive cancers located in the primary or secondary bronchi. Small, peripheral lung lesions usually do not shed cells in sputum or brushings, and their discovery is usually based on roentgenologic finding. The identity of such lesions can be confirmed in most cases by a transcutaneous aspiration. Most of the peripheral malignant lesions are small adenocarcinomas or epidermoid carcinomas, both resectable by routine surgical procedures. Less commonly, oat cell carcinomas may be observed and these lesions should not be treated by surgery. Benign lesions such as granulomatous inflammation and fungal infections may also be identified by aspiration techniques. The prognosis of the resectable carcinomas varies with their size and the presence or absence of regional lymph node metastases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cytologic diagnosis of oral, esophageal, and peripheral lung cancer. 841 10

Unlike mediastinoscopy in lung cancer, there exists no standard minimally invasive test to stage esophageal cancer. If it were possible to obtain exact preoperative staging in esophageal cancer, patients could be separated prospectively to receive neoadjuvant therapy appropriately. We studied the feasibility and efficacy of thoracoscopic and laparoscopic lymph node staging in esophageal cancer. Thoracoscopic staging was performed in 45 patients with biopsy-proven carcinoma of the esophagus. Laparoscopic staging was done in the last 19 patients. Thoracoscopic staging was aborted in three patients because of adhesions. Thoracic lymph node stage was N0 in 39 patients and N1 in three; celiac lymph nodes were normal in 13 and diseased in six. Esophageal resection was performed in 30 patients after thoracoscopic staging; 17 of these underwent laparoscopic staging. Thoracoscopic staging showed N0 lymph node status in 28 patients and N1 in two patients. Two of the 28 patients (7%) with N0 disease were found at resection to have paraesophageal lymph node involvement (N1); thus the disease was understaged by thoracoscopic staging. Thoracoscopic staging was accurate in detecting the presence of diseased thoracic lymph nodes in 28 of 30 cases (93%). Laparoscopic staging detected normal celiac nodes in 12 patients and diseased lymph nodes in five patients. After esophagectomy, the final pathology report in the 12 patients with N0 disease was N0 in 11 and diseased lymph nodes in one patient. Thus laparoscopic staging was accurate in detecting lymph node metastases in 16 of 17 patients (94%). Thoracoscopic and laparoscopic staging are more accurate than existing staging methods. Six of 19 patients in whom laparoscopic staging was used had unsuspected celiac axis lymph node involvement that had been missed by standard noninvasive techniques. One of three patients with thoracic lymph nodes and three of six with celiac lymph nodes were downstaged after preoperative chemotherapy/radiotherapy. The role of thoracoscopy and laparoscopy in staging esophageal cancer should be further evaluated in a multiinstitutional trial.
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PMID:Combined thoracoscopic/laparoscopic staging of esophageal cancer. 861 40

Esophageal, gastric, and pancreatic cancers frequently present with extensive local regional disease, which can be difficult to resect or to definitively control with radiation therapy given as a single modality. In addition, these patients are at high risk for the development of distant metastasis. Neoadjuvant chemotherapy is a promising experimental approach for the use of combined modality treatments that involve a systemic component. The theoretical background for the use of chemotherapy followed by an operation or chemotherapy plus radiation in these tumors has been extensively described. For esophageal cancer, many phase II trials have demonstrated tolerance to systemic chemotherapy; chemotherapy plus radiation prior to operation has more toxicity. Definitive phase III studies testing the hypothesis that this approach is superior to operation alone have recently been performed in the United States and Europe. These data are currently being analyzed. For the use of combined modality therapy of chemoradiation, random assignment trials have demonstrated an improvement in cure rate for patients with squamous cell carcinomas of the esophagus. Preliminary data suggest a similar outcome for adenocarcinoma, but the number of patients who have been studied is smaller. Newer phase III studies involve the use of new systemic agents that have demonstrated activity in metastatic disease (such as paclitaxel) or the use of higher doses of radiation therapy. For gastric cancer, a substantial number of phase II trials have again demonstrated tolerance to preoperative chemotherapy with no increase in operative morbidity or mortality. Small-scale phase III trials have been performed that suggest an improvement in outcome. Definitive studies are in the planning stage. Finally, for pancreatic carcinoma, in which local control is an even more difficult issue, a major stumbling block remains the development of newer systemic therapies that have activity in this disease. The recent identification of gemcitabine as having modest activity as a single agent and its potential use with radiation therapy is being explored in the neoadjuvant setting.
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PMID:Neoadjuvant therapy for upper gastrointestinal tract cancers. 886 8


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