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)

The systemic administration of 89Sr has proven effective in the palliation of painful osseous metastases. Biodistribution studies with the gamma-emitter 85Sr suggest that both its uptake and retention are increased in bone metastases, where increased mineral turnover takes place. To study the pattern and nature of this process further, bones containing metastatic deposits were obtained from three patients who had previously been treated with 148 MBq of 89Sr. The bones were cut into 0.5-1.0 cm sections. The cut surfaces which faced together were marked with India ink, and adjacent sections were submitted for histology and autoradiography. Strontium deposition and retention were observed in regions which exhibited significant osteoblastic activity, mostly in areas adjacent to metastatic deposits, but also in subchondral and endosteal locations, as well as in an area corresponding to a pathological fracture with callus formation. With these exceptions, strontium deposition was not observed in histologically normal bone or within the marrow. Our findings demonstrate directly the selective nature of accumulation and retention of 89Sr and confirm previous clinical impressions.
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PMID:Selective accumulation of strontium-89 in metastatic deposits in bone: radio-histological correlation. 754 2

In this retrospective analysis, data of 52 patients with Ewing's sarcoma or PNET with a pathological fracture in the area of the primary tumor were evaluated. All patients were treated according to the trials CESS 81, CESS 86 P, CESS 86, CESS 91 P and EICESS 92 of the German Society of Pediatric Oncology and Haematology (GPOH). At the date of evaluation (15. September 1994) all patients had completed treatment and had been under observation for at least one year following diagnosis. The median follow-up time was 28 months. 22 patients were female, 30 male. The median age was 12 years. 75% of primary tumors had a volume of > or = 100 ml. 30 patients presented with fractures in proximal, 12 in central and 10 in distal parts of the skeleton. 10 patients had primary metastases. The histological definition was Ewing's sarcoma (including atypical Ewing's sarcoma) in 43 patients, PNET in 8 and small-cell osteosarcoma in 1 patient. For local therapy the patients underwent surgery, definitive radiotherapy or a combination of both. The percentage of primary metastases in the group of the patients with pathological fractures is comparable to the whole reference group. The present analysis focuses on those patients with pathological fractures who had no metastases at diagnosis. The relapse-free survival of patients with a pathological fracture and no primary metastases is 58%, the overall survival 65%. These rates are similar to those of the reference group of protocol patients without pathological fractures at diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prognosis in Ewing sarcoma patients with initial pathological fractures of the primary tumor site]. 756 45

Human breast cancer frequently metastasizes to the skeleton to cause osteolysis and subsequent pain, pathological fracture, and hypercalcemia. Because bone continuously releases growth factors stored in bone matrix by bone resorption during physiological remodeling and, thus, possibly provides a favorable microenvironment for metastatic breast cancer cells to proliferate, inhibitors of bone resorption used either prophylactically or in patients with established disease, therefore, would seem likely to be useful adjuvant therapy in patients with breast cancer. However, the parameters for monitoring progressive osteolytic bone disease in humans are imprecise. We examined the effects of the third generation bisphosphonate, risedronate, which is a specific inhibitor of osteoclastic bone resorption, in a bone metastasis model in nude mice in which intracardiac injection of the human breast cancer cell line MDA-231 leads to osteolytic bone metastases. Risedronate (4 micrograms/animal/day) was given s.c. to animals (a) after radiologically small but defined osteolytic metastases were observed; (b) simultaneously with MDA-231 cell inoculation through the entire experimental period; or (c) by short-term prophylactic administration before inoculation of MDA-231 cells. In all experiments, risedronate either slowed progression or inhibited the development of bone metastases assessed radiographically. Furthermore, mice treated continuously with risedronate showed significantly longer survival than did control mice. Histomorphometrical analysis revealed that osteoclast numbers were diminished at metastatic tumor sites. Unexpectedly, there was also a marked decrease in tumor burden in bone in risedronate-treated animals. In contrast, the growth of metastatic breast cancer in soft tissues surrounding bones was not affected by risedronate. Moreover, risedronate had no effects on the local growth of s.c. implanted MDA-231 breast cancers in nude mice or on MDA-231 cell proliferation in culture. These data demonstrate that risedronate decreases metastatic MDA-231 breast cancer burden selectively in bone, as well as suppresses progression of established osteolytic lesions and prevents the development of new osteolytic lesions; thus, the data suggest that inhibition of osteoclastic bone resorption may be a useful adjunctive therapy for the treatment of cancers that have colonized in bone.
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PMID:Bisphosphonate risedronate reduces metastatic human breast cancer burden in bone in nude mice. 762 63

Skeletal metastases occur commonly, and frequently are complicated by the development of an impending or pathologic fracture. In the majority of instances, these patients are best treated by internal stabilization, frequently supplemented by methylmethacrylate, to relieve pain and maintain the patient's mobility. The underlying tumor may continue to grow, and if this occurs the progressive lysis may result in loosening and subsequent failure of the implant. To prevent additional local growth, postoperative radiotherapy is recommended, and many patients also receive endocrine or chemotherapy, but the adjuvant therapy is not always successful in preventing progressive local tumor induced osteolysis. It is possible that the addition of chemotherapeutic agents to the methylmethacrylate may inhibit local growth. This study was performed to determine the biomechanical, biologic, and systemic effects of adding methotrexate to methylmethacrylate. The results show that the addition of methotrexate in as much as a concentration of 2 g methotrexate per 40 g cement did not significantly alter the biomechanical characteristics of the bone cement. The incorporated methotrexate was released continuously from the loaded bone cement, and in the amount and concentration used did not have any toxic effects on the host animal. The methotrexate did not appear to be affected by the heat of polymerization and had a significant systemic effect. There was a significant reduction in pulmonary metastases with methotrexate loaded cement as compared with unloaded cement, the effect being dependent on the concentration of methotrexate in the cement. The results of these studies indicate that methotrexate loaded cement may have an important role to play as part of the orthopaedic management of impending and pathologic fractures.
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PMID:Methotrexate loaded acrylic cement in the management of skeletal metastases. Biomechanical, biological, and systemic effect. 763 1

Complications of cancer that are amenable to treatment with rehabilitation techniques will develop in many patients with skeletal metastases. This treatment can be given safely, with a low prevalence of pathologic fracture. Many patients with skeletal metastases and pathologic fracture have been shown to be good candidates for intensive rehabilitation programs if they do not have hypercalcemia caused by lytic metastases or pain severe enough to require parenteral narcotics.
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PMID:Rehabilitation of cancer patients with skeletal metastases. 763 3

For a long time, radiotherapy was considered as the best treatment for spinal metastases. However, radiotherapy alone could not resolve the problem of pathological fracture which is an important complication of spinal metastases. In this paper, we introduce pedicle fixation system as an adjuvant to radiotherapy to treat eight patients with thoracolumbar metastases. The result was encouraging that all the patients achieved spinal stabilisation and all but one had immediate postoperative relief of back pain. The operation time was short and none of the patients required a blood transfusion. Tissue diagnosis was possible through this approach.
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PMID:Pedicle fixation: an adjuvant for the treatment of thoracolumbar metastases. 769 5

We assessed the survival after surgery in 153 patients with extremity metastases and 88 with spinal metastases. The survival rate for the whole series of 241 patients was 0.30 at 1 year, 0.15 at 2, and 0.08 at 3 years. The 1-year survival rate was the same for the extremity metastases group and the spinal group. Univariate analysis showed that 1-year survival was related to metastatic load, site of primary tumor, and presence of pathologic fracture. Multivariate regression analysis showed that pathologic fracture, visceral or brain metastases, and lung cancer were negative prognostic variables. Solitary skeletal metastases, breast and kidney cancer, myeloma, and lymphoma were positive variables. A prognostication model based on these variables stratified the patients into 3 groups with a 1-year survival ranging from 0.5 to 0.0. These prognostic variables can be used for differentiating the treatment of cancer patients with pathologic fracture or epidural compression.
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PMID:Survival after surgery for spinal and extremity metastases. Prognostication in 241 patients. 774 Sep 44

Adamantinoma is a rare tumor of the appendicular skeleton, and only six cases of ulnar involvement have been reported. We present the case of a 58-year-old man who sustained a pathologic fracture of the proximal third of this right ulna. Biopsy at the time of intramedullary fixation revealed adamantinoma, and he was referred for treatment. There was no evidence of metastatic disease. At operation, the proximal 22 cm of ulna was excised en bloc and the defect reconstructed using a vascularized fibular osteoseptocutaneous flap. The postoperative course was uneventful, and the patient has remained free of disease with very good function 3 years later.
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PMID:Ulnar adamantinoma: en bloc excision and fibular osteoseptocutaneous free flap reconstruction. 805 81

We report a rare case of advanced renal cell carcinoma in a patient who showed complete resolution of metastases to the lung and bones after nephrectomy, partial jejunectomy and subsequent alpha-interferon therapy. The patient was a 54-year-old man whose right lung and left femur metastases were detected before nephrectomy. In the seventh week after nephrectomy, a partial jejunectomy was carried out because of the obstructive ileus caused by intraluminal multiple metastases of the jejunum. A pathological fracture of the metastasized right humerus occurred subsequently. After four months of intramuscular alpha-interferon administration (3 x 10(6) units/day), however, x-rays revealed the complete disappearance of the metastatic lung shadow and a solid union of the humerus, and there were no tumor cells in the femur specimen resected at the subsequent reconstruction surgery of the left leg. Seven years have passed from onset, and the patient is still alive and disease free.
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PMID:Regression of pulmonary and multiple skeletal metastases from renal cell carcinoma by nephrectomy and alpha-interferon therapy: a case report. 828 92

The preliminary results of a prospective and cooperative protocol for the treatment of soft tissue sarcomas of trunk and extremities, stages IB-IIIB are presented. Thirty one patients (17 males, 22 with a tumor larger than 5 cm) aged 16 to 68 years, were treated with one dose of epirubicin 70 mg/m2 i.v. and radiotherapy (3000 rads in 10 fractions) Two or three weeks later an ample surgical complications occurred in 6 patients and were all of infectious origin. The median follow up period has been of 26 months. During this period 5 patients presented late surgical complications (edema in 4 and a pathological fracture in 1), 2 patients had a local tumor recurrence and distant metastases appeared in 7. Actuarial survival was 60% at 48 months. Ninety six percent of surviving patients conserved their extremity. It is concluded that with this treatment modality local recurrence is acceptable, morbidity is low and that the majority of patients do not require amputations or crippling resection.
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PMID:[Soft tissue sarcoma. Combined treatment of drug therapy, radiotherapy and conservative surgery]. 830 10


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