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)

Intermittent intra-arterial infusion chemotherapy using implantable reservoir was performed for hepatic metastases and the therapeutic effects were evaluated. We treated 21 patients with hepatic metastases of gastric cancer in 8 cases, rectal cancer in 6 cases, colon cancer in 5 cases and breast cancer in 2 cases. The reduction rate of the tumor diameter as seen by CT scan was used as a criteria for antitumor effectiveness. Only 1 case was PR, for an efficacy rate of 5%. Changes in serum CEA level were related to antitumor effectiveness.
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PMID:[Intermittent intra-arterial infusion chemotherapy using implantable reservoir for the treatment of hepatic metastasis]. 153 Feb 96

Out of 79 cases dealt with reservoir, a response was obtained in 31% of 51 assessable cases. When assessed by cumulative survival with Kaplan-Meier method, the 50% survival was 8 months for total cases and prolonged to 21 months for responsive cases. However, eventually re-hospitalization was required for almost all cases. Although oral nutrition was impossible because of poor general condition, there were many patients who refused re-hospitalization and wished to continue treatment at home. In the present study, in 5 such cases the usefulness of home parenteral nutrition (HPN) combined with chemotherapy was determined. All the five patients in this study had gastric cancer with metastases and recurrent lesions in the liver or lymph node, or localized or with peritoneal spread. The site of the reservoir was within the artery in 4 cases and in the abdominal cavity in 1 case. The chemotherapy was multidrug-combination therapy consisting of 5-FU, MMC, CDDP and EPIR. In 4 cases local hyperthermia was added. In 3 out of the 5 cases (3 out of 7 lesions), a partial response (PR) was obtained. The mean dwelling period of the reservoir was 349.2 days for all cases, but longer than 400 days for 3 cases in which PR was obtained. For HPN, a catheter was inserted through the internal cervical vein, and 750-1,500 kcal/day was administered intermittently during night or constantly for 24 hours. In cases in which PR was obtained with chemotherapy and in those in which the reservoir for HPN was been in place before the terminal stage, the reservoir could be used for administration for a prolonged period. The mean dwelling period of the reservoir was 179.8 days and the duration of home stay was 121.2 days. All of the patients were classified as PS2 or higher and pronounced improvement in PS was obtained after HPN in only 1 case. Four out of the 5 patients were satisfied with receiving treatment at home. However, since HPN is associated with many problems such as sudden worsening in general condition, cancer pain and great burden to families, the solution to these problems remains.
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PMID:[Evaluation of loco-regional cancer chemotherapy with assistance of home parenteral nutrition]. 153 Mar 38

Repeated hepatic dearterialization combined with intra-arterial infusion chemotherapy was performed in 29 patients with unresectable primary or secondary cancer of the liver. Partial Response (PR) was obtained in 4 cases (1 hepatocellular carcinoma and 3 gastric secondaries), when evaluated by measuring the regression rate radiologically. The most remarkable effect was found in those with metastases from gastric cancer. A satisfactory result was not obtained for hepatocellular carcinoma with liver cirrhosis because of frequent associated complications. A strategy to modulate the resistance of tumors to ischemia and anticancer drugs should be considered in order to obtain a better clinical result by this method.
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PMID:[Evaluation of repeated hepatic dearterialization combined with intra-arterial infusion chemotherapy of unresectable primary or secondary cancer of the liver]. 153 Mar 50

The probability of survival of patients with gastric cancer depends upon depth of wall penetration by the primary tumour and metastatic lymph node burden. Radical lymphadenectomy may lead to prolonged survival but with increased morbidity. A computer program from Maruyama, National Cancer Centre, Tokyo enables evaluation of individual survival time and infiltration of lymph nodes. This analysis was applied to a German population. Computer-aided predictions were determined retrospectively using the prognostic factors of sex, age, Borrmann classification, histology, depth of wall penetration, location and diameter of the tumour. Data were collected from 222 patients at the Technical University of Munich (median age 66 years, sex ratio (M:F) 2:1), who had been operated on (72 per cent total gastrectomy, 28 per cent subtotal gastrectomy) for gastric cancer. The predicted results were compared with the postoperative pathological findings. The prediction of node metastases was highly accurate (lymph nodes 13-16, 96 per cent; 7-12, 89 per cent; 1-6, 82 per cent). These computer predictions may provide perioperative information of therapeutic value.
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PMID:Preoperative assessment of lymph node metastases in patients with gastric cancer: evaluation of the Maruyama computer program. 155 65

Data were analysed on 396 patients with early gastric cancer who underwent resection in this department; special reference was made to lymph node metastasis. Metastases were present in the dissected lymph nodes of 47 patients (11.9 per cent). The survival rate for patients with metastasis to lymph nodes was lower than for those without such metastasis (P less than 0.05). Lymph node metastasis was associated with larger tumour, a higher incidence of submucosal invasion, a higher rate of lymphatic vessel involvement, an advanced stage of disease and a non-curative resection rate of 6.4 per cent. Multivariate analysis showed that the independent risk factors for lymph node metastasis in patients with early gastric cancer were large tumour size, lymphatic vessel involvement and invasion into the submucosal layer. In patients with these risk factors, lymph node dissection and postoperative adjuvant therapy should be performed in an attempt to prevent recurrence in the form of lymph node metastasis.
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PMID:Predictors of lymph node metastasis in early gastric cancer. 155 92

Gastric cancer sometimes spread to peritoneal surfaces in the absence of lymphatic or hematogenous metastases. For the treatment of peritoneal carcinomatosis, we applied large volume intraperitoneal chemotherapy (L.V.I.C.). In L.V.I.C., drugs were administered with large volume of saline through the reservoir buried in the subcutaneous tissue of the abdominal wall. We used mitomycin C (MMC), 5-fluorouracil (5-FU) and CDDP and examined the pharmacokinetics of these drugs when they were administered by this method to the patients of peritoneal carcinomatosis. A marked pharmacokinetic advantage was observed when 5-FU and CDDP were administered. AUC of these drugs were much larger than that of MMC. In vitro sensitivity test (SDI test) was useful for the selection of adequate drugs for each patient. On this method, drugs were distributed widely in the abdominal cavity and the patients could be taken this treatment repeatedly as out-patient. L.V.I.C. seems to fulfill the need for a safe, effective and acceptable delivery system of intraperitoneal chemotherapy.
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PMID:[Large volume intraperitoneal chemotherapy as treatment for the peritoneal carcinomatosis from gastric cancer]. 155 95

The influence of oxygen-derived free radical scavengers on survival in gastric cancer, with serosal invasion and metastases to the lymph nodes surrounding the stomach, was assessed in a prospective randomized controlled double-blind trial conducted for 5 years. To this end, allopurinol (inhibits the enzyme xanthine oxidase which is responsible for the formation of superoxide radicals and scavengers hydroxyl radicals) and dimethyl sulphoxide (DMSO; scavengers hydroxyl radicals) were used. Following potentially curative distal two-thirds partial gastrectomy, 228 patients making an uneventful recovery from surgery were randomized to the control group or to receive allopurinol (50 mg by mouth 4 times a day) or DMSO (500 mg by mouth 4 times a day). In 160 fully evaluable patients who were studied for 5 years, allopurinol and DMSO incurred a significant (p less than 0.01) survival advantage over the whole period of study. The similarity in efficacy between allopurinol and DMSO and the fact that the only action they share is scavenging oxyradicals suggest that these radicals mediate the aggressiveness of gastric cancer by producing tissue damage, thus allowing the cancer to spread. Consequently, oxygen-derived free radicals are implicated in the mechanism of gastric cancer, and removing them provides patients with a survival advantage.
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PMID:Oxygen-derived free-radical scavengers prolong survival in gastric cancer. 159 48

This study was carried out to define independent prognostic factors influencing survival time and to examine the survival time of patients with advanced gastric cancer treated by curative resection. Six hundred and forty-eight patients were identified of whom 275 patients died of tumor recurrence during follow-up. Univariate analysis using Mantel-Cox analysis, indicated that tumor size, tumor location, gross appearance, degree of gastric wall invasion, lymph node metastasis and operative procedures were significant factors related to survival time (P less than 0.01 to P less than 0.05). Multivariate analysis using the Cox proportional hazard model adjusted for sex, age and other factors, suggested that tumor size (P less than 0.01, relative risk = 1.79), degree of gastric wall invasion (P less than 0.01, rr = 1.24) and lymph node metastasis (P less than 0.01, rr = 2.39) were the most independent prognostic factors statistically, although these three prognostic factors were inter-related. When the tumor is less than 5 cm and there is no serosal invasion or lymph node metastasis, then a longer survival time can be expected (88.7% at 5-years). If the tumor size exceeds 10 cm and there is invasion into neighboring structures and lymph node metastases, then survival time will be short (11.9% at 4-years).
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PMID:Prediction of survival time after curative surgery for advanced gastric cancer. 160 42

Nuclear DNA contents were comparatively determined by flow cytometry in primary and metastatic lesions from 112 cases with stomach cancer. Aneuploidy frequency and mean DNA index were higher in lymph node metastatic lesions than in primary lesions, both resected synchronously. In these lymph node metastatic lesions, DNA ploidy patterns did not change in 79% (89/112 cases), and did change in 21% (23/112 cases). Concordance of the DNA index between primary lesions and synchronous liver metastatic lesions was seen in 63% (5/8 cases), but the concordance rate was only 25% (4/16 cases) for primary lesions and metachronous liver metastatic lesions and 0% (0/8) for primary lesions and lung metastases. DNA ploidy changes in metastatic lesions were marked in distal metastatic lesions, or more marked in metachronous metastases than in synchronous ones. The results of the present study suggested the possibility of detecting changes in biological characteristics of metastatic lesions by flow cytometric DNA analysis.
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PMID:Comparison of flow cytometric DNA content in primary gastric carcinoma and metastases. 161 37

The accumulating data show that endoscopic ultrasonography (EUS) is highly compatible with the UICC/AJCC staging classification for esophageal and gastric cancer, based on the TNM system expressing anatomical extent of disease. The great strength of EUS in staging these cancers is its ability to image the gut wall and adjacent structures in unique detail. EUS is more accurate than computed tomography in staging the depth of primary tumor invasion (T) and regional lymph node metastases (N). High frequency EUS is not useful in staging for distant metastases (M) due to limited depth of the field. EUS also has limitations in reliably distinguishing between neoplastic and inflammatory tissue. Thus, the major use of EUS is in staging rather than in diagnosis. However, initial reports indicate that EUS may be helpful in the detection of malignancy in Barrett's esophagus, in diagnosing post-operative recurrent cancer, and in evaluating the response to non-operative therapy. EUS appears to represent an important advance in the staging and follow-up of patients with esophageal and gastric cancer. Instruments and techniques will continue to evolve, but the next level of research should be designed to show that the improved staging provided by EUS has clinical utility and can affect patient outcome.
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PMID:Endoscopic ultrasonography in the diagnosis, staging and follow-up of esophageal and gastric cancer. 163 69


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