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)

Eighty-one children with a diagnosis of Wilms' tumor who were treated at the Great Ormond Street Hospital for Sick Children between 1960 and 1972 are reviewed. The National Wilms' Tumor Study group staging system is used. Distribution by age and sex in each stage together with survival rate is given. Treatment and prognostic factors are discussed. Wilms' tumor is most common in children below the age of 3 years. There was a survival rate of 87% in Stage I, 36% in Stage II, 8% in Stage III, and 33% in Stage IV. The survival was worse in patients with locally advanced tumor than in patients who had pulmonary metastases in association with a locally resectable tumor. Whole abdominal irradiation is necessary in all patients in whom the tumor has breached the renal capsule. Single agent chemotherapy has not proved effective in preventing relapse in patients with advanced tumors. More intensive therapy is needed in this group to prevent both local recurrence and distant metastases. The addition of multiple drug chemotherapy to nephrectomy and whole abdominal irradiation is already improving the disease-free survival.
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PMID:Prognosis and treatment of Wilms' tumor at Great Ormond Street Hospital for Sick Children--1960-1972. 16 82

Thirty-six patients with nephroblastoma in Stages I, II and III treated at Radiumhemmet between 1966 and 1973, were analysed. The tumors were classified into three different histological types. All 10 patients in Stage III have developed metastases. All patients in Stages I and II (5 out of 26) who developed metastases had poorly differentiated (histological Type III) tumours. The indications for postoperative irradiation and chemotherapy for the different stages and histological types of the tumour are discussed.
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PMID:Considerations on treatment of nephroblastoma. A study of 36 cases. 17 37

An evaluation of single versus multiple therapy utilizing actinomycin D and vincristine to establish optimum therapeutic value on Wilms' tumor was completed in the present study. A Wistar/Furth Wilms' tumor model was treated with four dosage levels of actinomycin D and vincristine in single and multiple courses of treatment immediately after tumor injection. The results observed and analyzed indicated an optimum dose level for each drug and its most effective therapy course. Actinomycin D (at 300 mg/kg) in single or multiple dose was most effective, to an equal degree, in prolonging survival, decreasing the number of metastases, and the weight of the renal primary as well. Vincristine chemotherapy on a low-dose basis was associated chiefly with increased survival only.
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PMID:The effects of chemotherapy on the Wistar-Furth Wilms' Tumor. 17 92

A statistical analysis of 248 histologically proven cases of Wilms' tumor treated at the Institut Gustave-Roussy, Villejuif, France, from 1952 to 1967, is presented. Two years recurrence-free survival and five years survival have been selected as prognostic criteria. Patients under two years of age have significantly fewer metastases and a better five-year survival rate than those over two. Stage is stronly correlated with recurrences and survival. Influence of tumor size, number of tumor nodules, tumor rupture, adhesions, regional lymph node involvement, and renal vein infiltration is shown. Detailed analysis of histopathologic features indicates that a favorable clinical course is significantly related to the number of different varieties of epithelial differentiation (tubular, glomerular, microcystic) found in any tumor, whatever the abundance of each of them. Presence of striated muscular cells, however abundant, does not influence survival or metastatic rates. Cases where irradiation given prior to surgery resulted in complete destruction of tumor cells, form a distinctive group of very unfavorable prognosis. Relapse of tumor occurs in 54% of cases, 10% presenting with metastases. Involved sites are listed. No correlation is found between date of metastases and other parameters. The three major prognostic factors of age, stage, histologic pattern, bear prognostic value separately. Stage and age are linked, as well as histology and age. Stage and histology are not linked. Age in itself therefore seems less important. It is concluded that these well-defining treatment for each individual case.
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PMID:Wilms' tumor: natural history and prognostic factors: a retrospective study of 248 cases treated at the Institut Gustave-Roussy 1952-1967. 17 89

Urothelial spread of Wilms tumor is uncommon and only 5 instances of ureteral metastases have been reported previously. A case of Wilms tumor with mid ureteral metastasis is presented and the literature is reviewed. Clinical implications and suggestions for surgical management are discussed.
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PMID:Ureteral metastasis from Wilms tumor. 17 91

In an unselected series of 49 children with Wilms' tumour treated in 1969-74 the 5-year relapse-free survival and survival rates were 78% and 81%, respectively, whereas in the series of children treated in 1963-68 the corresponding rates were 49% and 70%. The significant improvement in the relapse-free survival rate was a result of adjuvant treatment with actinomycin D and vincristine (AMD + VCR), which, in some patients, eradicated occult metastatic disease. In the treatment of lung metastases the combination of whole-lung irradiation and maintained chemotherapy with AMD + VCR proved excessively toxic: in 5 of 11 patients acute diffuse pneumonitis developed, and it was fatal in 3. Adjuvant AMD + VCR therapy is advocated in all patients with Wilms' tumour except children less than 12 months old with a tumour of moderate size, limited to the kidney and completely resectable.
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PMID:Wilms' tumour: adjuvant treatment with actinomycin D and vincristine. 17 90

In a series of 87 patients with a diagnosis of Wilms' tumour seen at the Great Ormond Street Hospital for Sick Children between 1960 and 1973, 15 patients had pulmonary metastases at the time of diagnosis and a further 22 patients developed pulmonary metastases within 18 months of their initial nephrectomy. The incidence of later development of metastases was very much greater in those patients with locally advanced primary tumours than in those with a completely resectable, encapsulated tumour. In both groups of patients the disease-free survival rate was closely related to initial local tumour staging. In the whole series there were 11/37 (42-5%) patients with pulmonary metastases who survived disease-free for two or more years following treatment. The survival rate was highest in those patients who had a solitary pulmonary metastasis which was surgically resected (5/6); this type of lesion was seen only in those patients who had a localised primary tumour. In those patients with multiple pulmonary metastases, treated with irradiation to the whole lungs and single-agent chemotherapy, there were only 6/31 disease-free survivors; this group of patients all had advanced primary tumours and there was a high incidence of associated abdominal recurrence. The need for multiple agent chemotherapy in conjunctin with surgery and radiotherapy, both as prophylaxis against and in the treatment of metastases from Wilms' tumour is stressed.
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PMID:Pulmonary metastases in Wilms' tumour. 17 47

Wistar-Furth rats and BALB/c mice were implanted with tumor cells from metastases or primaries of an experimental Wilms' tumor or an experimental renal cell adenocarcinoma. The survival time, metastasis formation and growth of the primary tumor after implantation of metastatic tumor cells did not exceed those found after implantation of tumor cells from the tumor primaries. It is concluded that the higher growth rate usually found in metastases is not necessarily due to a selection of metastatic cells with a short cell growth cycle but that there are other environmental factors enhancing the growth of metastases.
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PMID:The growth characteristics of metastases from experimental renal tumors. 18 May 75

A case of Wilms' tumor with extensive bony metastases and involvement of unusual sites such as lacrimal and salivary glands without pulmonary metastases is presented.
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PMID:Wilms' tumor with bony metastases. 18 Jun 14

Whole-lung irradiation in Wilms' Tumor patients has been given prophylactically and for treatment of metastasis. Thirty-three children with Wilm's tumor who have survived for 4 to 20 years from the time of diagnosis were avaiable for study. Whole-lung irradiation was given in doses from 1163 to 1370 rads (orthovoltage). Eighteen patients (Group N) received no irradiation to the lungs. The remaining 15 patients were divided according to whether pulmonary irradiation was given for metastatic disease (Group M--10 patients) or for prophylactic treatment (Group P--five patients). All but five patients in Group N received at least one course of actinomycin D. A routine set of pulmonary function tests was done to assess possible abnormalities of lung volume and the mechanics of breathing. Group N was normal. The findings in Group M suggested moderately reduced lung volumes and may have also reflected obstruction of the large airways and/or a limited expiratory effort. Group P had essentially normal lung volumes but also appeared to have obstruction of the larger airways. Abnormalities were generally not severe; only two patients, in Group M, were symptomatic. Excess irradiation, presence of metastatsis, additional lung irradiation, and pneumonitis may have contributed to morbidity.
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PMID:Pulmonary function in survivors of Wilm's tumor. Patterns of impairment. 18 Nov 23


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