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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ovarian carcinoma frequently metastasizes to the peritoneum, both locally in the pelvis and elsewhere. Computed tomography (CT) has a limited ability to identify peritoneal implants with a diameter of 2 cm or less. Three cases of subphrenic, diaphragmatic peritoneal implants, preoperatively at CT thought to represent liver parenchymal metastases, are presented. The difficulty in the differentiation of diaphragmatic peritoneal implants from metastases to the capsule and parenchyma of the liver is discussed. To achieve a radical liver resection in patients with ovarian carcinoma, metastatic peritoneal implants must be excluded during operation.
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PMID:Peritoneal ovarian metastases simulating liver parenchymal metastases. 161 10

Ovarian carcinoma metastatic to the breast is uncommon. We report a rare occurrence of ovarian carcinoma that initially presented as a breast mass. Complete examination revealed bilateral ovarian tumors with widespread peritoneal and abdominal disease. One of the ovarian tumors was a papillary serous tumor of low malignant potential, and the other was a well-differentiated papillary serous carcinoma. Although the neoplasm within the breast resembled serous ovarian carcinoma with psammoma bodies, the initial presentation and the presence of an apparent intraductal component created a potential for its misdiagnosis as a primary breast carcinoma. Using DNA flow cytometry, we demonstrated the relationship between the breast, lymph node, and peritoneal metastases and the serous carcinoma, thereby supporting the histologic diagnoses.
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PMID:Well-differentiated serous ovarian carcinoma presenting as a breast mass: a case report and flow cytometric DNA study. 200 37

Based on material from two clinical trials performed by The Netherlands Joint Study Group for Ovarian Cancer, we constructed a prognostic index (PI) with considerable predictive power for long-term survival of patients treated with cytotoxic combination chemotherapy including cisplatin. The pretreatment characteristics needed for the calculation of the PI are the Karnofsky index, the site of metastases expressed as the International Federation of Gynecology and Obstetrics (FIGO) stage, the size of residual tumor, the Broders' grade, and the presence of ascites. In the subgroup comprising the 10% of the patients with the best prognosis, 4-year survival was 75%, whereas all of the patients in the subgroup comprising the 10% with the poorest prognosis died within 4 years, which illustrates the large variability of the prognosis among patients. The PI was found to retain its value after response was achieved. The information provided by the PI can be expected to be useful in treatment planning and for proper stratification of patients in clinical trials.
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PMID:Predictability of the survival of patients with advanced ovarian cancer. 265 32

Interdisciplinary protocols for management of advanced adenocarcinoma of the ovary have resulted in prolonged patient survival. A subset of patients is emerging in whom central nervous system (CNS) relapse occurs even following negative second-look procedures (SLP). Seven of 342 eligible patients entered in a National Cancer Institute of Canada Trial for Ovarian Cancer, from February 1, 1980 to March 31, 1984, had CNS relapse. All patients received adriamycin and cisplatin. SLP was performed in 5 patients, 3 of whom were complete responders (CR). Two additional patients failed to complete their chemotherapy and had progressive pelvic disease. The median age of these 7 patients was 57 years, their overall survival time was 28 months, compared with an average age of 58 years and survival of 21.6 months, for the entire group. Two patients had prolonged survival after their CNS relapse; 1 patient lived 26 months, and the other, who underwent craniotomy for primary management of the metastasis survived 18 months. Confirmation of metastatic disease was obtained in 4 of the 7 patients. The results of this study suggest that management of CNS involvement in adenocarcinoma of the ovary should be determined by overall performance status even in the presence of generalized disease.
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PMID:Advanced carcinoma of the ovary with central nervous system relapse. 313 78

Ovarian carcinoma is the only female genital malignancy surgically staged. Appropriate preoperative roentgenographic, isotopic, and endoscopic studies can help define the spread of disease and the extent of surgery required. At surgery, the common sites of metastases--pelvic and para-aortic lymph nodes, diaphragm, serosal surfaces and omentum--should be examined and biopsied or excised. Total hysterectomy, bilateral salpingo-oophorectomy, and appendectomy should also be performed in patients with epithelial ovarian tumors. Evidence suggests that patients who have had optimal cytoreduction of the tumor (less than 1.5 cm) have a better outcome following chemotherapy. Patients who have no clinical or CT evidence of disease after a full course of chemotherapy should be explored to confirm disease status. Peritoneoscopy can be used as an interval procedure to assess response to treatment.
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PMID:Staging and surgical evaluation of ovarian cancer. 638 56

Therefore, on discovery of a clinical Stage I or II ovarian carcinoma through a previously made subumbilical incision, the incision should be extended above the umbilicus to enable one to inspect the diaphragm and remove the omentum from the transverse colon. Biopsy of any raised lesion of the diaphragm can easily be done with laparoscopic biopsy forceps and is associated with minimal morbidity. Routine biopsy of a normal appearing diaphragm is not advocated. Pelvic and paracolic washings for cytological evaluation for malignant cells are obtained by instilling 100-200 cm3 of saline into the pelvis and a similar amount into the right and left paracolic spaces, respectively, and aspirating the fluid for cytological evaluation. Most women with ovarian cancers are still primarily operated on by gynaecologists who are not trained in para-aortic and pelvic lymph node sampling. Ideally, however, women with clinical Stage I or II ovarian cancers should have biopsy of any palpable para-aortic or pelvic lymph node. Such careful surgical staging will: define those patients who are apt to truly have Stage I or II ovarian cancer; improve and refine adjuvant therapy for Stage I and II ovarian cancer; and allow for adjuvant therapy for patients found to have Stage III ovarian cancer, discovered at the time of surgical staging for presumed localized ovarian cancer. The significance of the latter is seen in Table 10 and in the fact that with the subsequent increase to 61 patients evaluated by the Ovarian Cancer Study Group, the incidence of occult metastases from Stage I and II ovarian cancer remain strikingly unchanged (Young et al, 1983, unpublished observations).
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PMID:Importance of proper staging in ovarian carcinoma. 661 38

Ovarian carcinoma can arise synchronously from multiple independent sites and metastasize widely. Therefore, it is frequently unclear whether bilateral tumors represent two independent primaries or one primary and a metastasis. We have used X chromosome inactivation of the androgen receptor gene and microsatellite instability at four chromosomal loci to evaluate the clonal origin of 39 bilateral ovarian carcinomas. An identical monoclonal pattern was found bilaterally in all cases including 10 stage I bilateral ovarian carcinomas. Microsatellite alterations were identified in three cases, and in all three, identical alterations were present in tumor tissue from both ovaries. These results suggest that bilateral ovarian carcinomas evolve as unifocal neoplasias and that metastatic dissemination can occur early in the course of the disease.
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PMID:X chromosome inactivation and microsatellite instability in early and advanced bilateral ovarian carcinomas. 758 7

Ovarian carcinoma multicellular spheroids are an in vitro model of micrometastasis whose adhesive abilities have not been elucidated. In this study, we identified adhesion molecules that mediate the formation of ovarian carcinoma spheroids and their subsequent adhesion to extracellular matrix proteins. The NIH:OVCAR5, but not the SKOV3, ovarian carcinoma cell line formed spheroids similar to multicellular aggregates isolated from patient ascitic fluid. NIH:OVCAR5 spheroid formation was augmented by a beta 1-integrin-stimulating monoclonal antibody or exogenous fibronectin, but was inhibited by blocking monoclonal antibodies against the alpha 5- or beta 1-integrin subunits. By immunohistochemical staining, alpha 2-, alpha 3-, alpha 5-, alpha 6-, and beta 1-integrin subunits, CD44, and fibronectin were detected in NIH:OVCAR5 spheroids. NIH:OVCAR5 spheroids adhered to fibronectin, laminin, and type IV collagen, and this adhesion was partially inhibited by blocking antibodies against the alpha 5-, alpha 6-, and alpha 2-integrin subunits, respectively. A blocking monoclonal antibody against the beta 1-integrin subunit completely inhibited adhesion of the spheroids to all three proteins. These results suggest that interactions between the alpha 5 beta 1-integrin and fibronectin mediate the formation of ovarian carcinoma spheroids and that their adhesion to extracellular matrix proteins at sites of secondary tumor growth may be mediated by a complex interaction between multiple integrins and their ligands.
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PMID:Beta 1-integrins regulate the formation and adhesion of ovarian carcinoma multicellular spheroids. 1173 57

Ovarian carcinoma is the worst gynecologic cancer due to an advanced stage at diagnosis in two thirds of the cases. Advanced stages are usually characterized by a large tumor burden on the ovaries as well as metastatic disease in the peritoneal cavity. Early stages are more common in young women and the surgical treatment should comprise the tumor excision and a comprehensive abdominal staging to be sure that there is no extension beyond the ovaries--unilateral oophorectomy can preserve the fertility before childbearing. No treatment is needed after surgery in stage I without poor prognostic factors. Adjuvant chemotherapy should be applied postoperatively in the other cases. The best likelihood of prolonged survival is observed after optimal debulking surgery and chemotherapy in advanced stages. If possible surgery should be performed at first but in most advanced stage with large tumor volume in the upper abdomen according to clinical and CT-scan examination, the concept of chemosurgical debulking should be considered. Interval surgery underwent after three or four courses of front line chemotherapy but this strategy should be further evaluated by clinical trials. Currently paraplatin associated with paclitaxel is the most commonly used regimen due to its effectiveness and lower toxicity. In a near future progress can be expected with new protocols. Thank to aggressive surgery and chemotherapy many patients should be able to reach a complete remission of their disease but most of them will still die of recurrent disease. At this point, two questions should be answered: 1) how to manage the residual abdominal disease in order to prevent the recurrence. No consolidation treatment demonstrated any superiority but the French experience and trial with high dose chemotherapy supported by autologous stem cells transplantation showed recently positive results? 2) How to manage the recurrent disease with sometime indication for secondary surgical debulking and always chemotherapy? This is the field for testing new drugs or new strategies. A large number of patients should enter clinical trials in order to answer these questions and due to the very poor prognosis of this disease large attention should be given to the quality of life of theses patients.
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PMID:[Management of ovarian cancer]. 1179 75

Ovarian carcinoma is the leading cause of gynecological cancer deaths in the United States. Secondary tumor growths form by tumor cell invasion through the mesothelial lining of the peritoneal cavity and peritoneal organs. To study this interaction, we developed a dye-based in vitro model system in which mesothelial cells were grown as confluent monolayers, permeabilized, and then co-cultured with ovarian carcinoma cells for up to seven days. The mesothelial cells were then stained with trypan blue dye, which enabled the visualization of ovarian carcinoma cell invasion through the monolayers of mesothelial cells. Ovarian carcinoma cell invasion was inhibited for up to 7 days by the addition of GRGDSP peptides, a blocking monoclonal antibody against the beta1 integrin subunit, or blocking monoclonal antibodies against matrix metalloproteinases 2 and 9. Cell invasion was also inhibited by hyaluronan and GM6001, a chemical inhibitor of matrix metalloproteinases. Differential gene expression of matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases, and disintegrins were observed in primary ovarian carcinoma tumors and secondary metastases, compared to normal ovaries. Taken together, these results suggest that complex interactions between integrins, disintegrins, matrix metalloproteinases, and tissue inhibitors of matrix metalloproteinases may mediate ovarian carcinoma cell invasion, and that the dye-based assay described herein is a suitable model system for its study.
Clin Exp Metastasis 2003
PMID:Establishment of an in vitro assay to measure the invasion of ovarian carcinoma cells through mesothelial cell monolayers. 1285 22


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