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)

Pancoast-tumor is a rare form of malignant tumor in the superior pulmonary sulcus. In our clinic out of 910 operated bronchial carcinomas 18 were Pancoast-tumors. The clinical findings with tumor of the apical lobe of the lung, shoulder-arm pain, Horner syndrome, rib destruction as well as neurological findings are discussed. The proper treatment consists of radical resection of the affected lobe, cranial thoracic wall and affected nerve tissue. The prognosis depends on the extension and lymph node metastases. Only early diagnosis, radical tumor-resection and postoperative radiation can improve prognosis and survival time.
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PMID:[Pancoast's tumor. Symptoms, diagnosis and therapy]. 90 66

A retrospective study was made of eight patients who underwent operation in the period 1974-1987 because of a Pancoast (pulmonary sulcus) tumour. Of the five patients still alive, three have had no local recurrences for 15, 4 and 2 years, respectively, after the operation. Data from this investigation and from the literature confirm that the absence of metastases in mediastinal lymph nodes, and use of preoperative irradiation may have a favourable effect on the prognosis. The best result is achieved with preoperative irradiation followed by 'en bloc' resection of the affected pulmonary lobe, the tumour-infiltrated chest wall and, if necessary, part of the sympathetic trunk and the plexus brachialis inferior. Emphasis is laid on the importance of early recognition of the tumour in case of aspecific shoulder and arm symptoms.
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PMID:[The surgical treatment of the Pancoast tumor]. 231 5

We reviewed 100 operations performed on 95 consecutive patients with stage II (n = 7) and stage III (n = 88) primary lung cancer. The five-year survival of patients with N1 involvement was 58% and with N2 disease was 21%. Of 13 patients with Pancoast or chest wall involvement, 58% survived five years. The entire group had a 34% five-year survival and a median survival of 32 months. Preoperative and/or postoperative radiotherapy, in the presence of nodal disease, appears to improve local control, but an effective chemotherapy program is needed for unrecognized visceral metastases. In the absence of contraindications, surgical excision offers the best likelihood of survival and quality of life.
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PMID:Primary lung cancer surgery in stage II and stage III. 335 84

Long-term survival after treatment of Pancoast tumors has been limited in most series to those patients without positive lymph nodes or residual tumor. In our series of 18 consecutive patients treated with preoperative irradiation and resection, 14 underwent supplemental postoperative radiotherapy because of positive lymph nodes, tumor at the resection margin, or both. No hospital deaths occurred. Eight patients subsequently died, 6 because of metastatic disease; only 2 deaths were secondary to local recurrence. Ten patients are alive at 6 months to 13 years after resection, and 9 of the 10 have no evidence of tumor recurrence. The overall five-year observed survival (Kaplan-Meier) for the entire series was 56.1 +/- 12.7% (+/- standard error). Although the number of patients is small, the addition of postoperative radiotherapy for those with unfavorable operative findings resulted in long-term survival comparable to that of patients with negative nodes and margins.
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PMID:Pancoast tumors: improved survival with preoperative and postoperative radiotherapy. 380 Apr 79

The authors analyse the results up to death in 103 followed-up patients undergoing unilateral percutaneous cervical cordotomy for persistent cervico-thoracic malignant pain (45 cases of Pancoast syndrome and 58 cases of thoracic pain associated with lung cancer or metastases). On the basis of epidemiological data, relationships emerge between onset of pain, stage of cancer, patient survival and lasting efficacy of pain relief. Twenty (44%) of 45 patients with Pancoast syndrome were pain-free up to death as a result of cordotomy alone, while only 13/58 patients (22%) with thoracic pain were pain-free as a result of cordotomy alone owing to the very high incidence of mirror pain in this group of patients (42/58 patients, 72%) compared to those with Pancoast syndrome (14/45 patients, 31%). The type and intensity of mirror pain, however, were of such a nature in both groups as to be amenable to control with analgesic drugs. In both groups of patients, there was a low incidence of the causes of post-cordotomy pain recurrence contralateral to the lesion, i.e., deafferentation pain, fading of analgesia, and pain above the levels up to which deep pin-prick analgesia had been obtained. Cordotomy alone or, as necessary, in conjunction with analgesic drugs afforded complete pain control in 34/45 patients (75%) with Pancoast syndrome and in 50/58 patients (86%) with thoracic pain. These data provide evidence of the unique usefulness of the procedure in controlling otherwise intractable persistent cervicothoracic malignant pain, when the technique is correctly performed.
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PMID:Results up to death in the treatment of persistent cervico-thoracic (Pancoast) and thoracic malignant pain by unilateral percutaneous cervical cordotomy. 385 85

Apical caps, either unilateral or bilateral, are a common feature of advancing age and are usually the result of subpleural scarring unassociated with other diseases. Pancoast (superior sulcus) tumors are a well recognized cause of unilateral asymmetric apical density. Other lesions arising in the lung, pleura, or extrapleural space may produce unilateral or bilateral apical caps. These include: (1) inflammatory: tuberculosis and extrapleural abscesses extending from the neck; (2) post radiation fibrosis after mantle therapy for Hodgkin disease or supraclavicular radiation in the treatment of breast carcinoma; (3) neoplasm: lymphoma extending from the neck or mediastinum, superior sulcus bronchogenic carcinoma, and metastases; (4) traumatic: extrapleural dissection of blood from a ruptured aorta, fractures of the ribs or spine, or hemorrhage due to subclavian line placement; (5) vascular: coarctation of the aorta with dilated collaterals over the apex, fistula between the subclavian artery and vein; and (6) miscellaneous: mediastinal lipomatosis with subcostal fat extending over the apices.
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PMID:The apical cap. 678 37

A case of Pancoast's syndrome is reported, where subclavian arteriography was the only useful diagnostic procedure to make a diagnosis possible. Utilization and meaning of such a diagnostic technique is discussed, since the typical radiological picture of the syndrome may be lacking, especially in the early stage of the disease. Subclavian arteriography explores th costal-pleuro-vertebral space selectively, being aimed to one of the anatomical structure, the mechanical engagement of which is responsible of the syndrome. Such a technique is advisable even in cases where the Pancoast's syndrome is sustained by an infrequent aetiology, such as metastases.
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PMID:[Subclavian arteriography in Pancoast syndrome. Case report (author's transl)]. 721 53

Fifty-three patients with superior sulcus (Pancoast) tumors of the lung followed for up to 12 years by the Armed Forces Central Medical Registry were divided into three groups. In Group 1, preoperative stagin as determined by bone, brain, and liver scans or combinations thereof and the presence of local nodal extension as determined by mediastinoscopy or scalene fat pad biopsy were negative. These 16 patients received preoperative irradiation followed by en bloc resection of the lung and of the involved chest wall in most of them. Five-year survival as determined by the actuarial method was 49.7%. The 12 patients in Group 2 either had localized nodal involvement or were not diagnosed preoperatively. Survival in this group was 13.1%. Group 3 patients were considered inoperable and were given palliative irradiation. There were 25 patients in this group, and survival was 5.5% at 4 years. It would appear that preoperative irradiation and en bloc resection give improved survival in those patients judged free from metastatic disease preoperatively.
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PMID:Influence of staging in superior sulcus (Pancoast) tumors of the lung. 737 81

There is consensus regarding a pretreatment minimal staging protocol for non-small cell lung cancer. We adopted the new TNM-classification and staging system. For the preoperative mediastinal exploration CT scan (with contrast) and mediastinoscopy are complemental explorations. We avoid to operate on patients with multiple involved mediastinal lymph nodes (N2) or with involved contralateral (N3) or supraclavicular lymph nodes (N3). The final goal is a complete or potentially curative resection including mediastinal lymphadenectomy. The survival of the patient is mainly dependent of the N-status. When N2 disease is unsuspectedly discovered at operation, complete resection with mediastinal lymphadenectomy is performed. The subgroup with the best prognosis is the group with negative mediastinoscopy, lobectomy for central tumor and minimal N2, intracapsular. Multimodal therapy is investigated via multi-institutional trials. Chest wall involvement by lung cancer (T3) does not imply a hopeless prognosis. En-bloc resection of lung and partial chest wall is performed if possible. The 5 year survivors share common features: asymptomatic before operation, non-smokers, no riberosion, squamous cell carcinoma, chest wall resection limited to two ribs and N0-status. For Pancoast-tumors (T3) we follow the Paulson treatment protocol. After the usual staging, the candidates for surgery receive preoperative radiotherapy, followed by complete en-bloc resection, and eventual postoperative radiotherapy in case of incomplete resection. Careful follow-up of all patients operated for lung cancer is necessary, as the incidence of a metachronous lung cancer is as high as 10% for the long survivors. When a second or third primary lung cancer appears, reoperation is the treatment of choice in the absence of metastases or other contraindications. In most cases a complete curative resection is possible. Pulmonary resections have to be complete, but as conservative as possible, eventually with broncho- and angioplasty.
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PMID:Present views of the surgical treatment of non-small cell lung cancer. 789 46

The initial clinical manifestations of lung cancer are diverse and may occur with or without symptoms. Manifestations of pulmonary malignant lesions are produced by local growth or invasion, metastatic disease, or paraneoplastic processes. Patterns of local invasion such as Pancoast's syndrome or the superior vena cava syndrome are relatively uncommon but well recognized. Metastatic lung cancer can involve almost any anatomic area by hematogenous, lymphatic, or, occasionally, interalveolar dissemination. Complications related to malnutrition, infection, electrolyte disturbances, and coexisting diseases influence the initial manifestations. Although individual tumor cell types are associated with characteristic features, no constellation of findings is pathognomonic for a specific histologic variant. Because successful treatment of pulmonary carcinoma depends on early detection, awareness of the typical clinical manifestations is important.
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PMID:Clinical manifestations of lung cancer. 847 71


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