Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

CA-125, a serum marker of epithelial ovarian cancer, was studied by a radioimmunometric method: the sensitivity and specificity of the assay was studied in 260 patients with non ovarian carcinomas and 120 patients with non malignant diseases. The ideal threshold value has been discussed. Levels higher than 20 UI/ml (cut-off value) have been found in 53% of cases. Sensitivity falls to 25% if the cut-off value is 65 UI/ml. The serum levels correlated well with the existence of a metastatic disease (P less than 0.001). A second assay allowed to study in 163 cases the correlation between the variations of the serum level and the clinical evolution; a good correlation was found except in case of stable disease. High levels have also been found in patients with benign diseases, most of all in cases of pneumonia and severe liver cirrhosis.
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PMID:[CA-125 in non-ovarian benign and malignant pathology: study on 380 patients]. 281 61

The Radiation Therapy Oncology Group conducted a Phase III single blind trial to evaluate the addition of Levamisole to post-operative thoracic irradiation (200 cGy five times weekly to a total of 5000 cGy plus 1000 cGy boost) in patients with resected RTOG Stage II-III non-small cell lung cancer with positive nodes. Between February 1980 and February 1983, 74 patients from 18 RTOG institutions were randomized; accrual to this study was prematurely terminated due to poor accrual and the inferior survival observed in the levamisole-treated patients on another RTOG trial. Sixty-four patients were evaluable; 32 assigned to levamisole and 32 were assigned to placebo. Over 95% of the patients have been followed for a minimum of 4 years or to death. Two patients on placebo and 5 on levamisole experienced Grade 3 pneumonitis or esophagitis; 1 patient on placebo and 2 on levamisole experienced Grade 3 pulmonary fibrosis. Three patients on levamisole experienced other Grade 3 or 4 toxicity: 1 case of intractable nausea and vomiting and 2 with Grade 4 neutropenia (less than 500 per mm3). There were no fatal complications. Median disease-free survival was 13 months in the placebo group and 9 months for the levamisole group. Median time to distant metastases was 18 and 12 months, and median survival was 20 and 13 months, respectively. We concluded that this study failed to demonstrate an advantage for levamisole.
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PMID:Post-operative thoracic irradiation with or without levamisole in non-small cell lung cancer: results of a Radiation Therapy Oncology Group Study. 282 70

We evaluated the effect of radiation therapy in 57 patients with obstruction of a large bronchus with NSCC. Response with aeration of the atelectatic lung was seen in 12 patients (21 percent). Three patients (5 percent) showed partial response with persistent partial atelectasis, and nine patients (16 percent) showed good response with complete aeration of the atelectatic lung. In these patients the response appeared to be related to the dose of radiation. All of the patients who responded received more than 50 Gy. The difference in the response rate related to the dose of radiation was statistically significant (p less than 0.05). The rates were similar with all histologic types of NSCC. Regardless of the clinical response observed, bronchoscopy performed two to four months after completion of radiation therapy in 14 patients revealed persistent endobronchial tumor. There was no significant relationship between the persistence of endobronchial tumor, the dose of radiation therapy, and the tumor's histologic type. Of the 12 patients with radiographic improvement in atelectasis, fibrotic changes developed in four (33 percent) patients and pneumonitis in two (17 percent). Progression of disease with distant metastases occurred in 58 percent (seven) of the 12 patients who showed a clinical response of their bronchial obstruction. The median time to survival was nearly identical in responders and nonresponders.
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PMID:Effect of radiation therapy on bronchial obstruction due to bronchogenic carcinoma. 292 May 87

Detection of aortopulmonary window lymph node enlargement by chest radiography was assessed in 67 patients with bronchogenic carcinoma. All patients underwent computed tomography (CT). Surgical confirmation of the radiographic and CT findings was available in all patients with lymph node size smaller than 2.5 cm in diameter on CT (47 patients) and in 6 of 20 patients with nodes greater than 2.5 cm in diameter. Forty-one had normal-sized and 26 had enlarged (greater than 1.5 cm diameter) aortopulmonary nodes. Lymphadenopathy was detected on the chest radiograph in 21 of the 26 patients with enlarged nodes. It was wrongly suspected in one of the 41 patients with normal-sized aortopulmonary nodes on CT. Three patients with lymphadenopathy had a normal aortopulmonary window on the chest radiograph. In these patients, the nodes measured 1.6-2.6 cm in diameter. In two patients with enlarged nodes and in two with normal-sized nodes, the aortopulmonary window could not be assessed on the radiograph because it was obscured by concomitant atelectasis and obstructive pneumonitis of the left upper lobe. We conclude that in the absence of left upper lobe atelectasis, chest radiography has a high sensitivity (87%) and specificity (97%) in detecting aortopulmonary lymph nodes larger than 1.5 cm in diameter. In only one patient was metastatic disease detected at surgery in a node smaller than 1.5 cm diameter.
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PMID:Accuracy of the plain radiograph in the detection of aortopulmonary lymphadenopathy. 295 83

Mean values for serum angiotensin-I-converting enzyme (SACE), determined spectrophotometrically in 648 subjects, using the synthetic substrate hippuryl-L-histidyl-L-leucine, and expressed in units per milliliter, were: controls, 11.11 +/- 3.97 (n = 89); lung cancer, 6.50 +/- 3.26 (n = 87); tuberculosis of the lung, 8.93 +/- 4.60 (n = 68); pulmonary sarcoidosis, 21.18 +/- 14.93 (n = 48); pneumonia, 9.81 +/- 6.83 (n = 52); fibrosis, 11.18 +/- 8.26 (n = 34); diabetes mellitus, 10.90 +/- 7.51 (n = 29); ischemic heart disease, 8.98 +/- 6.19 (n = 42); pulmonary embolism, 13.20 +/- 3.91 (n = 5); and lymphomas, 11.66 +/- 5.44 (n = 36). The lowest values for SACE (5.92 +/- 1.95) were observed in 7 patients with pulmonary metastases. No relationship could be found between SACE and other laboratory parameters, nor between the enzyme activity in men and women. Evidence suggests that low SACE activity is often associated with extrapulmonary cancers of various organs. Levels were significantly decreased in cancer of the lung and pulmonary metastases and significantly (p less than 0.001) increased in sarcoidosis compared with other diseases, suggesting that SACE activity may be of value in the diagnosis and prognosis of cancer of the lung.
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PMID:The value of angiotensin-I-converting enzyme determinations in malignant and other diseases. 299 Jul 99

The study relates to patients with bronchioloalveolar carcinoma who had undergone operation. On reassessment of histological specimens, 92 patients were considered to have been suffering from bronchioloalveolar carcinoma. Bronchioloalveolar carcinoma was further classified according to histological findings as typical or of mixed type. The latter included cases on which there was differentiation towards pulmonary adenocarcinoma. A third group consisted of 32 cases of peripheral pulmonary adenocarcinoma originally diagnosed as bronchioloalveolar carcinoma. Pulmonary tuberculosis was found to have occurred oftener in bronchioloalveolar carcinoma cases than in mixed bronchioloalveolar cases (p less than 0.005). A history of pneumonia was commoner in mixed bronchioloalveolar and adenocarcinoma patients than in bronchioloalveolar patients (p less than 0.05). Lobectomy or more conservative resection had been possible in the majority of cases. There had been no surgical or hospital mortality. No differences existed between the groups as regards surgical treatment, postoperative radiotherapy or chemotherapy. Local recurrence was commoner in bronchioloalveolar patients than in mixed bronchioloalveolar patients (p less than 0.001) or adenocarcinoma patients (p less than 0.025). Mixed bronchioloalveolar and adenocarcinoma patients had distant metastases oftener than bronchioloalveolar patients (p less than 0.025 and p less than 0.001). Adenocarcinoma patients also had more metastases than mixed bronchioloalveolar patients, but the difference was not statistically significant. Most metastases (82%) were discovered within three years of operation. The incidence of local recurrences increased from three years after operation. The five-year survival rate was 57% in the bronchioloalveolar group, 45% in the mixed bronchioloalveolar group and 17% in the adenocarcinoma group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of surgical treatment in bronchioloalveolar carcinoma. 302 37

One hundred and thirteen patients with early gastric cancer operated on during the period from 1967 to 1982 were followed up until 1985; 24 of them died. The 5- and 10-year cumulative survival rates of 99 patients, excluding 14 (12.4%) who died of diseases unrelated to gastric cancer, were 97.8% and 89.1%, respectively. Of the 24 deaths, seven were due to recurrence of gastric cancer, one to pulmonary metastasis found preoperatively and 16 to diseases unrelated to gastric cancer. Recurrence took the form hepatic metastasis in four cases, bone metastasis in two and recurrence in the gastric remnant in one. The metastases were distant in the majority of cases of recurrence, and recurrence characteristically occurred late, with six patients dying more than 5 years and one dying 10 years after surgery. The recurrences were mostly found in patients with poorly differentiated adenocarcinoma. On the other hand, the causes of death in 16 patients were diseases unrelated to gastric cancer, i.e., primary cancer of other organs in six, operative complications, heart diseases, senility, and pneumonia in two each, and a traffic accident and apoplexy in one each. Thus, Many of the deaths were due to primary cancer of other organs. Four patients underwent non-curative resection. One had lung metastasis found preoperatively and the remaining three had positive margins. The latter three did not undergo a second operation, but the causes of their deaths were not recurrence of gastric cancer. It is necessary to follow up patients from the standpoint not only of recurrence of gastric cancer, but also of diseases other than gastric cancer and multiple gastric cancer in elderly patients.
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PMID:Factors influencing the postoperative course 113 patients with early gastric cancer. 302 77

Two cases of angiosarcoma of the scalp were reported. The patients were elderly men and died from pulmonary complications, including pneumothorax, pulmonary haemorrhage and pneumonia, associated with metastatic tumours in the lungs. The data recorded from 95 autopsies of patients with angiosarcoma in Japan during 1980-1984 were analyzed. According to the anatomical distribution of the primary tumour, the patients could be subdivided into a scalp group and non-scalp group. In both groups, the most common metastatic site was the lung. The patients of the scalp group had more frequent pulmonary complications such as pneumonia, haemothorax, atelectasis and pneumothorax, when compared with the patients of the non-scalp group. In particular, pneumothorax was observed only in the patients of angiosarcoma of the scalp. The results indicate that angiosarcoma of the scalp tends to metastasize to the lung, especially to the subpleural or surface pleural area and these metastatic tumours are prone to necrosis, causing characteristic pulmonary complications.
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PMID:Angiosarcoma of the scalp: report of two cases with fatal pulmonary complications and a review of Japanese autopsy registry data. 312 Apr 5

Transthoracic esophagogastrectomy is a safe operation. Mechanical staplers and a cervical anastomosis have been emphasized to avoid catastrophic consequences of anastomotic leaks in the chest. Transhiatal esophagectomy has been proposed to bring the anastomosis into the neck. It is meant to be a palliative procedure and consequently denies the patient the best chance for surgical cure. The emphasis should be on anastomotic technique and sound principles of surgical oncology. Since 1980, we have performed 104 esophagectomies for carcinoma of the esophagus. We used a left thoracoabdominal incision for distal tumors (64) and the Ivor Lewis technique (40) for more proximal tumors. A two-layer inverting interrupted silk suture technique was used for all anastomoses. More than 90% of the procedures were performed by resident staff. The operative mortality was 2.9% (3 patients). There were no anastomotic leaks. Five patients required between one dilation and three dilations postoperatively. A positive smoking history was present in 83 patients and substantial alcohol use, in 33. Median estimated blood loss was 500 ml, and 60% of patients required no transfusions. Major complications included pneumonia (12 patients) and reexploration for bleeding (2). Minor complications included atelectasis (71 patients), atrial fibrillation (9), ventricular arrhythmias (9), urinary tract infection (3), and wound infection (2). Squamous cancer was present in 31 patients and adenocarcinoma, in 73. Positive lymph node metastases were present in 75%. Anastomotic recurrence was documented in 6 patients. Standard techniques of esophagogastrectomy and a two-layer anastomosis will give excellent results with low mortality and acceptable morbidity.
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PMID:Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. 327 51

Surgical resection of hepatic metastases offers long-term survival, and possible cure, for selected patients with colorectal carcinoma. Fifty percent of patients considered candidates for resection are found to have disease confined to the liver. The resections necessary are often more extensive than predicted preoperatively, which provides an opportunity for innovative approaches using radiation therapy. The intraoperative radiation therapy technique presented here offers the ability to control multiple metastatic deposits in patients not deemed resectable. This is achieved using remote afterloading interstitial (Ir-192) radiation therapy to deliver tumoricidal radiation doses to limited volumes within the liver. The technique was used to treat 11 patients in a pilot study, delivering radiation doses of 20 Gy to the periphery of predetermined target volumes in a single treatment. The number of metastatic deposits treated ranged from 2 to 11 separate tumors with maximum diameters from 3 to 9 cm (median 6 cm). Hospitalizations were from 6 to 23 days (median 8) with only one patient experiencing a surgically related complication (wound dehiscence and pneumonia). There were no radiation related complications on follow-up to 18 months. Biopsies of two treated sites in a patient undergoing reoperation confirmed control of tumors by this procedure. This technique is offered as a standby procedure to patients undergoing exploration for hepatic resection at our institution.
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PMID:Intraoperative radiation therapy of hepatic metastases: technical aspects and report of a pilot study. 336 Jun 45


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