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)

The German Society of Pediatric Oncology in 1981 initiated the Cooperative Ewing's Sarcoma Study (CESS 81) using a four-drug combination of chemotherapy prior to definitive local control with surgery and/or radiation. From January 1, 1981 until February 28, 1985, 93 patients were registered at the trial office from 54 participating institutions in West Germany, Austria, Switzerland, and the Netherlands. On February 1, 1987, 54 of 93 patients were disease-free. Using the Kaplan-Meier life table analysis, the estimated disease-free survival (DFS) rate was 60% at 36 months and 55% at 69 months. The median period of observation was 29 months, ranging from 22 months to 69 months. Twenty-one of 93 patients (23%) had local failure, 18 of 93 patients (19%) developed systemic metastases. The local failure rate was particularly high in patients treated with radiation and was reduced when radiation planning was centralized within the study based upon the extent of disease at diagnosis. Cox regression analysis of prognostic factors showed that tumor volume was a significant factor influencing prognosis. The estimated 3-year DFS rate was 80% for patients with small tumors (volume less than 100 ml) compared to 31% for patients with large tumors (volume greater than or equal to 100 ml). In patients who had surgery for local control, the histologic response to chemotherapy was analyzed on the surgical specimen and had a strong influence on survival: 79% DFS at 3 years for patients with less than 10% viable tumor (good responders) compared to 31% DFS for patients with more than 10% viable tumor (poor responders). Tumor load and responsiveness to chemotherapy are the two major factors influencing prognosis in patients with primary Ewing's sarcoma of bone.
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PMID:Multidisciplinary treatment of primary Ewing's sarcoma of bone. A 6-year experience of a European Cooperative Trial. 333 50

Mammography is currently the most effective method for detecting early breast cancer. In one community hospital during the decade 1974 through 1983, 35% of 415 cases of breast cancer were discovered by xeromammography alone, with a false-positive interpretation rate of 65% and a false-negative rate of 11.1%. Mammography was responsible for detecting an increasing number of smaller cancers with fewer axillary metastases. Such lesions have the most favourable five- and ten-year survival rates. Much lower detection rates of preclinical breast cancer have been reported from other community hospitals.
West J Med 1986 Jan
PMID:Mammographic detection of early breast cancer. Ten years' experience in a community hospital. 395 69

The pathologic findings of 232 consecutive cases of hepatocellular carcinoma (HCC) autopsied during the past ten years at Kurume, Japan, were analyzed from the point of view of global epidemiology, in relation to clinical feature, and in regard to incidence, age, sex, etiologic factors, size of liver, changes in noncancer parenchyma, gross type of tumor, extrahepatic metastases, intravascular and intraductal growths, cancer cell histology, hepatitis B surface antigen (HBsAg) in hepatocytes and cancer cells, liver cell dysplasia, and frequency and clinicopathologic characteristics of minute HCC. Furthermore, postmortem hepatic arteriography and portography were done in 152 livers for comparison with gross anatomy and celiac angiograms. It was found that: (1) epidemiologically, HCC in Japan is distinct from that in the West that it is frequently encapsulated, livers are generally small because of frequent and advanced cirrhosis and small cancer, minute HCC, is not uncommon at autopsy, cirrhosis most commonly associated is the one with thin stroma and medium size nodules, and micronodular cirrhosis is very rare despite frequent alcohol abuse; (2) HCC is increasing in incidence; (3) HBsAg is frequently found in parenchyma; (4) liver cell dysplasia is indirectly related to HBsAg with no evidence for premalignancy; (5) the lung is the most frequent site of metastasis but peritoneal dissemination is unusual; (6) intraportal tumor growth is very common and the hepatic vein is less frequently affected; (7) growth in the major bile duct is frequently associated with intraportal growth and clinically presents as obstructive jaundice; and (8) tumor is supplied solely by arteries and celiac arteriograms are closely correlated with gross pathologic findings.
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PMID:Pathology of hepatocellular carcinoma in Japan. 232 Consecutive cases autopsied in ten years. 629 17

This review analyzes 12,785 cases of pathologically confirmed brain tumors from three published subseries in the People's Republic of China (PRC). No major differences among these series (from different geographical locations) were found. The incidence of glioma was lower in the PRC than in the West, but higher than in Japan; the incidence of meningioma in the PRC was close to that reported from Japan, but lower than that in the West. In the PRC, neurinomas and pituitary adenomas were more frequent than in the West or Japan, and dysembryoplastic tumors seemed to be much more common than in the West or Japan. Metastasis of breast carcinoma to the brain was rare in the PRC. According to a statistical study of 4,059 cases, there were more brain tumors in males than in females (ratio, 1.7:1). Children compose 19% of the series, and elderly patients (over 55 years old) constitute 2.8%.
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PMID:Brain tumors in the People's Republic of China: a statistical review. 705 73

Improved surgical and chemotherapeutic management has ensured that more than half the patients with advanced ovarian cancer will be clinically free of disease shortly after treatment begins. Aggressive cytoreductive surgical treatment and combination cytotoxic chemotherapy have appreciably prolonged survival and have induced cures in some women with metastatic disease. An increasing number of women are being seen with small residual disease at second-look laparotomy, and intraperitoneal administration of chemotherapeutic and immunotherapeutic agents is being investigated for these patients. Specific immunotherapies, including monoclonal antibodies raised against patients' own tumor cells, are also being investigated. During the next five years we may see significant improvement in the cure rate for this disease.
West J Med 1982 Oct
PMID:Recent progress in the treatment of epithelial ovarian malignancy. 717 43

Thirty-five patients with carcinoma of the penis were treated at the teaching hospitals of West Virginia University Medical Center during the last 15 years. All cases were epidermoid carcinoma except for one case of melanoma. Factors adversely affecting prognosis were (1) the presence of clinically palpable lymph nodes, (2) age over 65 at diagnosis, (3) location of the lesion on the shaft of the penis, (4) high stage and poor differentiation of the lesion, (5) primary lesions requiring total penectomy, and (6) proven metastases to lymph nodes.
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PMID:Carcinoma of the penis. 739 99

The relationship between estrogen receptor (RE) content of primary breast cancer and subsequent prognosis was examined with regard to nodal status for patients who presented with operable breast cancer to hospitals in the West of Scotland at least 36 months ago. The majority of patients with primary disease were treated by simple mastectomy and axillary clearance to the level of the axillary vein. The initial study involved 50 patients with functional estrogen RE and, for direct comparison, 50 patients in whom no receptor could be detected in either fraction of the biopsy. It was found that within a particular nodal group, patients with tumors containing fully functional RE experienced a longer disease-free interval than those with RE disease. A previous observation that RE-primary disease gave rise to distant metastases as 1st site of recurrence more often than did RE+ disease was not sustained. The patients with RE+ disease had a much reduced chance of dying from cancer within a 3-year period.
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PMID:Soluble and nuclear oestrogen receptor status in human breast cancer in relation to prognosis. 745 40

A 30-year retrospective review of cases of lung cancer from the Cancer Registry of the University College Hospital (UCH), Ibadan Nigeria was carried out. A total of 142 cases were analyzed with a male:female ratio of 1.7:1. Peak age incidence in females was 2 decades (4th) earlier than for males. Squamous cell carcinoma was found most commonly but adenocarcinoma predominated in females. Mucoepidermoid and adenoidcystic carcinomas were absent. About 27% of patients were under 40 years old and the majority of these (82%) showed the bad prognosis histological variants (i.e. anaplastic carcinoma, adenocarcinoma, small cell tumours and sarcomas). At autopsy the original lymph nodes were founded to be most commonly involved by secondary metastases while the spinal cord was least involved. The epidemiology of malignant lung tumours in Ibadan probably differs from that in the more industrialized countries and this suggests a different view of risk factors for this environment. Additionally there is an urgent need for developing methods for earlier diagnosis if the mortality associated with this disease is to be reduced especially as it occurs predominantly in young people.
West Afr J Med
PMID:Lung cancer at the University College Hospital, Ibadan, Nigeria. 762 34

A body of evidence that vascular-mediated damage occurs in murine tumours after many existing forms of anti-tumour therapy is rapidly accumulating (see Gray Conference Proceedings edited by Moore & West, 1991). Rapid conventional screens of cells in vitro or using leukaemias of lymphomas will not detect this mode of action and such screens will therefore miss effective agents. A change in the approach to experimental cancer therapy is needed to ensure that this important new avenue is fully investigated. Solid tumours will need to be studied and the importance of specific tumour cell biochemistry (e.g. on tissue factor procoagulant activity), of endothelial status and the immunocompetence of the host are all likely to be important. It is a subject of considerable debate at present whether transplanted subcutaneous mouse tumours are adequate models and whether they will reflect the response of spontaneous tumours, or even of transplants into other sites. Xenografts are not likely to be appropriate if the immuno-suppressed hosts lack the cells needed for the cytokine component of the pathway. The strategy of design and screening of new agents, for scheduling of existing agents and particularly the sequencing of adjunctive therapies are likely to be completely different for the "direct" tumor cell or "indirect" vascular-mediated approaches. It may eventually be appropriate to combine vascular manipulation with direct cytotoxicity aimed at malignant cells but the two mechanisms must be recognized as distinct entities and considered separately before attempting to coordinate them. It is important therefore to identify the "hallmarks" of vascular mediated injury and the means by which this can be distinguished from direct cell kill. These may be detectable in the tumour response but clues can also be gained from the side effects that are seen in normal tissues both with existing and with novel therapies (Figure 7). The appeal of vascular-mediated ischaemic therapy is that it is systemic and will have the potential of being effective on any tumour with a newly evoked vascular network, i.e. of about 1 mm in diameter, but it will be even more effective on large tumours than on small. Thus it should affect both large primary tumours and disseminated small metastases. The studies with many different anti-cancer agents have illustrated the potential complexity of responses that can appear to cause tumour cell death by collapse or occlusion of the blood supply. They have also focused attention on features of disparate agents, e.g. TNF, FAA, PDT, which may share similar pathways. No single feature of neovasculature can be highlighted as the sole route by which such antivascular therapy should be targeted. Rapid proliferation of the endothelial cells may prove to be a target, but it also influences differentiation characteristics, so that the immature cells will function abnormally. The permeability of these poorly formed vessels may lead to extravasation of proteins leading to increase interstitial pressures and by this means to an imbalance between intravascular and extravascular pressures and hence to collapse of the thin-walled vessels. Changes in systemic blood pressure, cardiac output, viscosity or coagulation and especially a redistribution of regional perfusion would all have differential effects in tumours and normal vessels. Clearly both vascular patho-physiology and the complexity of endothelial cell function and its imbalance in neovasculature will be important in understanding the mechanism of action of antivascular strategies. This very challenging boundary between oncology and a number of other medical and biological fields promises to lead to altered attitudes to existing therapies and the discovery of completely new classes of anti-cancer agents. The next decade should translate into clinical benefit for patients if the progress in this field continues to be as rapid as it has been in the late eighties. We must now determine what characteristics make one tumour more sensitive than another to agents such as heat, PDT, cytokines and FAA, and learn how to extrapolate from those rodent tumours to the human.
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PMID:Review article: angiogenesis, neovascular proliferation and vascular pathophysiology as targets for cancer therapy. 768 69

I present the only comprehensive review of hepatic abscess from Klebsiella pneumoniae. The world literature contains 46 individually reported cases and 3 large studies of K pneumoniae liver abscess. The source of the abscesses frequently was not found. Diabetes mellitus was a frequent underlying condition and may predispose patients to the development of liver abscess with this organism. The exact mechanism is unclear, and further investigation is necessary. In addition, extrahepatic metastases, such as septic endophthalmitis, often occurred with serious complications, particularly in patients with diabetes. The association between K pneumoniae liver abscess and diabetes is so close that a search for underlying diabetes mellitus is warranted in all patients with K pneumoniae liver abscess. Fortunately, earlier diagnoses and better treatment modalities have improved the outcome for these patients.
West J Med 1995 Mar
PMID:Review of hepatic abscess from Klebsiella pneumoniae. An association with diabetes mellitus and septic endophthalmitis. 772 4


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