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

Histology and stage make it possible to predict statistical life expectancy in patients with bronchial carcinoma. These data serve to select the appropriate therapeutic modality which may influence an individual patient's life expectancy and quality. If the tumor is presumably resectable, a search for extrathoracic metastases is conducted by computed tomography and bone scan only if clinically suspected. If ct-scans reveal enlarged and therefore probably malignant mediastinal lymph nodes, curative resection is evaluated by mediastinoscopy. Correlations also exist between stage and spontaneous course as well as the probability of treatment-induced remission and life prolongation in small cell lung cancer.
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PMID:[Clinical staging of bronchial carcinoma]. 253 6

Clinico-diagnostic correlations were studied in 74 patients suffering small cell lung cancer. Metastases to the brain were mostly multiple (66.22%) affecting the posterior cranial fossa (75%), right hemisphere and subtentorial area (34.6%). Diagnosis made by neuro-oncological examination was confirmed in 90.54%, brain scan--77.78, computed tomography--84.91, ophthalmological examination--28.81, EEG--58.18 and emission tomography--80%.
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PMID:[Metastatic brain lesion in small-cell lung cancer]. 253 67

Symptomatic brain metastases are found in about 40% of patients with small cell lung cancer. Cranial irradiation is the first line treatment for this form of metastatic disease. Frequently brain metastases recur after this treatment or develop after prophylactic cranial irradiation. For these patients no effective antitumour therapy is available. In this study the efficacy of high dose etoposide 1.5 g m-2 was evaluated. In 10 (43%) out of 23 evaluable patients a response was seen. Toxicity was severe with five aplasia-related deaths. For palliative purposes this regimen is too toxic in heavily pretreated patients.
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PMID:High dose etoposide for brain metastases of small cell lung cancer. A phase II study. The EORTC Lung Cancer Cooperative Group. 253 74

The records of 610 consecutive patients with small cell lung cancer, treated on a common protocol in a multicentre trial, were reviewed and 24 (4%) cases of spinal cord compression identified. Five hundred patients had isotope bone scans performed at presentation, and in 131 (26%) there was abnormal isotope uptake in the spinal column; only 7% of these patients developed spinal cord compression. However, of the 24 patients who presented with back pain and had a positive bone scan affecting the spine, 36% developed cord compression. Cerebral metastases occurred at some stage in 19.5% of all patients and in 45% of patients with cord compression. The combination of cerebral metastases and a positive bone scan gave a 25% chance of developing spinal cord compression. There were two distinct forms of clinical presentation. Six patients (group A) presented with cord compression: All had back pain and positive bone scans, five out of six had sphincter disturbance, and median survival from cord compression was 30 weeks. Eighteen patients (group B) developed cord compression while on treatment: 28% had positive initial bone scans, 44% back pain and 61% sphincter disturbance, and median survival from cord compression was 4 weeks. Spinal cord compression is an important cause of morbidity and mortality in small cell lung cancer. We suggest that it may be possible to select patients who should receive radiotherapy to the spine to try to prevent the development of this complication.
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PMID:Spinal cord compression in small cell lung cancer: a retrospective study of 610 patients. 254 Jul 90

Small cell carcinoma of the lung (SCCL) is a fulminant disease process with early extrathoracic dissemination. Surgery for cure has generally been abandoned and combined chemotherapy is the treatment of choice. The staging of SCCL is designed to identify areas of involvement for (1) comparison of therapeutic techniques, (2) prognostic determinations, (3) determination of sites of disease to use for assessment of response, and (4) for determination of areas that may require additional local therapy such as radiation or surgery. The staging evaluation, therefore, is designed to evaluate the extent of extrathoracic disease rather than just the presence of chest involvement. CT scanning has made a valuable contribution to the delineation of intrathoracic and metastatic disease and is now included in the staging workup of patients with SCCL since metastatic involvement of the liver, bone, bone marrow, CNS, and adrenal glands is common.
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PMID:Abdominal CT in the staging of small cell carcinoma of the lung. 254 Sep 35

The goal of this study has been to identify and characterize metalloproteinases from a highly metastatic human small cell lung cancer cell line. The cytosol isolated from NCI-H82 lung cancer cells propagated as solid tumors in nude mice contained a gelatinolytic enzyme that was subjected to ammonium sulfate precipitation, zinc chelate Sepharose column chromatography, anion exchange chromatography and gel permeation chromatography. This purification scheme resulted in a 280-fold enrichment of an active gelatin and type IV collagen-degrading enzyme. On gelatin zymography two bands of gelatinolytic activity were detected, corresponding to Mr of 75,000 and 63,000. Gelatinolytic activity was inhibited by metal chelators, tetracyclines, and serum. On immunoblotting using an affinity-purified polyclonal rabbit antibody to a peptide region of type IV collagenase, the tumor enzyme was identified as type IV collagenase. A second tumor metalloproteinase of Mr = 29,000, which degraded proteoglycan substrates, was also isolated.
Invasion Metastasis 1989
PMID:Gelatin-degrading type IV collagenase isolated from human small cell lung cancer. 254 76

Computed Tomography (CT) was employed to evaluate the incidence of brain and adrenal gland metastases in 74 patients (not-small cell lung cancer) staged for surgery. Nine patients presented one or more asymptomatic brain metastases, 4 adenocarcinomas, 3 epidermoid, 2 adenosquamous. In 6 cases adrenal gland masses were found, only one of which was confirmed as a secondary lesion at biopsy. The authors conclude that brain CT is useful in the preoperative staging of lung cancers, independent of the histology of the primary lesion. An accurate assessment of the utility of CT of the adrenal glands requires a larger sample of patients due to the high incidence of benign adrenal gland masses.
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PMID:[CT assessment of encephalic and suprarenal spread of "operable" pulmonary neoplasms. Preliminary results]. 254 39

Histopathologic specimens from 249 patients with small cell lung cancer (SCLC) were reviewed and classified into oat cell-type, pure intermediate cell-type (excluding specimens with mixed small cell/large cell features), and small cell/large cell-type. One hundred seventy (68%) specimens displayed oat cell features (including 30 with mixed oat cell/intermediate cell features), 66 (27%) displayed intermediate cell features, and 13 (5%) displayed mixed small cell/large cell features. No differences among these subtypes were found with respect to stage of disease, sex, age, performance status, and number and distribution of metastases. Complete and partial remission rates for the oat cell-type were, respectively, 31% and 38%, for the intermediate cell-type 20% and 45%, and for the small cell/large cell-type 38% and 31%. Two-year survival rates were 7%, 11%, and 15%, respectively. These data were all statistically insignificant, and comparisons of log-rank analyses of survival curves for these SCLC subtypes also showed no statistically significant differences. We thus conclude that histologic subtypes of SCLC are not distinct entities of clinical relevance, and that prognostic as well as therapeutic decisions cannot be based on histologic subtyping.
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PMID:Clinical relevance of histologic subtyping in small cell lung cancer. 254 96

Eight patients with local Stage II (T2N1) and III (T3N0, T3N1, T2N2) small cell lung cancer received combination chemotherapy prior to elective surgery to assess the effectiveness of such a regimen in improving operability, preventing local relapse and extending survival. The regimen was well tolerated and prevented local relapse. However, the median time to recurrence of disease was 10 months and the median survival time 13 months, results which are similar to those achieved with chemotherapy and radiotherapy. Distant metastases, particularly in the brain, occurred predictably indicating that successful adjuvant surgery, despite preventing local relapse, may not afford additional survival benefit with currently available drug regimens.
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PMID:Chemotherapy plus adjuvant surgery for local small cell lung cancer. 254 64

Small cell lung cancers are neuroendocrine tumours and therefore produce a lot of peptide hormones (calcitonin, ACTH, ADH), as well as the neuropeptide chromogranin A, which are all useful tumour markers. Furthermore, the tumour-associated antigens CEA and TPA, as well as the enzymes neuron specific enolase (NSE) and creatine kinase BB are used as markers in small cell lung cancer. At present, NSE appears to be the best marker for small cell lung cancer; elevated serum NSE levels are found in 65 to 85% of the patients. The serum level of the tumour markers is related to the stage of the tumour. When tumour regression occurs following therapy, elevated pretreatment levels decrease to the normal range. If the marker level increases again, tumour progression is indicated and this can be an early and sensitive sign denoting recurrence. Metastases in the central nervous system can be detected early by marker determination in the cerebrospinal fluid. At present, CEA appears to be the most valuable tumour marker for non-small cell lung cancer, but TPA may also be a useful marker.
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PMID:[Tumor markers in bronchus cancer]. 254 31


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