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)

A multifactorial analysis of 200 cutaneous melanoma patients with distant metastasis (stage III) was performed on 13 clinical and pathological factors using the Cox regression analysis. There were only three dominant prognostic variables that independently predicted the patient's clinical course: (1) number of metastatic sites (1 vs. 2 vs. greater than or equal to 3, p less than 0.00001), (2) remission duration (less than 12 mo vs. greater than or equal to 12 mo, p = 0.0186), and (3) the location of the metastases (visceral vs. nonvisceral vs. combined, p = 0.0192). Factors that were not significant in the multifactorial analysis included the patients' age and sex, the site of the primary melanoma, the sequence of metastases, and all histopathological features of the primary melanoma (thickness, level of invasion, ulceration, growth pattern, pigmentation, and lymphocyte infiltration). For a single metastatic site, the 1-yr survival rate was 36%, while it was only 13% for 2 sites, and 0% for greater than or equal to 3 sites (p less than 0.00001). The 1-yr survival for patients was 40% for nonvisceral sites (skin, subcutaneous, distant lymph nodes) compared to only 11% for visceral metastases and 8% for combined sites (p less than 0.00001). Pulmonary metastases were associated with a significantly higher survival rate than metastatic melanoma in any other visceral site. The most common first site of distant metastases (either alone or in combination) was skin (38%), lung (36%), liver (20%), and brain (20%). The skin, subcutaneous and distant lymph node group was the first site of metastases in 59% of patients. This finding emphasizes the importance of careful physical exams in routine metastatic evaluations. Only a minority (25%) of stage I patients progressed to stage III disease after a median interval of 2.8 years. In contrast, the majority (75%) of melanoma patients with nodal metastases (stage II) progressed to stage III disease after a median duration of only 11 mo. Of the patients who eventually developed stage III disease, 95% of those who initially presented with stage II disease progressed within 3 yr, while stage I patients who progressed to stage III did not reach a 95% cumulative incidence until 8 yr.
 ...
PMID:A multifactorial analysis of melanoma. IV. Prognostic factors in 200 melanoma patients with distant metastases (stage III). 666 96

Between 1976 and 1980, 136 patients were evaluated for primary treatment of cutaneous melanoma. Forty-nine lesions were invasive to Clark's Level II (38 patients) or III (11 patients) with a thickness of 0.3 to 1.2 mm. Conservative re-excision was advised as definitive therapy for these patients. The margin of resection was defined as the maximum excision that would allow primary closure of the wound. Pathology reports of the re-excised specimens revealed the narrowest margins to be 0.7 to 4 cm. Unexpected residual tumor was present in 2 specimens and melanocytic hyperplasia in 12 specimens. After a follow-up period of 2.5 to 7.0 years, there have been no local recurrences. One patient developed regional lymph node metastases 16 months and, then central nervous system (CNS) metastases 25 months after primary treatment. A second patient died with pulmonary metastases 4.5 years after initial therapy. Melanomas that are not deeply invasive do not require wide excision and skin grafting for local control. Occasionally these thin lesions do produce systemic metastases, emphasizing the need for long-term follow-up of even "low-risk" patients.
 ...
PMID:Conservative surgical management of superficially invasive cutaneous melanoma. 669 15

The authors present a case of secondary melanoma of the gallbladder, surgically discovered during a laparotomy for assumed biliary tract pathology. The primary tumor was a cutaneous melanoma at the right leg treated by surgery, four years before. At the laparotomy, the pancreas and the omentum contained also metastases. After cholecystectomy the cancerous evolution quickened and led to death after one year. The exceptional character of this observation lead the authors to review the literature.
 ...
PMID:[Malignant melanoma of the gallbladder]. 671 Dec 34

Cutaneous malignant melanoma has traditionally been treated by "wide" local excision with a 5-cm margin of normal skin about the tumor. The rationale of wide excision for melanoma has never been clearly defined, but the procedure is known to be effective in preventing local recurrence. We studied 105 patients who had 109 primary melanomas in 1977 and related margin width of the definitive excision to the presence of satellites, to the subsequent development of local recurrence and in-transit metastases, and to survival. Survival was not dependent on margin width, and there were no incidences of local recurrence. Satellitosis and in-transit cutaneous metastasis indicate that a melanoma is capable of local recurrence; these phenomena occurred only in tumors whose thickness (Breslow) was greater than 2.0 mm. These data provide a rationale for wide excision of "thick" melanomas and support more modest local therapy for thin cutaneous melanoma.
 ...
PMID:Optimal resection margin for cutaneous malignant melanoma. 684 24

Lymphoscintigrams were performed using technetium-99m antimony sulfur colloid in 21 patients with cutaneous malignant melanoma. Scintigraphic results were concordant with clinical prediction of lymph drainage in six of 11 patients with trunk melanoma, in five of seven patients with extremity lesions, and in none of three patients with scalp melanoma. Thirteen patients showed activity in more than one regional node group. Eleven patients had focal activity in areas other than regional node groups (i.e., in-transit or central lymph nodes). Lymphadenectomy was performed in 19 patients. In each case, the regional lymph node area chosen for resection was positive scintigraphically. The presence of 99mTc activity in excised lymph nodes was documented by scintillation counting and autoradiography. Metastatic disease was found in the resected nodes of 12 patients. Lymphoscintigraphy may be useful in planning lymphadenectomy in some patients with cutaneous melanoma.
 ...
PMID:Lymphoscintigraphy in malignant melanoma: 99mTc antimony sulfur colloid. 697 83

To our knowledge, only nine cases of retinal metastases from a primary cutaneous melanoma have been reported in the literature. A 44-year-old man had bilateral retinal metastases and choroidal metastasis documented clinically with color photography and fluorescein angiography. When ocular metastases occur, they usually are preceded by a known diagnosis of the skin lesion, usually of the superficial spreading type, with dermal invasion and widespread visceral and CNS involvement.
 ...
PMID:Bilateral retinal metastases from cutaneous malignant melanoma. 707 75

This report is an analysis of 63 cases of metastatic cancers to the uterine corpus from extragenital neoplasms. The patients' ages ranged from 34-88 years (mean, 59.7 years). Twenty lesions were discovered in surgical specimens and 43 were detected at autopsy. The primary tumors arose in the breast (42.9%), colon (17.5%), stomach (11.1%), pancreas (11.1%), gallbladder (4.8%), lung (4.8%), cutaneous melanoma (3.2%), urinary bladder (3.2%), and thyroid (1.6%). In five (25%) of the surgical cases, uterine metastases were the first indication of the presence of an extragenital primary cancer. Metastases to leiomyomas were found in 13 instances. The myometrium was more often involved than the endometrium, but endometrial curettings contained the metastatic tumor in numerous cases. Metastases to the ovaries were detected in almost two thirds of cases. Although an infrequent event, abnormal uterine bleeding may result from secondary spread to the uterine corpus from an extragenital primary neoplasm.
 ...
PMID:Metastases to the uterine corpus from extragenital cancers. A clinicopathologic study of 63 cases. 712 56

Twelve prognostic features of melanoma were examined in a series of 185 patients with nodal metastases (Stage II), who underwent surgical treatment at our institution during the past 20 years. Forty-four per cent of the patients presented with synchronous nodal metastases (substage IIA), 44% of the patients had delayed nodal metastases (substage IIB), and 12% of the patients had nodal metastases from an unknown primary site (substage IIC). The patients with IIB (delayed) metastases had a better overall survival rate than patients with IIA (synchronous) metastases, when calculated from the time of diagnosis. These differences could be explained on the basis of tumor burden at the time of initial diagnosis (microscopic for IIB patients versus macroscopic for IIA patients). Once nodal metastases became evident in IIB patients, their survival rates were the same as for substage IIA patients, when calculated from the onset of nodal metastases. The survival rates for both subgroups was 28% at five years and 15% for ten years. Substage IIC patients (unknown 1 degrees site) had better five-year survival rates (39%), but the sample size was small and the differences were not statistically significant. A multifactorial analysis was used to identify the dominant prognostic variables from among 12 clinical and pathologic parameters. Only two factors were found to independently influence survival rates: 1) the number of metastatic nodes (p = 0.005), and the presence or absence of ulceration (p = 0.0019). Additional factors considered that had either indirect or no influence on survival rates (p > 0.10) were: anatomic location, age, sex, remission duration, substage of disease, tumor thickness, level of invasion, pigmentation, and lymphocyte infiltration. All combinations of nodal metastases were analyzed from survival differences. The combination that showed the greatest differences was one versus two to four versus more than four nodes. Their five-year survival rates were 58%, 27% and 10%, respectively (p < 0.001). Ulceration of the primary cutaneous melanoma was associated with a <15% five-year survival rate, while nonulcerative melanomas had a 30% five-year survival rate (p < 0.001). The combination of ulceration and multiple metastatic nodes had a profound adverse effect on survival rates. While tumor thickness was the most important factor in predicting the risk of nodal metastases in Stage I patients (p < 10(-8)), it had no predictive value on the patient's clinical course once nodal metastases had occurred (p = 0.507). The number of metastatic nodes and the presence of ulceration are important factors to account for when comparing surgical results, and when analyzing the efficacy of adjunctive systemic treatments.
 ...
PMID:A multifactorial analysis of melanoma: III. Prognostic factors in melanoma patients with lymph node metastases (stage II). 721

Using auto-radiographic techniques in vitro studies performed to analyse the growth rate in 13 cases of neuroblastoma, 6 recurrent tumours (assorted) and 7 metastatic tumours. The cell kinetic parameters using 3H thymidine markers, DNS synthesis, mitotic rate and mean cycle rate were investigated. The growth rate can only be calculated approximately. The results show that neuroblastomas grow incredibly fast. The cell-cycle period varies between 13.1 and 266.3 hours and averages 71 hours. Recurrent tumours have a tendency to have the same growth rate as the primary tumour. Primary metastases of Wilm's tumours and osteogenic sarcomas proliferate rapidly with a cell-cycle of 13.0- 87.0 hours (average 37.7 hours). All tumours have a distinctly individual proliferation pattern. Cell division and growth rate of malignant tumours are important in relation to radiotherapy and the use of cytotoxic drugs. These factors are expressed as a "cell-kinetic therapeutic index", which helps to predict the effectiveness of cytotoxic drugs and radiotherapy. Two cases of neuroblastoma were classified as resistant. Most tumours excluding the fibrosarcomas react well against two cytotoxic reagents. The cell-kinetic pattern and the sensitivity results are used in determining the treatment of recurrences and metastases. The relationship of these investigations in clinical practice is discussed.
 ...
PMID:[The role of cell proliferation kinetics and cytostatica - test for sensitivity of neuroblastomas, recurrent tumours and tumour metastases (author's transl)]. 728 79

Clinical and clinico-pathoanatomical comparisons (60 observations) have shown that in patients with primary cutaneous melanoma and its metastases treated by modern methods the tumour metastasis to the brain occurs in late periods of the disease at the stage of the neoplastic process generalization. Histological examinations of the melanoma metastases of various localization revealed a much lesser differentiation of the tumour cells and a greater vascularization of the tumour. The pronounced vascularization is characteristic for metastases of any localization, both visceral and cerebral, at the stage of the process generalization.
 ...
PMID:[Metastatic melanoma of the brain]. 729 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>