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

Patients after operative and/or radiological therapy for cervical cancer should have gynecological follow-up examinations every two months in the first year. In cases of urological complications after irradiation therapy, radionephrography, infusion urogram, blood count, cystoscopy, and cystometry should also be carried out after two months. Depending on the clinical picture, radionephrography, blood count and urinalysis are to be repeated in regular intervals. After lymphography with positive findings, x-ray controls are necessary after two and four months. In cases of increasing hydronephrosis and hydroureter due to fibrostenosis of the ureter plastic surgery is recommended. Most urological complications are to be expected after radical operation and postoperative irradiation. In patients with endometrial uterine cancer, metastases mostly occur paraurethrally and in the lungs. Chest x-ray is to be taken every six months. Suspicious paraurethral hardening is cytologically diagnosed by needle biopsy. In ovarian carcinoma stage III and IV repeated x-ray controls of the lungs during longterm polychemotherapy are advisable. Prior to second look operations after combined treatment a second look laparoscopy is particularly important. Urological complications are more frequent after therapy of cervical cancer while ovarian carcinoma is more likely to develop complications of the small bowel.
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PMID:[Clinical and urological after care in gynecologic neoplasms]. 21 74

Eighty-six patients with pelvic malignancies had paraaortic node dissection; 30% had positive paraaortic lymph nodes. At the time of laparotomy, 77 patients had malignancies apparently confined to the pelvis after extensive work-up and histologic examination of tissue biopsies outside the pelvis; 20 (26%) had metastatic cancer in the paraaortic lymph nodes. Thirteen of 49 patients with cancer of the cervix, 5 of 18 with uterine cancer, and 2 of 10 with ovarian cancer had positive paraaortic lymph nodes. The value of paraaortic dissection in patients with pelvic malignancies apparently confined to the pelvis is discussed.
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PMID:Paraaortic lymphadenectomy in gynecologic malignancies confined to the pelvis. 90 4

We retrospectively analyzed 216 previously untreated patients with cervical cancer treated by high dose-rate intracavitary irradiation between 1978 and 1986. Cumulative 5-year survivals in stage Ib, IIa, IIb, IIIa, IIIb and IVa were 72.3%, 88.9%, 68.9%, 75.0%, 64.0% and 16.7%, respectively. Cause-specific 5-year survivals in stage Ib, IIa, IIb, IIIa, IIIb and IVa were 93.3%, 88.9%, 74.7%, 75.0%, 68.9%, and 18.8%, respectively. Recurrences outside the pelvis in stage IIb and IIIb (14.9% and 24.0%) were more common than loco-regional recurrences (10.3% and 12.0%). However, loco-regional recurrences (50%) were most frequent in stage IVa. Thirteen patients (6.0%) required surgical management for intestinal complications (severe). Six patients (2.7%) died due to intestinal complications (fatal). These fatal and severe complications were closely correlated with the dose of external radiation. These data suggest that intracavitary irradiation using a high dose-rate system is useful for the treatment of uterine cancer; however, further efforts to reduce intestinal complications by lowering the dose of external radiation will be necessary. It is also suggested that a combined modality, such as chemotherapy, is necessary for controlling metastases outside the pelvis in stage IIb and IIIb, and for local control in stage IVa.
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PMID:[Results of radiation therapy for squamous cell carcinoma of the uterine cervix using high dose-rate intracavitary irradiation]. 154 49

The correlation between histological ovarian metastasis and histologic cell type, clinical stage, depth of invasion, lymph node metastasis, and menstrual activity were analyzed in 566 patients who underwent surgery for uterine cancer at the hospital of Niigata University between January, 1971 and May, 1990. Ovarian metastasis was studied in 456 patients with stage Ib or more advanced cervical cancer and 110 patients with stage Ia or more advanced endometrial cancer. The following results were obtained: 1. The incidence of ovarian metastasis of cervical cancer by histologic cell type was 18.6% (8/43) for adenocarcinoma, 6.7% (1/15) for mixed type adenocarcinoma and squamous cell carcinoma, and 0% (0/398) for squamous cell carcinoma. The metastasis rate in patients with endometrial carcinoma was 10.8% (10/93) for adenocarcinoma, but there was no metastasis of 2 squamous cell carcinoma, 13 mixed type of adenocarcinoma and squamous cell carcinoma or 2 undifferentiated carcinoma. 2. The incidence of metastasis of cervical adenocarcinoma by stage was 5.3% (1/19) for stage Ib and 29.2% (7/24) for stage II. The metastasis rate of mixed type of adenocarcinoma and squamous cell carcinoma was 0% (0/6) for stage Ib and 11.1% (1/9) for stage II. The incidence of metastasis of endometrial carcinoma was 2.1% (1/47) for stage Ia, 15.0% (3/20) for stage Ib, 15.0% (6/40) for stage II and 0% (0/3) for stage III. 3. All the patients with ovarian metastases of uterine cervical cancer had invasion to a depth of more than 2/3 of the uterine cervix, while the incidence of ovarian metastasis of endometrial carcinoma was increased with deep invasion of the uterine muscular layer, and metastasis was present even in shallow invasion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The study of ovarian metastasis in uterine cancer]. 160 54

Thirty-three bronchial carcinoid tumours operated on in a 22-year period are reviewed. They were histologically verified as typical carcinoids with Grimelius' argryophilic staining (25 cases), electron microscopy (6) and immunostaining for synaptophysin (4). Nineteen were endobronchial and 14 peripheral, intraparenchymal tumours. Lymph-node metastases were present at operation in two patients. Two tumours, in patients with Cushing's syndrome, were hormonally active (one secreting ACTH and the other ACTH and calcitonin). There was one case of multiple endocrine neoplasia syndrome, but none of carcinoid syndrome. During follow-up for 5-18 (mean 8.2) years five patients died of unrelated causes. Only one patient showed distant metastasis (after 15 years in salivary gland and a year later in mediastinal fat). Extensive clinical re-examination was performed on 20 patients, and six others were interviewed. All were well but one, who died of uterine cancer 8 weeks later. Typical bronchial carcinoid is concluded to be of low-grade malignancy and suitable for limited pulmonary resection.
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PMID:Bronchial carcinoid: a clinical follow-up study of 33 cases. 166 42

99mTc-methylene diphosphonate (99mTc-MDP) bone scans in 80 patients, 30-80 years old (average, 62 years old) with uterine cancer who received high doses of radiation (10-60 Gy; average, 46 Gy) were reviewed retrospectively to evaluate the frequency of pelvic insufficiency fractures caused by radiotherapy and to study the appearance of the fractures on bone scans. Bone scans in 29 of 80 patients showed abnormalities in the pelvis: insufficiency fractures were identified in 27 patients (34%) and osseous metastases were found in two patients (3%). The fractures and metastases were diagnosed by CT and were confirmed by observing the patients' clinical courses. Fractures were identified in 27 (39%) of 69 postmenopausal women and in none of 11 premenopausal patients (p greater than .05). Fractures were found in 21 (84%) of 25 patients who had pelvic pain and in six (11%) of 55 patients who were asymptomatic (p greater than .001). Scintigrams in patients with fractures showed more than one fracture in most patients (85%), and fractures were often symmetric (67%). Scintigrams in two patients with osseous metastases showed increased activity in an iliac wing that was outside the radiation field. Our results suggest that a marked increase in insufficiency fractures occurs after radiation therapy, especially in postmenopausal patients. A symmetric area of increased uptake of radionuclide is a characteristic scintigraphic appearance of an insufficiency fracture.
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PMID:Radiation-induced insufficiency fractures of the pelvis: evaluation with 99mTc-methylene diphosphonate scintigraphy. 173 2

Cancer is the second cause of mortality in Chile: 12,000 deaths and 27,000 admissions were registered during 1982. Gastric and pulmonary cancer account for the highest mortality rates (23.2 and 9.7/100,000). Cancer prognosis has improved in thyroid, uterus and testes cancers, melanoma, Hodgkin's Disease etc, with 67 to 92% 5-year survival rates, while results are not as good in lung, gastric, colorectal, kidney, pancreas, etc, with only 3 to 52% 5-year survival rates. Treatment failure is attributed to cellular mutations and early metastases. At present, surgery is less aggressive and is associated to radiotherapy and chemotherapy; megavoltage radiation equipment and the use of radiosensitizers allow double radiation dose; chemotherapy complications are avoided with hematopoietic growth factors. It is possible to improve the prognosis of lung cancer avoiding the use of tobacco and of colorectal cancer reducing fats in the diet of these pts. Early detection and better chemotherapy have improved the prognosis of breast and uterus cancer. With these measures a 20 to 50% reduction in cancer rates is expected in the USA for the year 2000. Their application is urgent in our country.
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PMID:[Present status of cancer treatment]. 184 13

In summary, neither radiation nor surgery is clearly superior. The benefits of surgery include: 1) emotional satisfaction that the tumor has been removed, 2) accuracy of surgical staging, 3) preservation of the ovaries, 4) no secondary uterine cancer (a very uncommon problem), and 5) complications that are more readily correctable. Radiation offers the major advantages of being useful in most patients regardless of age or medical condition and is the choice for large cancers. Because stage IB cervical cancer is a very diverse pathological entity with a number of potential prognostic factors (including cell type, depth of invasion, tumor volume, lymphatic space involvement, and occult lymph node metastases), and because patients present with a number of other conditions (including excess weight, advanced age, prior pelvic surgery or infection, and severe medical illness), we are fortunate to have two good methods for treating cervical cancer. Prospective randomized studies will be necessary in the future to better define specific advantages in the various clinical settings. But, in general, the following have proven most expedient: 1) class I hysterectomy, for microinvasive cancer of 3 mm invasion or less without lymphatic space involvement, 2) modified, extended hysterectomy (class II) and pelvic lymphadenectomy for lesions of 3 mm and lymph vascular space involvement or when the lesion seems to just exceed 3 mm and for very early adenocarcinoma, 3) an extended hysterectomy (class III) and pelvic lymphadenectomy for larger IA2, IB, and IIA lesions that are less than 4 cm, particularly for the pregnant or younger patient, and when ovarian conservation is desired, 4) radiation therapy is used for lesions over 4 cm and for women with severe medical illness making extended hysterectomy too hazardous, 5) combination therapy and chemotherapy are now reserved for study in poor prognosis patients with very large lesions (greater than 6 cm), occult metastases, and unfavorable histologic criteria (Table 2).
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PMID:Surgery or radiation for early cervical cancer. 228 54

From 1973 through 1985, 49 women received postoperative open-field whole abdominal radiotherapy as primary management for peritoneal metastases from uterine cancer. The 5-year relapse-free rate was 63% in women with endometrial carcinoma, and two prognostic subsets were identified. Five-year relapse-free rates fell from 77% in women with spread to the adnexa or peritoneal fluid to 36% in women with macroscopic spread of cancer beyond the adnexa. Any peritoneal spread of cervical carcinoma yielded a 3-year relapse-free rate of 31%. Although abdominal spread of cervical cancer was associated with other poor prognostic factors, peritoneal metastases frequently occurred in otherwise early endometrial cancer. Four percent of patients developed small bowel obstruction requiring surgical intervention. The utility and limitations of whole abdominal radiation are discussed.
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PMID:Abdominal radiotherapy for cancer of the uterine cervix and endometrium. 254 96

From 1979 to 1987 retroperitoneal lymph node dissection was performed at the Tokyo University Hospital in 41 cases (pelvic lymph node biopsy was done in 4 cases, pelvic lymphadenectomy in 23 cases, pelvic and paraaortic lymphadenectomy up to the renal vessels in 14 cases) of Stage Ia to IV ovarian cancer following cytoreductive surgery. The incidence of retroperitoneal positive nodes was 11.1% (2/18) in Stage I, 50.0% (5/10) in Stage II, 50.0% (5/10) in Stage III and 0% (0/3) in Stage IV (FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes). The positive rate of lymph node involvement in Stage II and Stage III was significantly higher than that in Stage I. The tumors involving both ovaries were more likely to metastasize to retroperitoneal lymph nodes. Enlargement of tumors and increased ascites were not the risk factors of retroperitoneal lymph node metastasis. These data suggest that the occurrence of retroperitoneal lymphatic spread in ovarian cancer is comparable to that in uterine cancer and increased by involvement of both ovaries and extension to other pelvic tissues.
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PMID:[Retroperitoneal lymph node metastasis in patients with ovarian cancer]. 274 72


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