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)

Serum values of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) have been used to monitor disseminated testicular carcinoma. Serial measurements of these markers have been used to monitor the response to therapy, to follow the progress of disease, and to detect subclinical recurrences. With increasingly effective chemotherapy for systemic disease, central nervous system (CNS) metastases in testicular carcinoma are becoming increasingly important as a cause of treatment failure. Cerebrospinal fluid (CSF) values of AFP and HCG seem to be important ancillary acids in the neurosurgical management of CNS metastases from testicular cancer. Our preliminary experience with three cases suggests that these CSF markers (plus computerized tomograhic scanning) should be evaluated in patients with this disease.
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PMID:Cerebrospinal fluid markers in central nervous system metastases from testicular carcinoma. 8 23

Patients with metastatic nonseminomatous testicular cancer received an induction regimen consisting of bleomycin in 24-hour infusions and bolus iv doses of vinblastine followed by an Adriamycin and cis-dichlorodiammineplatinum(II) combination. Patients achieving complete remission after one or two cycles of this induction chemotherapy were then randomized to receive either radiotherapy (RT) to the previously involved tumor areas or maintenance chemotherapy (MCT) with CCNU, methotrexate, and vinblastine for 2 years. Among 62 evaluable patients, induction chemotherapy achieved 15 (24%) partial remissions and 35 (56%) complete remissions. Two patients with partial remission and single pulmonary metastases were rendered disease-free by surgical resection of residual tumor. Twenty patients received MCT and 15 received RT. To date, median survival is 10,8+ months in the MCT group with five relapses and 12.5 months in the RT group with two relapses. Toxicity in the induction phase was moderately severe with two drug-related deaths.
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PMID:Treatment of metastatic nonseminomatous testicular cancer: a preliminary report of induction chemotherapy followed by maintenance chemotherapy or radiotherapy. 9 36

A multimodality treatment program for disseminated testicular cancer using vinblastine/bleomycin/cis-dichlorodiammineplatinum(II) remission-induction therapy followed by surgery and cyclophosphamide/Adriamycin maintenance therapy has been used in 25 patients. The overall complete and partial response rate was 100%. Six of six patients (100%) with stage II (advanced abdominal) disease have remained in complete remission for a median followup period of 8 months. Seventeen of 19 patients (89%) with stage III metastatic disease have been in complete remission for a median duration of 20 months. No relapses have occurred in any patients who achieved a complete remission. Two of 19 patients (11%) with stage III disease achieved a partial response; one died at 4 months and the other died at 14 months. The toxicity was severe, especially during remission induction. However, there were no drug- or surgically related deaths.
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PMID:Sequential combination chemotherapy and surgery for disseminated testicular cancer: cis-dichlorodiammineplatinum(II), vinblastine, and bleomycin remission-induction therapy followed by cyclophosphamide and adriamycin. 9 38

Twenty-six patients with metastases from a germinal cancer of the testis were treated with Mithramycin. After an observation time of between one-half-3 one-half years, 18 are still alive, of which 12 appear to be free from cancer. The 2-year survival rate is 50% (5/10). The side effects of Mithramycin therapy are described and discussed.
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PMID:The treatment of low differentiated germinal cancers of the testis using mithramycin. 12 44

From the clinical point of view, histologic classification is intended to give suggestions for therapy (therapeutic classification) and to provide the basis for an assessment of end results (prognostic classification). In adults, the essential therapeutic question is: seminoma (only seminoma) or non-seminoma? The frequency of seminoma among the germinal testicular tumours influenced by the subtlety of the histologic examination. The histologic report should include the MOSTOFI (25) classification and the prognostic group classification of DIXON and MOORE (7). Staging of testicular cancer and criteria for the comparison of treatment results are discussed. The topography of lymphatic metastases of testicular cancer was investigated. The great majority of testicular cancers metastasize regularly, i.e., primarily into the testicular lymph center and/or along the testicular vein, and only secondarily in other lymph nodes. This provides a foundation for the increasing tendency to modified bilateral retroperitioneal node dissection.
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PMID:Testicular cancer, histologic classification and staging, topography of lymph node metastases. 86 89

We describe our experience with BEP (bleomycin, etoposide, cisplatin) therapy as chemotherapy for testicular tumors in 11 patients. Eight were non-seminomatous testicular cancer patients and 3 were seminoma patients. Three of 8 non-seminomatous testicular cancer patients had no evident metastasis and BEP therapy was performed for prophylaxis of recurrence. Other 5 non-seminomatous testicular cancer patients and 3 seminoma patients had metastatic lesions and BEP therapy was performed to cure these metastatic lesions. Ten of our 11 patients are living and disease-free. One non-seminomatous testicular cancer patient who had brain, lung, eye and bladder metastases and had an extremely elevated human chorionic gonadotropin (hCG) level responded only partially and died later due to disease progression. Side effects in most patients were nausea, vomiting, alopecia and leucopenia and all these side effects were reversible. Neuromuscular toxicity such as paresthesia or abdominal cramp that is sometimes encountered in PVB (cisplatin, vinblastine, bleomycin) therapy was not seen in our patients. Our results support the concept that BEP therapy is better than PVB therapy as an initial chemotherapy for testicular tumors.
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PMID:[BEP (bleomycin, etoposide, cisplatin) therapy for testicular tumors]. 128 74

In a prospective study, 63 patients with histopathologically proved Stage III nonseminomatous testicular cancer (NSTC) were analyzed to predict the need for surgical resection of residual masses after cis-platinum-based chemotherapy. Of these 63 patients, 23 (37%) had residual masses after cis-platinum-based chemotherapy requiring surgical resection. Of the 23 patients undergoing surgical resections for their residual masses, 18 patients (78%) had matured teratoma, 3 (13%) had fibrosis with necrosis, and 2 (9%) had residual tumors. Twenty of the 23 (91%) patients with residual disease had either teratomatous elements in primary tumor or bulky metastatic disease at the time of initial chemotherapy. Two patients had incomplete resection of the metastatic disease containing teratoma and required additional resection of recurrent growing matured teratomas. We conclude that teratomatous elements in primary tumor having also bulky metastatic disease are strong predictors of residual disease after initial chemotherapy requiring surgery (21 of 23 or 91%).
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PMID:Predictors of residual mass requiring surgical resection after chemotherapy of stage III testicular cancer. A prospective study. 132 Mar 3

Detection of serum and cellular AFP and hCG has made a significant contribution in understanding and management of testicular cancer. It is essential to remember the following events in utilizing these markers: (1) Histologic diagnosis of seminoma, but AFP is elevated. There is usually an element of choriocarcinoma. (2) Histologic diagnosis of seminoma and highly elevated hCG greater than 100 ng/ml has usually an element of choriocarcinoma. (3) Histologic diagnosis of choriocarcinoma with an elevated serum AFP. There is usually an element of embryonal carcinoma. (4) Pathologic stage I nonseminomatous testicular cancer with elevated serum markers is either stage II or stage III. (5) In a recent study of 23 patients undergoing resection of residual nonseminomatous testicular cancer after intensive chemotherapy, 21 had either teratoma in primary tumor or bulky metastatic disease. The markers were normalized after chemotherapy and prior to resection. (6) Although normalization of these markers after chemotherapy indicates effective therapeutic response, one should look of residual tumor utilizing radiologic investigations.
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PMID:Current status of tumor markers in testicular cancer. A practical review. 138 31

Minimally invasive laparoscopic surgical techniques are being increasingly applied to the treatment of urological diseases. We report a case of a laparoscopically performed modified bilateral retroperitoneal lymph node dissection for clinical stage 1 testicular cancer. The laparoscopic surgical approach to the retroperitoneal nodes is a technically feasible procedure that can remove lymph node tissue from all primary landing sites for testicular cancer metastases with potentially decreased morbidity.
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PMID:Laparoscopic retroperitoneal lymph node dissection in a patient with stage 1 testicular carcinoma. 143 38

In testicular cancer epidemiology, the increasing recognition that germinal epithelial atrophy is the final common pathway in the development of this tumor has developed along with reports that elevated follicule-stimulating hormone levels at the time of diagnosis of first tumor correlate with risk of developing a second tumor. There is also evidence from experimental studies that atrophy is a complication of vasectomy, a recently reported risk factor. In the area of new diagnostic approaches, correlation of the rate of rise of tumor markers after orchiectomy in patients with metastases has defined a new risk factor for predicting drug-resistant disease. In the treatment of nonseminoma, it has been reported that use of adjuvant chemotherapy for stage I tumors with two courses of combination chemotherapy produces a relapse rate lower than that seen after surgical staging. For seminoma, chemotherapy results have improved, with nearly 100% of patients cured by combination regimens and 80% cured by single-agent carboplatin. This success is finally leading to questioning of the role of radiotherapy as adjuvant therapy for stage I tumors. A study using two courses of adjuvant carboplatin produced equivalent results and possibly less toxicity.
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PMID:Testicular cancer. 165 30


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