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

Diagnosis of the retroperitoneum to deliniate metastases of nonseminomatous germinal cell testicular cancer, when combined with Computer tomography, Sonography and Lymphography has a high specificity. With regard to treatment, the differentiation between stage I and stage II is very important. In the so called high risk groups (MTU-Tumour, T3-Primary tumour) a stage I can actually be a stage II. Computer Tomography of the thorax should be made to deliniate a stage III tumour.
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PMID:[Diagnostic parameters and their value in testicular tumors]. 301 65

From 1980 to 1984 inclusive, ninety-one consecutive evaluable patients underwent primary retroperitoneal lymphadenectomy for clinical stage IIA or IIB nonseminomatous germinal testicular cancer. Nodes were negative in twenty cases (22%), and forty-seven patients (52%) were treated with chemotherapy either postoperatively (thirty clinically understaged patients) or at relapse (seventeen cases). After a median follow-up period of nearly 5 years (range 18-78 months) the disease-free survival was 98%. None of thirty patients with radiographic abnormalities greater than or equal to 3 cm in the retroperitoneal nodes had negative histology, and twenty-two (73%) were treated with chemotherapy. Preoperative serum levels of AFP and hCG were not useful in selecting patients with positive nodes. Primary chemotherapy is now used in patients with radiographic evidence of retroperitoneal metastases greater than or equal to 3 cm.
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PMID:Retroperitoneal lymph node dissection in clinical stage IIA and IIB nonseminomatous germ cell tumours of the testis. 303 96

The clinical experience is reviewed in 597 Norwegian testicular cancer patients (age range: 15-45 years) treated from 1979 to 1986. During this period, computer tomography, determination of serum AFP/HCG, and cisplatin-based chemotherapy represented the modern diagnostic and therapeutic modalities. Before orchiectomy 67% of the patients had elevated AFP/HCG. An abnormal postorchiectomy serum tumour marker decrease and the presence of small vessel infiltration in the histological sections of the primary tumour significantly predicted microscopic retroperitoneal metastases in patients with clinical stage I (CSI) nonseminoma. One-third of these patients had a pathological stage II (PSII). After radiotherapy 99% of 90 seminoma patients (CSI/IIa) survived for 5 years. After cisplatin-based chemotherapy (+radiotherapy/surgery) the 5-year survival rate in 25 patients with advanced seminoma was 81%. The survival rate in 148 nonseminoma patients PSI/IIa was 100% and 87% in 94 patients with advanced nonseminoma (greater than or equal to CSIIb). Nausea, general exhaustion, myelosuppression, peripheral neuropathy, and Raynaud-like phenomena were the main acute treatment-related side effects. Slight gastrointestinal problems, slight peripheral neuropathy, Raynaud-like phenomena, and fertility disturbances were frequent late side effects. The sexual life in testicular cancer patients did not seem to be significantly impaired as compared to the normal population. Most of the patients reported no or only slight emotional problems during and after treatment. The need of thorough information at the time of diagnosis was stressed by most of them. Secondary cancer was diagnosed in 27 of 795 patients (1970-1982) (Testicular: 15; pulmonary: 4; sarcoma: 2; others: 6). Testicular cancer is today a curable malignancy. Future clinical research has to concentrate on the identification of high-risk and low-risk patients, the avoidance of overtreatment, and the reduction of toxicity (especially of long-term side effects).
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PMID:Testicular cancer in young Norwegians. 304

Treatment for testicular cancer has dramatically improved during the last 15 years. Much of this success has come about because of improved staging and operative techniques but, most importantly, through the introduction of successful systemic chemotherapy. Nonetheless, relevant issues still remain to be addressed in regard to the optimal therapy for patients with germ cell neoplasms. Included in these issues is delineating the most effective but minimally morbid treatment for patients with early-stage and low-volume metastatic disease while continuing to create innovative treatment approaches for poor-risk patients with metastatic disease. The unique association of primary mediastinal germ cell neoplasms with the development of non-germ cell cancers and Klinefelter's syndrome may provide some early clues for the determination of factors controlling differentiation. These observations issue a challenge to both clinical and preclinical researchers involved in the study of this neoplasm.
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PMID:Testicular cancer: the quest continues. 305 Jan 40

Testicular cancer, which predominantly occurs in young men, has become increasingly common; it is presently the most common malignancy in men aged 20-34. Despite a lack of knowledge of aetiology, empirical advances, particularly in the management of patients with advanced disease, have been dramatic. Prior to the development of effective chemotherapy in the 1970s, less than 10% of men with metastatic non-seminomatous germ cell tumours were cured; nowadays approximately 90% of patients are potentially curable. The introduction of effective chemotherapy has led to a reappraisal of surgery and radiotherapy in the management of early stage disease and the introduction of a policy of surveillance in patients without evidence of metastases at the time of removal of the primary tumour. Following chemotherapy, surgery is required in approximately 25% of patients with advanced disease to excise residual masses, which in one-fifth of cases will show evidence of residual malignancy. In a proportion of patients, testicular cancer develops on a background of long-standing infertility, whereas in many men there is temporary oligospermia, despite a previous history of fertility. The majority of patients with prior evidence of spermatogenesis recover this function following chemotherapy and there is no evidence that children fathered by such patients have an increased risk of malformation. Despite physician optimism and excellent prospects for cure, significant psycho-social morbidity is associated with the diagnosis and treatment of testicular cancer. Factors contributing to this are being identified and will lead, hopefully, to the minimisation of such problems by appropriate intervention.
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PMID:Testicular cancer. 306 Jan 53

A case is reported in which a testicular cancer presented as a metastatic deposit in the eyelid. The histological appearances of both the metastasis and the subsequently detected primary were diagnostic of malignant teratoma trophoblastic (MTT). After comments on the testicular tumour, metastases occurring in the eye and adnexa are discussed.
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PMID:Testicular cancer presenting as a red swollen lid. 320 64

Between January 1981 and December 1985, 122 patients with non-seminomatous germ cell tumours (NSGT) were seen at a regional referral centre. Of these, a total of 98 patients received chemotherapy for metastatic disease. Treatment was given within collaborative EORTC Urology group studies, all of which involved cis-platin-containing schedules. Ninety patients had tumours of testicular origin, and their 2 year actuarial survival rate is 91%; 8 had tumours of extragonadal origin and their 2 year actuarial survival is 25%. Patients with testicular tumours were subdivided by volume of metastatic disease using the recommendations of the Testicular Cancer Subgroup of the MRC Urological Cancer Working Party and survival was significantly worse in the group with very large volume metastatic disease (VLVM, 57%) compared with the groups with large volume metastases (LVM, 100%) and small volume metastases (SVM, 98%). There were 31 patients with Stage I disease at presentation; of these 6 were treated by prophylactic abdominal radiotherapy and 25 were managed by a policy of surveillance only. Seven of these Stage I patients (23%) relapsed with metastatic disease (median 8 months); all have been successfully treated with chemotherapy. These data confirm that the majority of patients now presenting with metastatic NSGCT are curable with chemotherapy, but that a small proportion with very large volume metastases or extragonadal tumours require alternative chemotherapy schedules.
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PMID:Results of treatment of non seminomatous germ cell tumours; 122 consecutive cases in the West of Scotland, 1981-1985. 335 8

We report a case of a teratoma thrombus within the inferior vena cava subsequent to chemotherapy for embryonal carcinoma of the testis. A review of the literature indicates that intracaval metastases occur in approximately 1 per cent of the patients with bulky retroperitoneal disease. Seminoma and embryonal carcinoma have been identified previously within the inferior vena cava, and teratoma is now added to that list. The potential lethality of teratoma owing to local growth alone is underscored by its intracaval presence in this case. We recommend close inspection of the inferior vena cava at operation for bulky disease to exclude an intracaval thrombus, as well as complete excision of all residual masses following chemotherapy for testis cancer.
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PMID:Metastatic testicular teratoma invading the inferior vena cava. 337 82

The rarity of testicular and paratesticular cancer makes the evaluation of treatment and results difficult. One childhood tumour which differs from adult testicular cancer is the yolk-sac tumour. Because of its less aggressive nature and the young age at which these children present, radical orchidectomy is adequate surgery. There is little evidence to support the view that retroperitoneal node dissection, radiotherapy or prophylactic chemotherapy improves the survival rate. By careful follow-up, metastatic disease or recurrence can be detected and early chemotherapy instituted. The overall prognosis for children with these tumours is good. In a series of 9 patients with yolk-sac tumours 8 have survived free of disease for 9 months-14 years since diagnosis.
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PMID:Testicular tumours in children. 346 69

Significant advances in the therapy of genitourinary cancers have occurred, yet the challenge of metastatic disease in many of these tumors remains unsolved. The great success achieved in the treatment of testicular cancer has been in large part due to the development of effective systemic therapy. Effective treatment for metastatic transitional cell carcinoma is just beginning to be described. Advanced renal and prostatic carcinomas remain a major clinical problem with no effective curative therapy. Novel new approaches to systemic therapy developed on sound basic experimental principles are needed. Several potential approaches such as angiogenesis factor, interleukin II, lymphokine activated killer cells, and tumor necrosis factor are discussed.
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PMID:Future developments and new research in genitourinary cancers. Perspectives. 349 47


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