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)

In an attempt to reduce the recurrence rate and to improve survival in resected stage-II nonseminomatous testicular cancer, two consecutive series of patients were treated with adjuvant vinblastine-bleomycin (VB) continuous infusion, or cisplatin, vinblastine, bleomycin (PVB). 11 former patients who received no adjuvant chemotherapy and 5 who refused the adjuvant treatment were considered historical controls. After a median follow-up of 5 years, relapses were 4 in 15 patients treated with VB (27%), 1 in 29 treated with PVB (3%) and 8 in the untreated (50%). Adjuvant PVB significantly reduced the recurrence rate (p less than 0.001), while VB did not (p = 0.4). However, the advantage of adjuvant PVB was evident only in patients with retroperitoneal metastases larger than 5 cm, macroscopic extranodal spread, and tumor invasion into retroperitoneal veins, who were classified as pathologic stage II-C: no relapse and 100% survival following adjuvant PVB in 11 cases, versus 86% relapses and 28.5% survival in 7 untreated patients (p less than 0.01); 2 relapses and 2 survivors in 3 treated with VB. On the other hand, only 1 of the 39 patients with less extensive retroperitoneal disease died of testicular cancer, and he was in the VB adjuvant treatment group. We conclude that only aggressive adjuvant chemotherapy significantly reduces the recurrence rate and improves survival in resected stage-II nonseminomatous testis cancer. However, it is mandatory only in the very high risk subset II-C of patients, while the others could be carefully followed at monthly intervals and safely treated with aggressive chemotherapy only in the event of relapse.
 ...
PMID:Adjuvant chemotherapy in resected stage-II nonseminomatous germ cell tumors of testis. In which cases is it necessary? 632 14

Abdominal ultrasonic scanning was compared to lymphangiography and intravenous urography in 50 patients with testicular cancer. In 25 lymphangiographic stage I patients, the ultrasonic scanning was normal in all cases, too. In 5 out of 25 lymphangiographic stage II patients, the ultrasonic examination demonstrated a wider extension of the retroperitoneal metastases than combined lymphangiography and urography. The ultrasonically demonstrated masses were proven to contain malignant cells through an ultrasonically-guided fine-needle puncture in all 5 cases. Sufficient planning of the radiation ports would not have been possible in these patients without the additional ultrasonic scanning. In monitoring of the therapeutic response, ultrasonic scanning was found superior to lymphangiography.
 ...
PMID:Abdominal ultrasonic scanning versus lymphangiography in testicular cancer. 638 97

Twenty-five patients with nonseminomatous germ cell carcinoma of the testis underwent CT and nuclear magnetic resonance (NMR) of the retroperitoneum followed by radical retroperitoneal lymph node dissection for surgical proof of metastatic disease. Computed tomography correctly predicted the presence or absence of adenopathy in 88% and assigned the correct stage in 84%. Nuclear magnetic resonance had comparable figures of 84 and 80%. Computed tomography appeared superior to NMR in detecting other abdominal abnormalities, although these were few in number. Nuclear magnetic resonance is nearly equivalent to CT in staging retroperitoneal lymphadenopathy from testicular cancer and may surpass CT following technical advances and the introduction of oral contrast agents.
 ...
PMID:Comparison of NMR and CT imaging in the evaluation of metastatic retroperitoneal lymphadenopathy from testicular carcinoma. 653 90

The usual indication of improvement in metastatic cancer is diminution of the mass. When a mass persists after treatment, it is presumed the lesion either does not respond or has stopped responding to the therapy. Two patients with brain metastases, one biopsy proven, from breast cancer and eight patients with presumed metastatic testicular cancer to the lung, liver, or retroperitoneum have been identified in whom surgery or autopsy revealed only necrosis and/or fibrosis in the persistent mass; the mass had been "sterilized." Although this phenomenon is not frequent, it is not uncommon in testicular cancer. Our observations are offered to make others aware that persistent mass need not indicate viable tumor. When sufficient examples are accumulated, some clues to predicting this phenomenon may help resolve the therapeutic dilemma it presents.
 ...
PMID:Sterilized metastases: a diagnostic and therapeutic dilemma. 660 Mar 7

The prognosis of nonseminomatous germ cell testis tumors has been significantly improved during the past two decades due to progress in cytostatic treatment. General trends and our own long term experience with sequential combination chemotherapy (velbane/bleomycin; adriamycin/cisplatin; ifosfamide/etoposide) in testicular cancer are presented. In disseminated stages survival was closely related to the initial concentration of human chorionic gonadotropin (HCG) and tumor burden (two year survival: more than 80% in patients with minimal pulmonary disease, 40-50% in patients with massive pulmonary disease, and less than 30% in patients with pulmonary metastases and massive retroperitoneal disease). New diagnostic and therapeutic methods to increase survival rates further in nonseminomatous testicular cancer are discussed.
 ...
PMID:[Testicular tumors--a breakthrough?]. 663 28

The efficacy of lymphography and computed tomography (CT) in staging nonseminomatous testicular cancer was analyzed in 41 patients. Retroperitoneal lymphadenectomy in 30 patients with early tumor stage revealed 56% sensitivity, 90% specificity, and 80% overall accuracy for lymphography; CT was less accurate (44% sensitivity, 81% specificity, 70% overall accuracy). The presence of advanced disease in 11 patients was depicted equally by lymphography and CT, but CT better demonstrated the anatomic extent of the metastases. CT is valuable for discriminating between advanced and early tumor stages; the similar inaccuracy of lymphography in early disease militates against its routine and complementary use; retroperitoneal lymphadenectomy then remains the only accurate staging modality.
 ...
PMID:Lymphography and computed tomography in staging nonseminomatous testicular cancer: limited detection of early stage metastatic disease. 665 4

19 of 53 patients (36%) with non-seminomatous testicular cancer, clinical stage I (CS I), had retroperitoneal lymph node metastases, pathological stage II (PS II), demonstrated by retroperitoneal lymph node dissection (RLND). RLND was done unilaterally in peroperatively tumor-free patients (PS I: 34 patients; PS II: 3 patients) and bilaterally if metastatic lymph nodes were found peroperatively. Patients with PS II received adjuvant cis-platinum containing combination chemotherapy. Postoperative tumor activity was observed in 3 patients (median observation time: 31 months). They were cured by salvage chemotherapy. 12-18 months after RLND no ejaculatory disturbances were observed in 28 of 36 unilaterally operated patients. After unilateral RLND, 7 patients fathered children. Unilateral RLND seems to be a sufficient diagnostic procedure in patients with non-seminomatous testicular cancer, CS I, who were found tumor-free during the operation. Fertility is preserved in the majority of the unilaterally operated patients.
 ...
PMID:Unilateral retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumor in clinical stage I. 669 81

Approximately 25 per cent of patients with nonseminomatous testicular cancer and infrahilar lymph node disease will also harbor suprahilar metastases. Some patients also will have retrocrural metastases. Therefore, careful attention should be paid to retrocrural adenopathy before radical surgical resection for cure.
 ...
PMID:Retrocrural lymphadenopathy in testicular cancer. 669 69

Between 1977 and 1979 we evaluated 224 patients with testicular cancer. Of these patients 32 had undergone inadequate primary procedures, such as transscrotal orchiectomy, transcrotal exploration, biopsy or aspiration. These 32 patients were compared to a cohort population who had undergone radical inguinal orchiectomy. Differences in management, nodal metastases, local recurrences, intervals free of disease and survival by stage of disease were determined. Patients with seminoma and a contaminated scrotum received radiation therapy to the involved hemiscrotum . Partial scrotectomy without ilioinguinal node dissection was performed on most patients with nonseminomatous disease. An inguinal node metastasis developed before radiation therapy in a patient with seminoma. There were no local recurrences. No statistically significant difference in either intervals free of disease or survival between contaminated and cohort populations was found. We conclude that with prompt adequate management there is no adverse effect on prognosis due solely to scrotal tumor contamination, contrary to what has been implied in the literature.
 ...
PMID:Testis tumors: the clinical significance of the tumor-contaminated scrotum. 672 60

Metastases to the heart are rarely diagnosed before death. In this report the authors describe what they believe is the first case of metastasis from embryonal carcinoma of the testis to the heart that was successfully removed. Nine years after orchiectomy for embryonal carcinoma of the testis a 32-year-old man was found to have a right atrial tumour. The preliminary diagnosis was myxoma, but because of his previous testicular cancer and a metastatic deposit that had been found 6 years earlier, a diagnosis of cardiac metastasis seemed more likely. The tumour, removed from the lateral wall of the right atrium, had the same histologic features as the original embryonal carcinoma and the metastatic deposit. The patient made a smooth recovery.
 ...
PMID:Embryonal carcinoma of the testis with metastases to the right atrium. 682 73


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