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

Anatomical radical cystectomies with en bloc pelvic lymph node dissections were performed post mortem on 10 male cadavers. The traditional technique of radical cystectomy was used on 1 side and the potency-sparing technique was used on the opposite side. The tissue responsible for the differences in the surgical margins with the 2 procedures was examined by routine surgical pathological techniques to determine if it contained lymph nodes. Lymph nodes were identified in the bundle of tissue left in the pelvis with the nerve-sparing radical cystectomy in 6 of the 10 dissections (60 per cent). Because these lymph nodes may represent the potential first site of metastatic disease leaving the bladder, the reader is cautioned about adopting the nerve-sparing radical cystectomy as part of the management of invasive bladder cancer until the long-term sequelae of the procedure are known.
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PMID:The potency-sparing radical cystectomy: does it compromise the completeness of the cancer resection? 319 4

The distribution of laminin and collagen type IV in the basement membranes of 85 gastric adenocarcinomas was studied using immunoperoxidase techniques to check for invasive carcinoma. Lymph nodes with metastases were also studied in 23 cases. Thick and discontinuous staining of the basement membranes was observed in 12 cases of well differentiated adenocarcinoma; thin and discontinuous staining in 26 (12 well and 14 moderately differentiated adenocarcinomas); fragmentary staining in 36 (15 moderately and 21 poorly differentiated adenocarcinomas); and unrecognisable basement membrane staining in the remaining 11 cases of poorly differentiated adenocarcinoma. These patterns were largely related to the histological grade, the nuclear atypism and loss of polarity of tumour cells, and the degree of inflammatory infiltration.
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PMID:Distribution of basement membrane antigens in clinical gastric adenocarcinomas: an immunohistochemical study. 332 49

Thirty-three patients with thyroid cancer following irradiation of head, neck and chest were compared to 389 patients, with the same kind of cancer, who had not undergone irradiation therapy. The two groups showed a different distribution of different isotypes. In group 1 (following irradiation) the papillary isotype was most common in a much greater number of cases than in group 2. Lymph nodes metastases had a higher incidence rate in group 1. There was no significant difference as far as the histologic sub-groups associated with thyroid cancer were concerned. The results of the study were not altered by any such factor as age, which does usually modify the distribution of the isotypes.
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PMID:[Thyroid cancer induced by radiotherapy. Clinico-anatomopathological comparison with spontaneously occurring cancer]. 343 14

The records of 23 patients with confirmed carcinoma of the fallopian tube, treated between 1966 and 1983, were reviewed. Patients ranged in age from 41 to 88 years. A pelvic mass was the most common preoperative finding (61%), followed by abnormal bleeding (43%), and pain (39%). Fifteen patients had stage I or II disease, 8 had Stage III or IV disease. In patients with metastatic disease, involvement of the peritoneal surfaces, bowel, and omentum were noted most often. Lymph nodes were the most common site(s) of recurrent disease. Twelve evaluable patients with measurable disease were treated with cisplatin and cyclophosphamide (PC) +/- doxorubicin (PAC). There were 9 complete and 2 partial responses, a 92% response rate. Incorporation of cisplatin therapy appears to have resulted in improved short-term survival.
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PMID:Primary carcinoma of the fallopian tube: evidence for activity of cisplatin combination therapy. 355 96

Between 1971 and 1985, a total of 325 cases of cervical cancer, Stages IB to IIB, in which operation was performed were evaluated with a view toward prognostic factors and survival rates. In radical abdominal operations, a complete resection of parametrial tissue was the goal. Extensive lymphadenectomy of the pelvis was performed. Operative specimens were processed by giant sections comprising cervix, lateral parametria, and vaginal cuff. Lymph nodes were cut by step-serial sections. Exact measurements of tumor sizes were done along with investigations of parametrium and lymph nodes. Tumors were classified according to a ratio of tumor size to size of cervix. Incidence of lymph node involvement increased with tumor size, reaching a maximum of 68.3% in the group with a ratio from 70% to 80%. Direct spread into the parametrium was rarely found, even in larger tumors occupying the entire cervix. parametrial lymph nodes were most often involved; these were scattered over the entire ligament. Five-year survival rates reached 88.1% in patients with no nodal involvement and 60.9% with nodal involvement. In the latter, the results depended on the number of nodal groups involved and the diameter of metastases. Parametrial involvement alone had no influence on healing rates, but when pelvic nodes were simultaneously involved, the results were less satisfactory. Survival rates based on tumor size differed only between the group with a ratio up to 20% and the large-tumor groups, with rates ranging from 97.5% to 70.9%. There was no statistical difference between Stages IB (31.1% positive nodes) and IIB (44.1% positive nodes) with regard to survival rates (82.2% and 76.9%, respectively).
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PMID:Prognostic factors and operative treatment of stages IB to IIB cervical cancer. 357 11

The purpose of the present study was to clarify the anatomy of the lymphatic system of the para-aortic region with special reference to lymphatic pathways from the pancreas, and the incidence and extent of lymphatic metastases of pancreatic cancer to para-aortic lymph nodes. Lymph nodes were found mostly on the bilateral and anterior sides of the aorta, and rarely on its posterior side. Lymphatic vessels from the pancreas (peripancreatic nodes) were closely related to the para-aortic lymph nodes on the bilateral and anterior surfaces of the aorta ranging from the root of the celiac artery and that of the inferior mesenteric artery. Out of 10 autopsy cases of relatively small pancreatic cancer, 4 cases were found to have microscopic metastases in a few para-aortic lymph nodes. The localization of involved para-aortic nodes was compatible with that of anatomically related para-aortic lymph nodes. Lymph node dissection of the para-aortic region, if carried out in a patient with a possibility of radical resection of the primary pancreatic cancer, should be an en bloc resection of lymph nodes and surrounding soft tissues in the area ranging between the root of the celiac artery and that of the inferior mesenteric artery.
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PMID:[An anatomical and pathological study of autopsy material on the metastasis of pancreatic cancer to para-aortic lymph nodes]. 360 May 84

Experience with the surgical treatment of 12 patients with carcinoma of the adrenal cortex is presented. They were 6 men and 6 women. Their ages ranged from 23 to 66 years old (mean 38 years). Four carcinomas had detected hormonal activity. The location of the carcinoma involved the right adrenal in 8 cases and the left in 4 cases. The mean diameter of the mass was 15 cm. Excision of the adrenal cancer with the ipsilateral kidney was the usual procedure. Lymph nodes were involved in 5 cases and interestingly the kidney was only involved in 3 cases. One patient died during hospitalization from pulmonary embolus, whereas another one required re-exploration for postoperative hemorrhage. Nine patients developed pulmonary, hepatic and bone metastasis within 3 to 10 months, postoperatively. Radiation treatment and chemotherapy had poor results. Nevertheless, one patient in whom left adrenalectomy, splenectomy and partial pancreatectomy was performed, is doing well, despite the presence of hepatic metastases, with the addition of o,p' DDD, 24 months postoperatively. Another patient underwent reoperation and excision of recurrent local disease 12 months after adrenalectomy/nephrectomy. She is now alive 16 months following her second surgery. Based on the above, an aggressive surgical approach is advocated in the management of adrenocortical carcinoma.
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PMID:The surgical management of adrenal cortical carcinoma. 373 53

A group of 179 patients who had 205 neck dissections between 1979 and 1984 has been reviewed to assess the influence of adjuvant radiotherapy on survival. Lymph nodes were histologically involved in 91 of 107 radical neck dissections (85 percent) and 55 of 98 modified neck dissections (56 percent). Eighty-two patients received adjuvant radiotherapy of 5,000 rads or more. Patients with involved nodes had significantly lower survival rates than those with uninvolved nodes. Among patients with involved nodes, survival was significantly lower when two or more nodes were involved, when there was nodal involvement at multiple levels, or when extracapsular spread was present. Adjuvant radiotherapy was associated with a reduced recurrence rate in the ipsilateral neck but the incidence of distant metastases was higher. When patients with involved nodes were subgrouped according to prognostic factors, the survival of irradiated patients was improved only in the highest risk group, but this was not statistically significant. When radiotherapy is added to neck dissection for treatment of cervical metastases it can be expected to reduced ipsilateral neck recurrence and prevent relapse in the contralateral neck. Improved survival may depend on an ability to detect and treat occult distant metastases.
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PMID:Neck dissection with and without radiotherapy: prognostic factors, patterns of recurrence, and survival. 376 81

The Thomsen-Friedenreich antigen (TF-antigen), known as a precursor of the MN-blood-group system, has been suggested as a tumor-associated antigen of breast adenocarcinoma. In order to evaluate the TF-antigen as a tool in the histochemical detection of micrometastases, cryostat sections of 25 breast biopsies and 30 regionary lymph nodes were investigated. The study used a sensitive method for the fluorescent staining of the determining terminal disaccharide sequence of asialoglycophorin A by application of peanut agglutinin (PNA) and fluoresceinisothiocyanate-labeled F(ab')2 fragments of monospecific anti-PNA from rabbits. PNA binding was observed in 91% of the sections of predominantly ductal mammary carcinomas. In normal tissues and hyperplastic lesions, staining patterns were markedly different from that of malignant breast cells, and were confined to secretory glycoproteins. Lymph nodes, with histologically confirmed metastases of mammary carcinomas, showed specific PNA binding in the cytoplasm of tumor cells in 75% of cases. Even single malignant cells were demonstrable, which were not recognized at first by routine light microscopy. Fluorescent staining of lymph nodes, which were tumor-free in repeated histologic examinations, was confined to clearly diagnosible histiocytes in 3 of 15 cases. A sensitive indirect immunofluorescent technique demonstrating PNA binding is proposed to be of considerable value for the detection of single metastatic adenocarcinoma cells of the human breast.
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PMID:Detection of metastatic breast carcinoma cells by immunofluorescent demonstration of Thomsen-Friedenreich antigen. 633 28

Lymphatic metastasis is an important mechanism in the spread of human cancer. During its course, tumor cells first penetrate the basement of membrane of the epithelium, in which they arise, and then the underlying connective tissue, carried partly by hydrostatic pressure. They enter the lymphatic partly by active movement, pass up the lymphatic trunk; they then settle and proliferate in the subcapsular sinus, penetrate its endothelium and proliferate and destroy the node. There are varied forms of immune response in the node and in human nodes often a complex fibrous and vascular response. The degree of lymphocytic response may be important for prognosis. The nodal reaction may be stimulated by release of antigens from the tumor. One of the most studied animal models of lymphatic metastasis is that which occurs in the politeal node after injection of tumor into the footpad. This model has been used to show that tumor cells enter lymphatics through gaps in endothelium, probably between endothelial cells, and that lymph nodes can destroy small numbers of tumor cells. Local immunotherapy and chemotherapy can sterilize a lymph node of tumor cells; the modes of treatment used have included intralymphatic injection and encapsulation of chemotherapeutic agents in liposomes. Prior radiotherapy may accelerate metastasis possibly by making tumor cells shed into lymphatic vessels. Lymph nodes are rather poor barriers to tumor cells. The prognostic significance of lymph node metastasis varies within tumor type; if hematogenous metastasis is early, then the presence of lymph node metastasis is of lesser prognostic significance. Lymph nodes can probably destroy only small numbers of tumor cells. Tumor cell heterogeneity is of importance in many aspects of metastasis; while clonal variation may be of importance in determining lymph node metastasis, it is not yet clear how important this is, nor whether specific clones metastasize specifically to lymph nodes. Lymphography is well established in diagnosis of lymphatic metastasis. A recent interesting development has been to inject antibodies labeled with a radioactive label, and image the label in lymph nodes with a gamma-camera. If anti-tumor antibodies are used in this way it may be possible to detect lymph node metastasis. Within the expanding field of tumor metastasis, lymphatic metastasis needs much more attention, particularly in relation to the diagnosis and treatment of the lymphatic spread of human cancer.
Cancer Metastasis Rev 1983
PMID:Lymphatic metastasis. 636 69


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