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

Lymph nodes draining a progressively growing tumor contain T-cells which can be activated sequentially by anti-CD3 and IL-2 to differentiate into tumor-specific effector cells. In this study, long-term cultured T-cell lines were established from activated MCA 106 tumor-draining lymph node cells by periodic stimulation with irradiated tumor cells in the presence of low concentrations of IL-2 (< or = 60 International units/ml). Such long-term cultured cell lines maintained therapeutic effects when transferred to tumor-bearing mice. Although the initial anti-CD3/IL-2-activated T-cells displayed a broad distribution of T-cell antigen receptor beta chain variable region (V beta) usages, long-term cultured cells were dominated by T-cells expressing a few V beta elements. Of six cell lines, only three V beta phenotypes (V beta 5, 11, 13) were identified, and individual cell lines frequently expressed a single V beta gene product. Despite restricted V beta expression, each cell line mediated tumor-specific reactivity in adoptive immunotherapy. Many T-cell clones were isolated from long-term cell lines. Three V beta 13 T-cell clones demonstrated specific in vivo antitumor effects, whereas two V beta 11 and two V beta 5 clones revealed a significant degree of cross-reactivity against the antigenically distinct MCA 205 tumor. Although the initial anti-CD3/IL-2-activated cells lacked demonstrable cytotoxic reactivity, T-cell clones derived from them exhibited cytotoxic effects to the MCA 106 tumor cells. The specificity of the cytotoxicity mediated by each clone reflected its in vivo antitumor effects. Furthermore, studies of in vivo localization of cloned T-cells demonstrated tumor-specific infiltration of the 5A2 (V beta 13) clone to the MCA 106 tumor metastases, whereas clone 9H6 (V beta 5) revealed some accumulation in the MCA 205 tumor. Again, the in vivo antitumor effects of the 9H6 clone correlated with its in vivo infiltration into the specific MCA 106 and the nonspecific MCA 205 metastases. Taken together, the long-term culture of anti-CD3/IL-2-activated tumor-draining lymph node cells resulted in selective expansion of a few T-cells as evidenced by the limited T-cell receptor V beta expression. Our results also demonstrated that systemically administered antitumor T-cell clones gained access and accumulated at metastatic tumor sites, and the degree of infiltration correlated with the specificity of the in vivo antitumor effect as well as the in vitro cytotoxic activity.
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PMID:Characteristics and in vivo homing of long-term T-cell lines and clones derived from tumor-draining lymph nodes. 816 5

A 35-year-old woman with a histologically proven T2 N0 M0 adenocarcinoma of the breast was given 4 cycles of neodjuvant chemotherapy then underwent tumourectomy followed by irradiation. Lymph nodes were free from invasion. A 7 cm ovarian cyst developed during follow-up and after a 2 month regimen of lynestrenol, coelioscopy with peritoneal lavage was performed. The pathology diagnosis was papillary cystadenocarcinoma requiring laparotomy which revealed invasion of both ovaries, neoplasic granulations and involvements of the epiloon. Exceresis of the trocar tract also showed tumoural invasion. Pathology examination favoured metastatic extension of the breast cancer. A 6-month chemotherapy was programmed before a second look. This case illustrates the risk of neoplastic dissemination after puncture or rupture of a cyst misdiagnosed as benign. In patients with a history of breast cancer, the risk of discovering a primary malignant ovarian cancer at coelioscopy is 9%. Metastases are found in 15-30% of the cases compared with 0.4 to 1.8% in unselected subjects. Prevention of operative dissemination relies on cystectomy without opening the cyst. This may require transforming the coelioscopy into a laparotomy which should not be considered as an operative failure but as a necessary method of preventing dissemination and clinical aggravation. Careful history taking, a rigorous coelioscopy technique and extension to laparotomy in cases with suspected diffusion should reduce the number of dramatic situations where the malignant process had not been suspected in the precoelioscopic diagnosis.
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PMID:[Tumor dissemination after celioscopic treatment of a tumor of the ovary]. 817 59

Between 1971 and 1989 a total of 420 patients underwent radical abdominal hysterectomy with pelvic lymphadenectomy at our hospital for stage Ib, IIa, or IIb cervical cancer. The entire lymph node material was processed in serial sections and stained with hematoxylin and eosin. Lymph nodes were counted and the sizes of metastases measured. The entire surgical specimen was fixed as a whole with the parametria spread out. The size of the tumor was measured by morphometry. Cases treated between 1971 and 1979 were compared with those treated between 1980 and 1989. The median number of pelvic lymph nodes removed per patient was 24 between 1971 and 1979 and 35 between 1980 and 1989 (P = 0.0001). Significantly more nodes were removed at each node group (P = 0.01). Between 1971 and 1979 no common iliac nodes were obtained in 56 patients and no left common iliac nodes in 74 patients, compared to only 1 and 6 patients, respectively, between 1980 and 1989. The rate of patients with positive lymph nodes was 33% (63/195) between 1971 and 1979 and 55% (101/225) between 1981 and 1989 (P = 0.008). In the first study period the median number of parametrial lymph nodes was 2 compared to 3 in the second period. The rate of patients with positive parametrial lymph nodes increased from 15 to 24% (P = 0.027). The results of this review indicate that exacting morphologic processing of the entire lymphatic tissue obtained at surgery permits accurate postoperative staging and assessment of risk factors for decisions on adjuvant treatment. Histologic evaluation objectifies the radicality of the procedure and is useful in the quality control of the surgical treatment of cervical cancer.
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PMID:Pelvic and parametrial lymph nodes in the quality control of the surgical treatment of cervical cancer. 840 96

Preoperative evaluation of stenotic rectal tumors is important since they often involve adjacent organs and thus may require additional therapy. Previous reports on endosonographic staging have excluded stenotic tumors because they could not be fully visualized with the available equipment. In this study, we have evaluated the role of endosonography in staging stenotic rectal tumors, with special attention to the use of forward-looking endoprobes. Preoperative staging was performed in 28 patients with stenotic rectal tumors. Tumor extension was evaluated according to the TNM classification, and the results were compared with surgical and histopathologic findings. Endosonography accurately assessed tumor extension in two T2 tumors, 14 T3 tumors, and seven T4 tumors. Three T2 tumors were overstaged, and two T4 tumors were staged as T3. The accuracy was 82 percent. Twenty-two tumors were subject to histopathologic evaluation of lymph nodes. Lymph nodes larger than 1 cm had been seen by endosonography in eight patients, five of whom had nodal metastases. Lymph nodes smaller than 1 cm or no lymph nodes were found in 14 patients, four of whom had nodal metastases. In conclusion, full sonographic visualization of stenotic rectal tumors and thus evaluation of tumor extension can be achieved by using forward-looking endoprobes.
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PMID:Rectal endosonography in the evaluation of stenotic rectal tumors. 844 33

In order to detect micrometastatic disease, our laboratory has developed a method for evaluating lymph node sections from patients with stage 1 or 2 melanoma. Lymph nodes isolated from standard dissections are bivalved; one half is subjected to routine histopathological evaluation and the other half disrupted and placed into cell culture. The cultured cells are identified by cytologic examination, immunohistologic staining, and the presence of melanoma-associated antigens. Lymph nodes (448) from 62 patients with malignant melanoma were evaluated by tissue culture. Fifteen patients were upgraded from stage 1 or 2 to stage 3 disease after micrometastases were identified in lymph node cultures. Recurrence of disease in histologically node negative patients, during a mean 24-month follow-up, has only been observed thus far in patients with culture positive lymph nodes. In addition, these results add evidence to the belief that missed micrometastatic disease in regional nodes is a sign of occult systemic metastases that would account for the defined recurrence rate in histologically node negative patients.
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PMID:Identification of submicroscopic lymph node metastases in patients with malignant melanoma. 851 18

We compared the abilities of positron emission tomography and computed tomography to detect N2 or N3 lymph node metastases (N2 or N3) in patients with lung cancer. Positron emission tomography detects increased rates of glucose uptake, characteristic of malignant cells. Patients with peripheral tumors smaller than 2 cm and a normal mediastinum were ineligible. All patients underwent computed tomography, positron emission tomography, and surgical staging. The American Thoracic Society lymph node map was used. Computed and positron emission tomographic scans were read by separate radiologists blinded to surgical staging results. Lymph nodes were "positive" by computed tomography if larger than 1.0 cm in short-axis diameter. Standardized uptake values were recorded from areas on positron emission tomography corresponding to those from which biopsy specimens were taken; if greater than 4.2, they were called "positive." Seventy-five lymph node stations (2.8 per patient) were analyzed in 27 patients. Computed tomography incorrectly staged the mediastinum as positive for metastases in three patients and as negative for metastases in three patients. Sensitivity and specificity of computed tomographic scans were 67% and 83%, respectively. Positron emission tomography correctly staged the mediastinum in all 27 patients. When analyzed by individual node station, there were four false positive and four false negative results by computed tomography (sensitivity = 60%, specificity = 93%, positive predictive value = 60%). Positron emission tomography mislabeled one node station as positive (100% sensitive, 98% specific, positive predictive value 91%). The differences were significant when the data were analyzed both for individual lymph node stations (p = 0.039) and for patients (p = 0.031) (McNemar test). Positron emission tomography and computed tomography are more accurate than computed tomography alone in detecting mediastinal lymph node metastases from non-small-cell lung cancer.
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PMID:Mediastinal lymph node staging of non-small-cell lung cancer: a prospective comparison of computed tomography and positron emission tomography. 860 80

Adoptive immunotherapy with immune T cells mediates regression of established tumors in animal models. We previously demonstrated that precursor lymphocytes of sensitized T cells can develop into mature effector cells after in vitro activation with anti-CD3 mAb and IL-2. We demonstrate here that tumor cells genetically modified to secrete IL-2 can enhance the precursor response in the tumor-bearing host and subsequently augment the antitumor efficacy of adoptive immunotherapy. MCA205 and MCA203, weakly immunogenic fibrosarcomas, were transfected in vitro with cDNA encoding for IL-2, IL-4, or IL-6. Lymph nodes (LN) draining these cytokine-producing tumors for 7 days were harvested, activated in vitro with anti-CD3/IL-2, and adoptively transferred into mice bearing established parental MCA205 pulmonary metastases. The effector cells generated from LN draining the IL-2 producing tumor exhibited enhanced antitumor activity compared with cells from LN draining parental, IL-4-producing, or IL-6-producing tumor. Phenotype analysis of cells from LN draining the IL-2-producing tumor revealed selective expansion of V beta 8+ cells. Depletion of V beta 8+ effector cells abrogated the antitumor efficacy indicating that V beta 8+ cells constituted the majority of antitumor reactivity and that secretion of IL-2 from tumor cells promoted the priming of V beta 8+ precursor cells, which can develop into mature effector cells. These results have important clinical implications that the method presented here could be applicable to the treatment of human cancer as more effective immunotherapy.
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PMID:Adoptive immunotherapy with tumor-specific T lymphocytes generated from cytokine gene-modified tumor-primed lymph node cells. 862 26

Lymphatic spread pattern in 17 cases of adenocarcinoma of fallopian tube is reported. Median age of the patients was 48 years. All patients underwent surgical staging including total abdominal hysterectomy, bilateral salpingo-oopherectomy omentectomy, and appendectomy. Systematic pelvic and paraaortic lymphadenectomy was feasible in 15 cases. Majority of the patients (11 of 17 cases, 64%) had advanced disease and showed serous adenocarcinoma (83%). Lymph nodes were involved in 10 of 17 cases (59%). Node metastases rate increased significantly (P < 0.01) with intraperitoneal stage of disease and with grading. Interestingly, positive nodes were also found in 2 cases (33%) of 6 patients with disease still limited to fallopian tube. Overall, patients with negative nodes had a median survival of 76 months, compared with only 33 months if node metastases were found. In conclusion, combined pelvic and para-aortic lymphadenectomy seems to be necessary for staging and perhaps for prognosis of this disease.
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PMID:Fallopian tube cancer: incidence and role of lymphatic spread. 875 49

Selective neck dissection has been used clinically in elective treatment of carcinoma, although many surgeons continue to advocate modified radical or radical neck dissection for therapeutic management of the neck. In a retrospective study 167 previously untreated patients were reviewed following curative laser microsurgical resections of oral or pharyngeal primary tumors and a unior bilateral selective neck dissection. In all, 221 (54 bilateral) neck dissections were performed. In patients with oral primary disease lymph nodes of levels I-III were removed, while nodes in levels II and III were removed in patients with pharyngeal tumors. Level IV was dissected when several metastases were suspected during operation. The posterior triangle was not dissected. Lymph nodes were histopathologically negative in 73 patients and positive in 94 patients. Twenty-five of these latter cases had pN1 disease, 55 had pN2b disease and 10 had bilateral lymph node metastases. Twenty patients in the pN0 group and 63 patients in the pN+ group received postoperative radiotherapy (to 56.7 Gy to the primary site and 52.5 Gy to the neck). With a median follow-up interval of 34 months, recurrence in the dissected neck occurred in 3 of 73 patients (4.1%) with pN0 disease and 6 of 90 patients (6.6%) with pN+ necks. Four patients with pN+ necks had simultaneous recurrences at the primary site. The addition of adjuvant radiotherapy seemed to improve disease control in the neck and improve overall survival in patients with an unfavorable prognosis due to multiple metastases or metastases with extracapsular spread.
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PMID:Selective neck dissection in the management of squamous cell carcinoma of the upper digestive tract. 885 56

The aim of a cancer registry is to study the incidence of cancer in a well-determined population and to allow epidemiological research to the setting up of diagnosis and therapeutic strategies. The Belgian Thyroid Cancer Study Group (BTCSG) was founded in 1990. In the present study we report data collected from 1988 to 1995 in 397 patients with a differentiated (papillary and follicular) thyroid carcinoma living in the french-speaking area of Belgium. The sex ratio female/male is 3.5 and the median ages at the diagnosis, is similar (45 yrs, 12-82) in both sexes. Seven cases of thyroid cancer were registered in young patients less than 18 yrs old. Thyroid carcinoma were associated with multinodular goiter in more than 50% cases. Cancer was bilateral in 17%. Papillary histological type accounts for 84% in our series while its diagnosis was established in 45% at early clinical stages (TO-T1). These observations could probably be related with 1) broader indications and more aggressive options for the surgical removal of diffuse multinodular goiter, 2) more sophisticated pathologic examinations that might have led to the detection of a greater incidence of occult carcinomas, incidentally discovered. Lymph nodes metastases were present at the time of diagnosis in 20%, especially in young patients. The risk for local and/or lateral recurrence or distant metastases is significantly related to the size of the tumor, histologically verified lymph node metastases and the values of the EORTC prognostic index (> or = 50) that additionally takes into account the differentiation of the tumor. Considering our short median follow-up time of 25 months, it is currently too early to define if the controversial attitude about the extent of surgery (total thyroidectomy plus I131 or individualized surgery) can also negatively influence the risk for recurrence. In our series, eight patients died of thyroid cancer.
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PMID:[Belgian registry of thyroid cancer. Preliminary epidemiological characteristics revealed by a retrospective study (1988-1995). Belgian Thyroid Cancer Study Group]. 923 37


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