UMLS:C0027627 - FACTA Search

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

Histopathology is the bedrock and cornerstone in the management of malignant tumors. Careful macroscopic description with selection of representative tissue for histologic examination is required for quality assurance and quality improvement and for assessing prognostic factors in cervical cancer specimens. The pathology report in cervical cancer (CX) should include three-dimensional tumor measurement, the exact measurement of depth of infiltration of the cervical wall, tumor grading, the presence of lymphatic space as well as blood vessel involvement. The statement for resection margins should include the vaginal, parametrane, rectal and vesical direction. All resected lymph node should be counted, measured and processed completely in step sections. If lymph node metastases are diagnosed, the report should include the size and count of metastatic nodes in relation to resected nodes. Pelvic and para-aortal nodes should be reported separately. Lymph nodes in the parametrane tissue represent regional nodes; and metastatic involvement should be stated as pN1 and not as pT2b. The tumor typing and staging should be conform with WHO-classification of malignant tumors and the TNM-classification system. The last one should be used in all cases which were surgically treated. Konizations and LOOP-excision specimens should be processed completely in step sections. The pathology report must include the severity of CIN-lesion, changes caused by HPV-infection, according to colposcopic localisation.
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PMID:[Pathologic-anatomic description and basic morphological information for management of dysplasias and carcinomas of the cervix uteri]. 1144 18

The distribution of metastatic pelvic lymph nodes (PLNs) and aortic lymph nodes (ALNs) in 27 node-positive endometrial carcinomas (ECs) was analyzed in comparison with that in 25 node-positive cervical carcinomas (CCs) and 58 node-positive ovarian carcinomas (OCs). All patients underwent systematic pelvic and aortic lymphadenectomy. Lymph nodes were classified into the five subgroups: ALN above the inferior mesenteric artery (IMA; A1), ALN below the IMA (A2), the common iliac and sacral LNs (P1), the internal and external iliac LNs and obturator LNs (P2) and the suprainguinal LNs (P3). EC was similar to CC in that metastases to P2 were more frequent compared to A1 or A2, whereas EC and OC shared a common feature in that A1, A2 and P2 were involved at high rates. ALN metastases were significantly associated with P1 positivity in both EC and CC (P<0.05), but not in OC. However, the incidence of both ALN and PLN metastases in EC (67%) was similar to that in OC (61%), being much higher than that in CC (36%). ALN involvement alone was observed in 7% for EC, 0% for CC and 21% for OC. Based on the distribution of LN metastases, it appears that CC metastasizes primarily to PLN, whereas OC metastasizes almost equally to both PLN and ALN. Interestingly, EC can directly metastasize to both PLN and ALN with PLN metastases being dominant, a distinct lymphatic spread pattern better viewed as being somewhere between CC and OC.
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PMID:Distinct lymphatic spread of endometrial carcinoma in comparison with cervical and ovarian carcinomas. 1191 74

A rare case of early colonic adenocarcinoma of the appendix confined to the mucosa is reported. The patient remained well 5 years after simple appendectomy. We also review the Japanese literature on early colonic adenocarcinoma of the appendix. Twenty-seven cases of early colonic adenocarcinoma of the appendix, including ours, have been reported in Japan. In 20 of these patients, right hemicolectomy or ileocecal resection was performed. Eighteen patients were available for lymph node evaluation. Lymph nodes were negative for metastasis in 17 of the 18. Only one patient, with poorly differentiated adenocarcinoma invading the submucosa, had lymph node metastases. Our study shows that well-differentiated adenocarcinoma invading the submucosa, or adenocarcinoma of any differentiation confined to the mucosa, may be feasibly treated with simple appendectomy.
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PMID:Early appendiceal adenocarcinoma. A review of the literature with special reference to optimal surgical procedures. 1248 56

BACKGROUND: Precise knowledge of the abdominal nodal spread of cardia adenocarcinoma in relation to the depth of invasion of the tumor and its longitudinal extension may be very important for the surgeon as a guide in choosing the type of resection and lymphadenectomy.METHODS: The frequency of node metastases in each abdominal station of the first and second tier was prospectively studied in 101 patients with type II and III cardia cancer (defined as approved by the consensus conference held during the second International Gastric Cancer Conference in Munich in April, 1997) who underwent total gastrectomy with D2 lymphadenectomy during the period January 1994 to April 1998. Lymph nodes were retrieved immediately after operation by the surgeon and assigned to the appropriate station according to the classification of the Japanese Research Society for Gastric Cancer.RESULTS: In early gastric cancer, of both type II and type III, lymph node involvement was limited to the perigastric nodes of the upper half of the stomach and to the lymph node station of the celiac trunk. In advanced cancers, whether of type II or type III, there was a fairly high frequency of metastases to the perigastric nodes of the lower half of the stomach; there was also high frequency of metastases at N2 stations, without differences in frequency between pT2 and pT3 tumors (staged according to the classification of the Japanese Research Society for Gastric Cancer).CONCLUSIONS: The results of our study provide evidence for the need to perform a total gastrectomy with D2 lymphadenectomy in all patients with advanced cardia cancer type II or type III. In early cancers, a less extensive resection (proximal gastrectomy) with D2 lymphadenectomy may be indicated.
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PMID:Nodal abdominal spread in adenocarcinoma of the cardia. Results of a multicenter prospective study. 1195 59

Fluorodeoxyglucose positron emission tomography (FDG-PET) is more accurate than computed tomography (CT) for evaluating lymph node metastases and for N staging, but less accurate than combined CT and endoscopic ultrasonography (EUS). Lymph nodes located adjacent to the primary lesion tend to be false negatives. We consider that combined FDG-PET and EUS is the most accurate for the detection of lymph node metastasis in esophageal cancer. FDG-PET is also more accurate than CT for detecting distant metastases and improves the detection of stage IV disease compared with the conventional staging modalities. For the diagnosis of recurrence except for perianastomotic recurrence, FDG-PET provides additional information and is more sensitive than conventional work-ups. FDGPET is a valuable tool for the noninvasive assessment of tumor response after neoadjuvant therapy. 11C-methionine (MET) is another tracer for PET that can be used to assess the metabolism of amino acids, since MET accumulates in esophageal malignant tumors. Choline-PET is more accurate than FDG-PET for the detection of mediastinal lymph node metastases.
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PMID:[Diagnosis of esophageal cancer using positron emission tomography]. 1199 19

Mycosis fungoides is an epidermotropic cutaneous T lymphoma. It's a non Hodgkinian lymphoma. We report the results of a retrospective review of 11 mycosis fungoide seen during 22 years. The frequency of MF was about 39.3% among all cutaneous lymphoma. Six patients were male and 5 were female; the mean age was about 56 years. Mean delay between diagnostic and the first manifestation was about 25 months. All patients had the progressive form: 4 had infiltrate plaques and 7 were at the tumoral phase. Lymph nodes and medullar metastases were noted respectively in 1 and 2 cases. Treatment was mono or polychemotherapy associated in 6 cases with topical drug. Three patients died of their diseases According to our experience and after reviewed the literature, we notice that our patients are slightly younger without male predominance. The diagnostic was done tardily and this may explain the pejorative prognostic.
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PMID:[Mycosis fungoides. Study of a series of 11 Tunisian cases]. 1207 Oct 44

In patients with squamous cell carcinoma of the esophagus, the preoperative clinical staging of the N category is primarily based on the lymph node size. Lymph nodes > 10 mm are considered to be tumor-infiltrated. This histopathologic study investigated the correlation of lymph node size and metastatic infiltration in esophageal carcinoma of patients with and without neoadjuvant radiochemotherapy. The specimens of 40 patients with squamous cell carcinoma of the esophagus were included in a prospective morphometric study. Half of these patients (n = 20) received preoperative radiochemotherapy. The number of resected lymph nodes were counted, and the largest diameter of each node was measured. Metastatic involvement of each node was analyzed by histologic examination. The frequency of lymph node metastases was calculated and correlated to the lymph node size. A total of 1196 lymph nodes with an average of 29.9 nodes per patient were resected and analyzed; 129 lymph nodes (10.8%) showed metastatic infiltration. The average size of 1067 tumor-free lymph nodes was 5.1 +/- 3.8 mm in maximum diameter, whereas the average size of 129 metastatic lymph nodes was 6.7 +/- 4.2 mm (p = 0.00006). Of all resected lymph nodes, 761 (63.6%) were < or = 5 mm in maximum diameter. Only 9.3% (n = 111) of all resected lymph nodes were > 10 mm in maximum diameter. There was no significant correlation between lymph node size and the frequency of nodal metastases. No difference in size could be demonstrated between patients with and without neoadjuvant radiochemotherapy. Diagnostic imaging techniques using size as the criterion of nodal infiltration cannot exactly assess the nodal status of patients with esophageal carcinoma. This is also true for patients after neoadjuvant radiochemotherapy. Therefore, evaluation of the nodal status in patients with squamous cell carcinoma of the esophagus is entirely based on pathohistologic analysis after a well defined lymphadenectomy.
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PMID:Lymph node staging of esophageal squamous cell carcinoma in patients with and without neoadjuvant radiochemotherapy: histomorphologic analysis. 1209 49

Papillary thyroid carcinoma is the most common malignant tumor of the thyroid and usually behaves in an indolent fashion. At most institutions these tumors are treated by near-total or total thyroidectomy followed by radioactive iodine ablation. The 2 main reasons for this extensive treatment include high rate of multicentricity in papillary carcinoma and difficulty in ablating large thyroid remnants with radioactive iodine after partial thyroidectomy. Some authors believe, however, that this treatment protocol may not be justified in all cases of papillary carcinoma. We analyzed 253 total thyroidectomies performed for papillary thyroid carcinoma for the following pathologic variables: tumor size, presence of tumor capsular and/or vascular invasion, intrathyroidal spread, tumor in the contralateral lobe, and lymph node metastases. Tumors measuring less than 1 cm and those with extrathyroidal soft tissue extension were excluded from this study. Among 253 cases (197 females, 56 males, age range 14-88 years), the primary tumor size ranged from 1-9.5 cm; 162 cases were completely encapsulated. Tumor capsule invasion was seen in 139 (86%) and vascular invasion was present in 32 (13%) cases; of these 27 (11% of the total) patients showed both tumor capsule and vascular invasion. Seventy-four (29%) patients showed tumor in the contralateral lobe; in 35 (47%) of these cases the contralateral tumor measured less than 1.0 cm. Lymph nodes were sampled in 106 cases, metastases were present in 67 (67/106 = 63%) and only 16 cases with lymph node metastases showed contralateral tumors. No significant correlation was noted between tumor size, occurrence of contralateral tumors, and lymph node metastases. Seventy-one percent of cases included in this study failed to show contralateral tumors. Hence, pathologic parameters such as lack of vascular invasion and lack of multifocality may be used to identify patients who can benefit from conservative therapy alone.
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PMID:Can we rely on pathologic parameters to define conservative treatment of papillary thyroid carcinoma? 1249 Sep 76

The purpose of this prospective study of sentinel lymph node (SLN) biopsy in a large series of melanoma patients with clinically negative regional lymph nodes from one cancer centre was to analyse the reliability of the procedure, the pattern of failures during follow-up and the factors affecting the clinical outcome of patients. Between April 1995 and November 2001, 726 consecutive patients with primary cutaneous malignant melanoma underwent SLN biopsy with preoperative lymphoscintigraphy. The vital blue dye technique was used in 170 patients, and the blue dye technique combined with intraoperative lymphoscintigraphy in 556 patients. The primary melanoma sites were head and neck in nine patients, the extremities in 419 patients, and the trunk in 298 patients. The median Breslow thickness was 3.0 mm. All patients were followed closely, the median follow-up time being 34 months. The sentinel node(s) were successfully identified in 96% of patients. Intraoperative lymphoscintigraphy combined with the blue dye technique improved the SLN identification rate (technical success in 97.3% of cases) compared with the blue dye technique alone (technical success in 91.6%). The rate of failed SLN procedures was significantly (P = 0.007) lower in inguinal basins (3.1%) compared with axillary basins (7.9%). SLN metastases were detected in 147 patients (20.2%). The presence of SLN metastases correlated significantly with primary tumour thickness and ulceration (P < 0.001). The false-negative SLN biopsy rate was 4.66% (27 out of 579 SLN-negative patients). All but two node-positive patients underwent complete lymphadenectomy. Lymph nodes other than SLNs were found to contain metastases in 26.9% of patients (39 out of 145). The 5 year overall survival (OS) rate was 84% for SLN-negative patients and 40% for SLN-positive patients. Five variables showed a strong, statistically significant negative independent prognostic association with OS: positive SLN status (P = 0.000001), primary melanoma thickness > 4 mm (P = 0.0009), male gender (P = 0.001), more than one lymph node involvement (P = 0.02) and lymph node extracapsular extension (P = 0.03). SLN biopsy is currently a valuable and effective diagnostic procedure for the precise staging of patients with clinically N0 cutaneous melanoma. So far SLN biopsy seems to be the only accessible method for consciously oriented detection of nodal micrometastases in melanoma that would otherwise go undetected. SLN status is the most important factor proven to distinguish high and low risk melanoma patients.
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PMID:Sentinel lymph node biopsy in melanoma patients with clinically negative regional lymph nodes--one institution's experience. 1256 83

The objective of the present study was to evaluate clinical condition and results of surgical treatment of patients with typical and atypical bronchial carcinoids. The study was based on retrospective analysis of a total of 96 patients (mean age 47.3 year, age range 21-76, 44 men and women 52), who were surgically treated for bronchial carcinoid between 1985-2001. We assessed symptomatology of the disease, type of surgical intervention, tumor histology and staging, and postoperative 5-year and 10 year survival rates. The main sign of disease was respiratory inflammation. The carcinoid syndrome was not found in any patient. Most patients (n=68) were operated for central form of the tumor. The micromorphological tumor diagnosis was established prior to surgery in 76.5% patients with the central form of carcinoid. Surgical treatment included lobectomy (n=49), bronchoplastic procedure (n=14), sleeve lobectomy (n=9), atypical resection and segmentectomy (n=11), pneumonectomy (n=7) and tumor enucleation (n=5). Histological analysis revealed typical carcinoid in 77 cases (80.2%) and atypical carcinoid in 19 (19.8%). Lymph nodes (N1 and/or N2) were examined by histology in 84 patients and lymph node metastases were found in 13 (19.4%) of 67 patients with typical carcinoid and in 5 cases (29.4%) of 17 with atypical carcinoid. In the postoperative period on patient died from embolism to the arteria pulmonalis. Postoperative complications (atelectasis, prolonged air leak, bronchopleural fistula) were observed in 11.4% of patients. Tumor relapse occurred only in two patients with typical carcinoid. Postoperative 5-year and 10-year rates amounted to 98.6% and 87.3%, respectively, in typical carcinoid 94.5% and 73.5% in atypical carcinoid. The survival rates of patients with typical and atypical bronchial carcinoids were not significantly different (p>0.05). The surgical management is the treatment of choice in bronchial carcinoids. Results of this study indicate that the 5-year survival in patients with either histological type of bronchial carcinoid is excellent and the prognosis of operated patients is very good even in the case of regional lymph nodes infiltration by the tumors.
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PMID:Bronchial carcinoid tumors: long-term outcome after surgery. 1268 80

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