Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With reference to the recent literature, a representation of case-history, therapy and prognosis of bronchial carcinoma is made. Inhalation of tar products by smoking, as well as predominantly occupational dust are the important etiological factors for the increase in bronchial carcinoma. Because of the long occult progression of the disease the diagnosis based on clinical symptoms is made very late. Only a greater effort in organisation and diagnostics permits an early detection in high-risk groups. Therapeutic success has remained constant since the sixties. Up to now only the consequent pre-operative selection of patients has been significant for improvement of surgical results. Five-year cures are more frequent after lobectomy than after pneumonectomy. In radiation therapy, the use of high-voltage gamma rays in contrast to conventional deep radio-therapy, has not brought any significant improvement. An additional intensive and individual care and follow-up of patients is of vital importance. The optimal curative radiation dose is 6000 rad. Particularly pre-operative irradiation is important to prepare some inoperable patients for curative surgery. Postoperative radiation therapy is also valuable for doubtful radical surgery and after exploratory thoracotomy. Palliative radiation therapy results in rapid disappearance of symptoms; with generalized disease or in suspicion for formation of metastases, chemotherapy should be preferred. This is particularly true for anaplastic, small and large cell carcinomas, and their rapidly growing metastases. In those cases, combination of polychemotherapy may decrease the tumor size and increase the length of remission. The prognosis depends on microscopic tumor type, stage of the disease, and therapy. Abnormal excretion of steroids and immunological disturbances are prognostic at the time of diagnosis.
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PMID:[Bronchial carcinoma. Problems and treatment with special reference to radiotherapy (author's transl)]. 7 Jul 93

Clinical features of recurrence in patients of lung cancer undergoing curative surgical resection were examined with special reference to the local recurrence. Subjects were 308 patients, consisting of 160 adenocarcinomas, 121 squamous cell carcinomas, 15 large cell carcinomas, 12 small cell carcinomas. They underwent curative resection in our department between 1973 and 1987. Local recurrence developed in 54 patients (18%). There was no significant difference in the incidence of local recurrence among the four histological types of carcinoma. According to the pathological stage, the incidence was 9% in stage I, 15% in stage II, and 35% in stages IIIA+IIIB. The local recurrence was subdivided into the following patterns: 1) lymphatic metastases to the hilar, mediastinal, or supraclavicular sites, 2) recurrence at the surgical margin, 3) malignant pleuritis or pericarditis, 4) so-called "endobronchial metastasis". The incidence of recurrence according to the patterns was 15%, 2%, 2% and 1%, respectively. The incidence of recurrence due to lymphatic metastases was correlated significantly with the pN factor but not with the pT factor. Patients with central type lung cancer showed a significantly higher incidence of lymphatic recurrence than patients with the peripheral type. Patients having postoperative radiotherapy to prevent local recurrence showed a lower incidence of lymphatic recurrence than patients having no radiotherapy. In conclusion, lymphatic recurrence was the most frequent pattern in local recurrence after curative resection of lung cancer, and therefore improvements in the operative procedure of lymphatic dissection, as well as in postoperative adjuvant therapy including radiotherapy will be urgently required for the purpose of reducing local recurrence.
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PMID:[Study on local recurrence in patients undergoing curative surgical resection of lung cancer]. 133 88

Paraffin sections of 247 primary and metastatic non-small cell lung carcinomas, the corresponding non-neoplastic lungs, and 75 other specimens were examined by immunohistochemical procedures using a panel of antibodies against the specific products of peripheral airway cells: the major surfactant-associated protein and 10-kD Clara cell protein. Non-small cell lung carcinoma tumors most frequently positive for either peripheral airway cell marker were adenocarcinomas (41%), especially those with papillolepidic growth pattern (56%), followed by large cell carcinomas (25%), other adenocarcinomas (22%), and squamous cell carcinomas (16%). Immunoreactivity was mainly focal and the expression of the two peripheral airway cell markers was discordant. The incidence of marker expression was similar in metastatic and primary non-small cell lung carcinoma. Other organs and their tumors were negative, with few exceptions. Non-small cell lung carcinomas positive for peripheral airway cell markers were associated with younger age and less-intense smoking, and surfactant-associated protein reactivity was more common in women than in men. Peripheral airway cell markers were independent prognostic factors for survival and delayed development of metastases in patients with less-advanced disease. It is concluded that surfactant-associated protein and 10-kD Clara cell protein are specific markers for non-small cell lung carcinoma and peripheral airway cell differentiation and provide useful tools to study the pathogenesis, biology, and prognosis of non-small cell lung carcinoma.
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PMID:Peripheral airway cell marker expression in non-small cell lung carcinoma. Association with distinct clinicopathologic features. 131 97

The role of immunity in the control of tumor metastasis is unclear, although various evidence suggests its existence. Immunosuppressive treatment is associated with increase in metastasis in both experimental animals and humans. Infiltration by T-lymphocytes is substantial in primary tumors while minimal or absent in their metastases. The capacity for metastasis is related to histologic type and grade of differentiation; small cell carcinomas of the lung are more metastatic than large cell carcinomas; small cell lymphomas are more metastatic than large cell lymphomas. Organ selectivity is evident in the patterns of metastasis; the spleen is common site of metastasis for lymphomas but not for carcinomas. In an experimental system, a virus-induced lymphoma invariably metastasized to the thymus while chemical-induced lymphomas metastasized to the liver; immunosuppression did not alter the patterns. Malignant tumors may exhibit years-long intervals of dormancy before metastasis and established metastases may regress spontaneously, both phenomena being altered by changes in immune status. Malignant tumors in persons with immune deficiency, particularly AIDS, like the opportunistic infections, have a tendency for early dissemination, including organs not usually affected.
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PMID:Immunobiology of metastases. 203 53

To evaluate the role of palliative radiotherapy for adrenal metastases, a retrospective review was performed on 16 patients treated between 1972 and 1988 for palliation of symptomatic adrenal metastases. The median patient age was 56 years. In 15 cases lung cancer was the primary site (7 adenocarcinomas, 3 squamous cell carcinomas, 3 large cell carcinomas, and 2 small cell carcinomas) and in 1 case there was an unknown primary (squamous cell carcinoma). Ten of 16 patients were treated with 3000 cGy to opposed anterior and posterior fields (300-cGy fractions [four patients] and 250-cGy fractions [six patients]). The remaining six patients were treated with a variety of techniques, with total doses ranging from 2925 cGy to 4500 cGy. The patients were analyzed for response at their first follow-up visit (2 to 4 weeks after treatment). The overall response rate was 75% (12 of 16 patients). Six patients (38%) had complete pain relief without medication that lasted until death. Two patients had marked pain relief, but still required analgesics. Four patients had marked or moderate pain relief that did not continue through follow-up. Four patients had minimal to no response. All patients were observed until death, with a median survival time after irradiation of 3 months (range, 0.5 to 11 months). Although the prognosis for patients with adrenal metastases is poor, radiotherapy to symptomatic adrenal metastases can be administered with a high probability of achieving effective palliation.
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PMID:Palliative radiotherapy for symptomatic adrenal metastases. 215 51

Carcinoma of the lung continues to account for more cancer-related deaths than any other neoplasm in the United States. The World Health Organization recognizes four main classifications of cell type. Squamous cell carcinoma is most often a central lesion that locally invades the hilus and mediastinum. Because of its localization within the chest, it shows the best survival statistics. Adenocarcinoma is probably the most common of the four cell types. It tends to present as a peripheral mass. Hilar, mediastinal, and extrathoracic metastases occur early in its course. Its 5-year survival rate is worse than that for squamous cell carcinoma. Alveolar cell carcinoma is considered by most to be a subtype of adenocarcinoma but demonstrates much better survival figures. Most typically it presents as a nodule, but is more often thought of as a diffuse or localized alveolar infiltrate. Large cell carcinoma resembles adenocarcinoma in that it is a peripheral mass, but often larger in size. Metastases are less frequent in large cell carcinoma than in adenocarcinoma. Large cell carcinoma demonstrates better survival figures than does adenocarcinoma. Small cell carcinoma is the most aggressive of the four cell types, having the worst prognosis. The classic presentation is the detection of hilar and mediastinal metastases while the primary tumor remains occult. Grossly enlarged hilar and mediastinal lymph nodes can be seen easily on chest radiograph and CT scan.
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PMID:Radiographic manifestations of primary bronchogenic carcinoma. 215 19

The prognostic significance of age, sex, location of the tumor in the various lobes, size, histological type, node metastases, local extent and stage has been studied in a series of 742 surgically resected lung carcinomas. The histological type was a very important prognostic factor: the highest survival was observed in epidermoid carcinomas, followed by adenocarcinomas, anaplastic large cell carcinomas, and anaplastic small cell carcinomas. The stage, as well, except for the adenocarcinoma, bore heavily on the prognosis; however, in small stage I tumours, the postoperative survival was independent from the histological type. The presence of lymph node metastases resulted in an extremely poor survival, except for the epidermoid carcinoma. The size of the tumours, excluding adenocarcinomas, was an important prognostic factor provided lymph node metastases were absent. No significant differences in survival according to the location in different lobes could be ascertained.
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PMID:[The postoperative survival in pulmonary carcinomas depending on the histological type and stage]. 256 16

One hundred cavitating pulmonary foci were examined by CT; the appearances have been analysed and compared with the histological findings. Three types of disease have been characterised: bronchial carcinomas, lung metastases and benign lesions. Compared with benign lesions, malignant disease shows a significantly higher incidence of cystic or multiple cavities: thick cavity walls; radiation of tumour tissue; enlarged mediastinal lymph nodes; ipsilateral displacement of the mediastinum; intrapulmonary satellite foci and infiltration of the thoracic wall. Morphologically, tumours can be most easily distinguished from metastases by their ill-defined outer contours. Non-epidermoid primary lung tumours have a higher incidence of pleural effusions and other pleural reactions than have tumours of other origins. 80% of cavitating lung tumours are squamous cell carcinomas, the remaining 20% consist of adeno- and large cell carcinomas. Small cell carcinomas practically never show cavitation.
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PMID:[Differential computed tomographic diagnosis of cavity-forming space-occupying lesions of the lung]. 282 80

Two hundred and thirteen lung tumours of primary site and 42 metastases were heterotransplanted into nude mice with an overall success rate of 44%. There were differences in success between the histological types. Squamous cell and adenocarcinoma had the highest success rate (51% and 43%, respectively) whereas large cell and small cell carcinoma had a lower success rate (38% for both). The average volume doubling times in the first passage in nude mice ranged from 8.2 in large cell carcinomas to 18.9 days in adenocarcinomas. In subsequent passages an increase in growth rate was found, the overall average doubling time falling from 14.5 days in the first passage to 7.1 days in the second passage. In a study with 171 non-small cell lung carcinomas (NSCLC), the growth data in nude mice were correlated with the clinical data of the corresponding patients. A relationship between the growth parameters in nude mice and prognosis of patients could not be found.
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PMID:Growth of human bronchial carcinomas in nude mice. 298 40

In a retrospective study of 280 patients with histologically verified bronchogenic carcinoma, pretherapeutic diagnosis using scanning procedures yielded 13.6% skeletal metastases, 8.6% liver metastases and 3.6% brain metastases. The total 23.9% of hematogenous metastases proved to be dependent on the histological type of tumor: it was highest in small cell anaplastic carcinomas (38.8%) and large cell carcinomas (32.5%), and lowest in epidermoid carcinomas (13.3%). If the localization of metastases was also taken into account, the highest rates of metastases in the skeleton (17.5% and 22.5%) the liver (15%) and the brain (7.5%) were always found with small cell anaplastic and large cell carcinomas. Besides the histopathological type of tumor, the frequency of metastases depended also on the local stage of bronchial cancer. While scanning of the skeleton and the liver for clinical staging of bronchogenic carcinoma should always be regarded as an essential part of primary diagnosis (alternatively ultrasonography and computed tomography of liver) the necessity for brain scan and/or computed tomography depends on the neurological findings and the histomorphological type of tumor.
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PMID:[Pretherapeutic metastases diagnosis in bronchial cancer with special reference to nuclear medicine procedures]. 626 83


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