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)

Advances in the surgical treatment of primary malignancies and the recent chemotherapy have led to an expansion of the surgical treatment of metastatic lung tumors. However, multiple pulmonary metastases are often found and may affect both lungs. It is difficult to reach tumors in the posterior parts of the lung when using a common midsternal approach, especially lesions located in the left lower lobe. We performed transsternal simultaneous bilateral thoracotomy on 10 patients with bilateral lung tumors (9 bilateral metastatic pulmonary tumors and 1 bilateral primary lung cancer). This procedure provides a wide operative field and is an effective method of thoracotomy for patients with bilateral lung tumors. In future, this method should be more actively performed for patients in whom it is indicated.
 ...
PMID:Transsternal thoracotomy for bilateral pulmonary metastasis. 159 80

To assess the efficacy of surgical resection of brain metastases from patients with multiple brain metastases or/and with other systemic metastases, the authors analysed treatment results of 90 cases of metastatic brain tumors. The patients were divided into three groups. Group A (nine cases): Patients with single brain tumor and their primary cancers were well controlled. Their brain tumors were removed surgically and followed by radiation. Their mean survival time was 17.0 months, and 14.6 months were independent (Karnofsky score greater than or equal to 70) in cases of lung cancer. Five patients (55.6%) improved by treatment. Group B (21 cases): Patients with multiple brain metastases or/and with systemic metastases. Their brain tumor(s) which gave rise to neurological symptoms were surgically removed in order to improve their quality of life. In cases of lung cancer, mean survival time was 9.5 months and 7.1 months were independent. 11 patients (52.3%) improved by treatment. Group C (60 cases): Patients treated conservatively. Their mean survival time was 4.9 months and 2.7 months were independent in cases of lung cancer. Only 13 patients (21.7%) improved by treatment. However 23 (38.3%) deteriorated in their quality of life during treatment. Two patients of this group had single brain tumor and their primary cancers were controlled well. They refused surgery. Their mean survival time was 13.0 months, and 7.0 months were independent. These times were statistically shorter than group A. Seven patients had similar systemic and neurological states as those in group B. Their mean survival time was 5.0 months and 3.0 months were independent. These times were also statistically shorter than those in group B.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Treatment of metastatic brain tumors: effect of surgery of multiple metastatic brain tumors and systemic metastasis with special reference to quality of life]. 160 73

From february 1965 to march 1990, 70 squamous cell carcinomas, 3 adenocarcinomas and 2 undifferentiated lung cancer were operated by lobectomy extended to the main bronchus: 44 right upper lobectomies, 22 left upper lobectomies, 5 left lower lobectomies, 2 right lower lobectomies, 1 middle lobectomy and one lower and middle bilobectomy. Respiratory function prevented pneumonectomy in 1 out of 3 patients. The postoperative mortality related to surgery (2.7%) has been eliminated since the introduction of systematic protection of the pulmonary artery from the bronchial suture (1976). The sutures are performed with very fine suture material. Endoscopic follow-up is essential: 11 cases of suture granuloma (1 laser) and 4 cases of fibrotic stenoses, including 1 post-irradiation stenosis (2 lasers). Fifty-three patients were N0 (28 T1, 22 T2, 3 T3) and 22 were T+ (including 4 N2). The actuarial survival for the N0 was 91% at 1 year and 60% at 5 years and decreased to 63% and 40% for N+. Eighty-three percent of the late cancer-related deaths had metastatic disease. Lobectomies extended to the main bronchus do not appear to compromise the oncological value of the resection and they offer the possibility of resection in some respiratory failure patients.
 ...
PMID:[Lobectomies enlarged to the main bronchus in the conservative treatment of lung carcinoma. Apropos of 75 cases]. 160 36

Fifty patients with lung cancer underwent transesophageal endoscopic ultrasonography (EUS) for preoperative detection of metastases to the hilar and mediastinal lymph nodes. An electronic ultrasonic fiberscope with a linear array (EPB-503-FS, Machida-Toshiba) was used. Later, in surgery, a total of 513 nodes that could have been detected by EUS were removed. Of these, 54 nodes were found to be metastatic histologically, and 459 were non-metastatic. The rate of detection by EUS was 65% (35/54) for the metastatic nodes; the rate was 41% (186/459) for the non-metastatic nodes (p less than 0.01). Metastatic nodes were detected at high rates in every lymph node site. Non-metastatic nodes were detected at low rates in sites 1, 2, and 4, and at the highest rate in site 7. Metastatic nodes had characteristic internal echoes, affected by the extent of tumor and necrosis present in a node, and were detected more easily than non-metastatic nodes. For larger or rounder nodes, metastasis was more common (p less than 0.01). Lymph nodes that could be detected were classified into six types by their internal echo patterns; three of these types were rarely metastatic, and were called 'negative'; the other three were often metastatic, and were called 'positive'. In histological examinations, of the 'negative' nodes found in fact to be metastatic histologically, invasion by the tumor tended to be diffuse and necrosis was minute. The 'positive' nodes that were in fact metastatic tended to have one of two internal echo patterns (depending on the amount of necrosis) when invasion was diffuse, and a third pattern when invasion was localized.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Endoscopic ultrasonography for preoperative diagnosis of the hilar and mediastinal lymph node metastases in lung cancer]. 163 42

Despite its appeal, lung cancer screening has been found to be of little value at this time. However, use of monoclonal antibodies to detect cancer cells in the sputum may prove to be of value in high-risk subjects. Once a cancer is diagnosed, anatomic staging by the International TNM Staging System has shown its effectiveness in directing the appropriate therapeutic interventions and predicting prognosis. Anatomic staging cannot be completely accomplished by computed tomography scans or magnetic resonance imaging of the chest, particularly relative to mediastinal lymph node involvement or to direct mediastinal extension of the tumor. To determine lymph node involvement, preoperative mediastinal exploration is indicated for all potentially operable patients in whom the lymph nodes are 1 cm or greater. Although a small percentage of normal-sized lymph nodes will contain tumor, routine investigation is not believed necessary. Direct mediastinal invasion as suggested by the computed tomography scan is most often indeterminate and thoracotomy is necessary in most instances to determine the resectability of the tumor. Data continue to accumulate showing that routine scanning of asymptomatic patients for the presence of metastatic disease to the brain or skeletal system is not effective.
 ...
PMID:Screening, staging, and diagnostic investigation of non-small cell lung cancer patients. 164 70

Although adrenal metastases are frequently noted with non-small-cell lung cancer (NSCLC) at autopsy, their incidence in patients with operable NSCLC is unclear. We prospectively assessed consecutive patients with otherwise operable NSCLC for the incidence and histology of unilateral adrenal masses. Assessment included blood chemistries, lung function tests, bronchoscopy, chest x-ray, bone scan, and computed tomography (CT) of the head, chest, and upper abdomen. Of 246 patients with otherwise operable NSCLC, 10 (4.1%) had a unilateral adrenal mass. Unilateral adrenal masses were needle-aspirated under CT control. If cytology was nondiagnostic, adrenalectomy was performed. Four (40%) of 10 patients had adrenal metastases proven by needle aspiration. Of the six (60%) patients with benign unilateral adrenal masses, one was demonstrated by needle aspiration. In the other five patients, a nondiagnostic needle aspiration led to adrenalectomy, which yielded two adenomas, two hyperplastic nodules, and one hemorrhagic cyst. There was no significant difference between the patients with benign and metastatic unilateral adrenal masses with respect to patient age or stage and size of adrenal mass. Patients with benign unilateral adrenal masses underwent curative resection of their NSCLC and had significantly prolonged survival compared with patients with metastatic unilateral adrenal masses treated with chemotherapy (P = .037). Median survival of patients with benign and metastatic unilateral adrenal masses was greater than 30 months and 9 months, respectively. In conclusion, the presence of unilateral adrenal masses in patients with otherwise operable NSCLC should not preclude thoracotomy without pathologic proof of metastatic disease.
 ...
PMID:Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer. 164 68

Squamous, large cell, and adenocarcinoma, collectively termed non-small cell lung cancer (NSCLC), are diagnosed in approximately 75% of patients with lung cancer in the United States. The treatment of these three tumor cell types is approached in virtually identical fashion because, in contrast to small cell carcinoma of the lung, NSCLC more frequently presents with localized disease at the time of diagnosis and is thus more often amenable to surgical resection but less frequently responds to chemotherapy and irradiation. Cigarette smoking is etiologically related to the development of NSCLC in the great majority of cases. Genetic mutations in dominant oncogenes such as K-ras, loss of genetic material on chromosomes 3p, 11p, and 17p, and deletions or mutations in tumor suppressor genes such as rb and p53 have been documented in NSCLC tumors and tumor cell lines. NSCLC is diagnosed because of symptoms related to the primary tumor or regional or distant metastases, as an incidental finding on chest radiograph, or rarely because of a paraneoplastic syndrome such as hypercalcemia or hypertrophic pulmonary osteoarthropathy. Screening smokers with periodic chest radiographs and sputum cytologic examination has not been shown to reduce mortality. The diagnosis of NSCLC is usually established by fiberoptic bronchoscopy or percutaneous fine-needle aspiration, by biopsy of a regional or distant metastatic site, or at the time of thoracotomy. Pathologically, NSCLC arises in a setting of bronchial mucosal metaplasia and dysplasia that progressively increase over time. Squamous carcinoma more often presents as a central endobronchial lesion, while large cell and adenocarcinoma have a tendency to arise in the lung periphery and invade the pleura. Once the diagnosis is made, the extent of tumor dissemination is determined. Since most NSCLC patients who survive 5 years or longer have undergone surgical resection of their cancers, the focus of the staging process is to determine whether the patient is a candidate for thoracotomy with curative intent. The dominant prognostic factors in NSCLC are extent of tumor dissemination, ambulatory or performance status, and degree of weight loss. Stages I and II NSCLC, which are confined within the pleural reflection, are managed by surgical resection whenever possible, with approximate 5-year survival of 45% and 25%, respectively. Patients with stage IIIa cancers, in which the primary tumor has extended through the pleura or metastasized to ipsilateral or subcarinal lymph nodes, can occasionally be surgically resected but are often managed with definitive thoracic irradiation and have 5-year survival of approximately 15%.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Non-small cell lung cancer. Part I: Biology, diagnosis, and staging. 164 34

Although intestinal metastases from lung cancer are not rare at postmortem studies, the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. We report a case of small intestinal hemorrhage leading to intestinal perforation secondary to metastases from a large cell carcinoma of the lung in a 31-year-old man along with a review of the literature.
 ...
PMID:A case of intestinal hemorrhage due to small intestinal metastases from primary lung cancer. 166 57

Efforts to diminish the overall morbidity and mortality of malignancy have required a variety of strategies and a balanced national research agenda. The design of curative regimens against leukemia, lymphomas, testis cancer, and childhood malignancies is a tribute to the interactions between laboratory and clinical scientists. Laboratory models illustrated the importance of dose and the need for combinations to avoid the emergence of drug resistance in heterogeneous tumors. In addressing the incurability of common epithelial cancers in adults once disseminated, again laboratory models suggested that regimens which produced responses in advanced disease might be curative in patients with micro-metastases. Such proved to be the case in adjuvant therapy for breast cancer involving lymph nodes and for osteogenic sarcoma. Recent studies have extended this strategy to less advanced breast cancer and to locally advanced colon cancer. Lung cancer has required a different strategy. A coalition has developed to support the strongest possible public position against smoking. For the first time lung cancer incidence has leveled off in white males. Women and minorities continue to be a major target for smoking cessation programs. While large randomized trials are expensive (and to some scientists, unexciting), they are our most reliable means of detecting treatment differences of 10 to 15%. Because lung, breast, and colon cancer kill almost 250,000 Americans each year, such "small" differences represent thousands of Americans. There are also a number of interesting current studies that may impact in the longer term on the care of patients with cancer. Research of three different groups of investigators has recently converged. Over the past 3 decades several groups of basic laboratory investigators had been studying and cloning hematopoietic growth factors. Large randomized trials now confirm that myelosuppression after intensive chemotherapy can be substantially ameliorated, reducing infections and decreasing hospital days, risks, and costs. Another cohort of clinical pharmacologists and clinicians were studying bone marrow transplantation, developing combinations of agents that can be given at high dose to overcome resistance, albeit with considerable toxicity. Other groups in blood banks and those interested in the regulation of hematopoiesis recognized that early hematopoietic progenitor cells circulate in the peripheral blood. Their number were increased after certain chemotherapy regimens, by growth factors and most remarkably, with growth factors given after chemotherapy. Patients supported with peripheral blood progenitor cells reengraft both platelets and granulocytes more rapidly than those given marrow, in the time frame of recovery after standard doses of chemotherapy (i.e., 21 days).(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:New developments in clinical oncology: the interdependence of bench and bedside. 167 75

We examined Southern blot analysis of genomic DNAs from 70 patients with sporadic renal cell carcinoma, using the human L-myc oncogene fragment as a hybridization probe. Our purpose was to study the relationship between the restriction fragment length polymorphism (RFLP) of the L-myc and the frequencies of metastasis. The patients were classified into 3 genotypes according to the polymorphic patterns defined by two alleles (L-L:17, L-S:31, S-S:22). The relative ratios of the 3 genotypes in the renal cancer patients were similar to those seen in healthy Japanese. However, of 20 patients who exhibited distant metastases at diagnosis, only 2 belonged to the L-L type. The incidence of distant metastasis in L-L type patients was significantly lower than that in L-S and S-S patients (p = 0.068, by Fisher's exact probability test). These results basically correspond to the previous findings in the lung cancer patients [Kawashima et al.: Proc. natn. Acad. Sci. USA 85: 2353-2356, 1988]. On the other hand, L-myc RFLP analysis in 50 prostatic cancer patients revealed that the incidence of metastasis at diagnosis did not correlate with L-myc genotypes. L-myc RFLP seems to be less promising in prostatic cancer than in lung or kidney cancer.
 ...
PMID:Restriction fragment length polymorphism of the L-myc gene and susceptibility to metastasis in genitourinary cancers. 168 40


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