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)

Immunoperoxidase staining for prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) help to identify patients with prostatic carcinoma presenting as metastatic disease from an occult primary source. To clarify further the reliability of these prostatic tissue antigens, we have examined the primary tumor and metastatic sites in 16 autopsy cases. Eleven of these had diffusely positive findings for PSA and PAP in the primary and all metastatic sites, and 1 case lacked both antigens in all locations. Four cases demonstrated variability between these antigens and among various sites. Prostatic primary lesions contained PAP and PSA in 13 (81%) and 12 (75%) cases, respectively. The most reliable metastatic sites were lymph nodes, seminal vesicles, lung, bone, and kidney; while liver, adrenal, and colorectal sites were less reliable. No relationship existed between serum PAP levels and tissue detectability of PAP. The use of both PAP and PSA increases the likelihood of properly identifying the prostate as the organ of origin of metastatic disease. In spite of the use of both markers, however, three primary lesions would have been misdiagnosed, and 1 case lacked both antigens in all metastatic sites as well. In poorly differentiated lesions, the lack of both antigens does not unequivocally eliminate the possibility of prostatic carcinoma.
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PMID:Immunoperoxidase localization of prostatic antigens. Comparison of primary and metastatic sites. 620 96

Diagnosis is suggested by the functional symptoms and digital rectal examination and must be confirmed by histological examination. The second step is to evaluate the patient's condition, the extent of the cancer and the consequences on the urinary system; the choice of the treatment depends on this evaluation. The most common tumors are adenocarcinomas with a histological grading strongly correlated to the lymphatic involvement and frequency of metastases. Lymphatic involvement is closely related to the local clinically demonstrable involvement, histological grade, serum acid phosphatase concentrations and results of lymphography. Upon diagnosis of cancer of the prostate more than half the patients already harbour metastases, usually of the bone. This percentage is correlated to the size of the primary tumor, involvement of the seminal vesicles, histological grade and lymphatic involvement. The authors propose a series of investigations adapted to each case.
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PMID:[Diagnosis and evaluation of the extent of cancer of the prostate]. 631 15

Magnetic resonance imaging (MRI) of the prostate was accomplished in 10 patients who subsequently had surgical exploration for histologic confirmation and tumor staging. Eight patients were found to have carcinoma of the prostate. Two patients had malignancies of the urinary bladder and were treated with radical resection of the bladder and prostate. The prostatic glands in the latter two patients were free of tumor. One gland was entirely normal; the other had extensive acute and chronic prostatitis. Two resected prostates with carcinoma and one normal prostate were available for in vitro MRI in a clinical magnetic resonance unit. The MRI finding of prostatic carcinoma was heterogeneous signal patterns, seen best on T2-weighted studies. A similar pattern was identified in the gland with acute and chronic prostatitis. There was a homogeneous MRI signal pattern of the normal prostate gland examined in vitro. In two instances, the MRI studies were accurate for the identification of tumor spread to the seminal vesicles, not diagnosed at the time of surgical resection. Microscopic metastatic disease of the lymph nodes in four patients was not identified by MRI.
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PMID:Clinical and in vitro magnetic resonance imaging of prostatic carcinoma. 633 96

The authors undertake a complete review of the literature concerning the various methods of spread of bladder tumours. They successively consider spread through the thickness of the bladder wall, surface extension, direct implantation of exfoliated cells, lymphatic spread, and venous dissemination both in the bladder wall as well as to the viscera by metastases. It is difficult to give a brief analysis of such an exhaustive review. However, a number of facts are worthy of emphasis: --the frequency of invasion of the seminal vesicles and the prostate; --the reliability of combined clinical, radiological and endoscopic findings, which may be used to differentiate deep tumours and superficial tumours in more than 80% of cases; --the importance of methods which await development, such as the scanner and, above all, ultrasound techniques; --the importance of study of the vesical mucosa at a distance from the tumour itself, both by fluorescent cystoscopic methods, as well as by distant biopsies (30 to 50% of premalignant cell changes found in cystoscopically normal zones); --the frequency if invasion of the terminal portions of the ureters (10% on average) and of the urethra (12 to 15%); --the prognostic gravity of tumour emboli in the intraparietal lymph vessels, the presence of which reduces the chances of cure at 5 years by two thirds; --the usual limitation of the first lymph node spread to the external iliac and hypogastric vessels with the exception of tumours of the bladder neck, where the first lymph node spread occurs to the aortic bifurcation; --the gravity of the presence of emboli in the parietal veins which reduces chances of survival at 5 years by half; --finally, the recently recognized frequency of secondary bone tumours; --and the supposed frequency of infraclinical metastases which would be a considerable argument in favour of complementary chemotherapy in therapeutic protocol for carcinomas of the bladder.
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PMID:[Various methods of spread of bladder tumours (author's transl)]. 703 79

A case of carcinosarcoma of the prostate is described. Review of the literature revealed few cases, only 2 being well documented. The tumor presented as a urethral polypoid obstruction of the bladder neck and proved to involve bilaterally, the prostate and the seminal vesicles with metastases to the regional lymph nodes. Light microscopic findings are described as a multimorphic tumor with simultaneous presence of sarcoma, characteristically being malignant cartilage, rhabdomyosarcomatous component, and poorly differentiated carcinomatous areas. Controversy of this morphologic entity is discussed briefly. These tumors are highly anaplastic and rapidly fatal.
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PMID:Carcinosarcoma of prostate. 725 48

Operation specimens of 165 radical prostatectomies were examined systematically for their pathological anatomy. In 22 cases (13.3%) there were metastases in the obturator and (or) iliac lymph nodes, in 12 cases these were micro-metastases with a maximal diameter of 2 mm. Ten were classified as N1, 7 ad N2 and 5 as N4. Lymph node involvement increased with increasing tumour staging: from 10% in T2 to 26.3% in T3. All metastasizing tumours had invaded the capsule (P3), 77% had additional infiltration of the seminal vesicles and in 73% the tumour volume was at least 50% that of the prostate. Thus prostate carcinoma must reach a certain size and penetrate the capsule before lymph node seeding occurs. The rate of metastases increases ninefold when the seminal vesicles are infiltrated. All metastasizing prostate cancers were polymorphic and in 73% the tumour differentiation in the metastases was identical. The findings as regards localisation of the tumour in the prostate and the metastases correlated in 91%. This result leads one to suspect a regular course of laterally localised spread in which the group of obturator lymph nodes appears to lie in the primary lymph drainage area of the prostate. The prognostic significance of regional lymph node metastases cannot yet be evaluated.
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PMID:[The incidence of regional lymph node metastases in operable prostatic carcinoma (author's transl)]. 746 Jul 82

A total of 71 patients with clinically localized prostatic cancer underwent preoperative biopsy of each seminal vesicle. Group 1 (67 patients) underwent 2 seminal vesicle biopsies before lymph node dissection and vesiculo-prostatectomy, while group 2 (4 patients) underwent seminal vesicle biopsy and lymph node dissection before radiation therapy. In group 1 there were 11 positive biopsies (16.5%) with a median prostate specific antigen (PSA) level of 24 ng./ml. (range 11 to 45). Of the biopsies 56 were normal, with a median PSA level of 11.8 (range 3.5 to 88, p < 0.008). Histological examination of the seminal vesicles on the prostatectomy specimen revealed 18 cases of seminal vesicle invasion (sensitivity 61%, specificity 100%, positive predictive value 100% and negative predictive value 87.5%). A positive biopsy was correlated with the mean tumor volume (10.3 cc with positive biopsies versus 4.9 cc with negative biopsies) and local invasion (positive margins in 36% versus 9%, respectively, and capsular perforation in 81% versus 25%, respectively). In group 2 the 4 seminal vesicle biopsies and lymph node dissections were positive. Overall (groups 1 and 2), positive seminal vesicle biopsies were predictive of lymph node involvement in 47% of the cases versus 7% when biopsies were negative (p > 0.001). The postoperative course was significantly different (local recurrence and metastases in 45% versus 9%, respectively, and median interval 8.8 months versus 18.3 months, respectively, p < 0.001). Seminal vesicle biopsy appears to have a satisfactory yield only in cases with a PSA level of greater than 10 ng./ml. A positive seminal vesicle biopsy confirms the presence of extraprostatic invasion of clinically localized cancer in a given patient. Seminal vesicle biopsy allows for better staging of prostatic cancer.
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PMID:Influence of preoperative positive seminal vesicle biopsy on the staging of prostatic cancer. 752 Sep 50

A total of 601 patients who underwent radical retropubic prostatectomy for localized prostate cancer at our institution was followed with serial prostatic specific antigen (PSA) determinations. Three separate groups were delineated by pathological stage: 293 patients with organ confined disease, 215 with involvement of the capsule or positive margins and 93 with extension to the seminal vesicles. Followup ranged from 12 to 237 months (median 34). Five and 10-year disease-free survival rates for the 601 patients were 86 +/- 2% and 78 +/- 3%, respectively. The rate of detectable PSA (greater than 0.4 ng./ml.), used as an indicator of cancer progression, revealed 5 and 10-year disease-free rates of 69 +/- 2% and 47 +/- 3%, respectively. When comparing the patients from an earlier series to those who underwent surgery after 1986, an improvement in the 5-year clinical disease-free rate was noted (78 +/- 2% versus 93 +/- 2%, respectively). Similarly, an improvement in the 5-year disease-free survival rate with nondetectable PSA level was demonstrated in our contemporary series (80 +/- 3%) compared to our historical series. Of the 601 patients 123 had a detectable post-prostatectomy PSA level with or without clinical evidence of metastasis. A PSA doubling time before onset of adjuvant therapy was determined in 94 patients. Post-prostatectomy PSA doubling times were significantly different when comparing the patients who ultimately had progression to distant metastases (median 4.3 months) to those with either clinical local recurrence or a PSA elevation as the sole indicator of recurrence (median 11.7 months). Radical retropubic prostatectomy, whether assessed by clinical or biochemical means, has demonstrated excellent disease-free survival rates, especially since the advent of PSA and anatomical radical prostatectomy.
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PMID:The incidence and significance of detectable levels of serum prostate specific antigen after radical prostatectomy. 793 40

Animal models of human prostate cancer are very limited in number but are of obvious importance to develop. Dr. Morris Pollard (M. Pollard, J. Natl. Cancer Inst., 51: 1235-1241, 1973) has reported that Lobund-Wistar rats develop spontaneous metastatic prostatic cancer when they become old (approximately 25% incidence after 25 months). A chemically induced form of the disease has also been described in Lobund-Wistar rats. However, recent reports suggest that most of the chemically induced adenocarcinomas are not prostatic in origin, with most arising in the seminal vesicle, and thereby raise questions about the origin of the spontaneous cancers. We herein report cancer spontaneously arising in the lateral lobes of the prostates in Lobund-Wistar rats. One of 8 rats killed at 16 months of age showed prostatic carcinoma in situ. Two of 39 rats killed at 20 months displayed early invasive adenocarcinomas with no signs of metastases. Because sectioning of the prostates in this study was limited to face sections from a single block for each rat, it is highly probable that the true incidence of dysplasias and carcinomas is underestimated by these data. Dysplastic or neoplastic changes were not seen in either the seminal vesicles or other portions of the prostatic complex. The nuclei of adenocarcinoma cells showed less labeling with antibody to the androgen hormone receptor than did normal cells. These data strongly support the validity of the Pollard model of spontaneous prostate cancer in Lobund-Wistar rats.
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PMID:Prostatic localization of spontaneous early invasive carcinoma in Lobund-Wistar rats. 752 50

Deoxyribonucleic acid (DNA) ploidy image analysis was used postoperatively to predict recurrence of 112 clinically localized adenocarcinomas of the prostate. All men underwent radical retropubic prostatectomy between 1978 and 1991. Patients with positive lymph nodes or positive seminal vesicles were excluded because progression is nearly inevitable in these men. The minimum followup for men without progression was 5 years (range 5 to 15). Patients were considered to have clinically evident disease progression based on local recurrence (8%), distant metastases (4%) and/or an isolated elevation of serum prostate specific antigen (87%). Of the tumors 43% were diploid and 57% were nondiploid. In a multivariate analysis comparing grade, ploidy, capsular penetration and surgical margins, Gleason sum was the best predictor of progression (p < 0.0001). Nevertheless, a subset of patients remained with well to moderately differentiated Gleason grade tumors (Gleason sum 6 or less) who failed. DNA ploidy was able to predict recurrence in this particular group (p = 0.034). In addition, we compared different methods of tissue preparation to determine which best predicted progression. We found that ploidy analysis on tissue sections was more predictive than ploidy performed on disaggregated tissue. In summary, our study revealed that DNA ploidy analysis can offer additional prognostic information following radical prostatectomy for men with low grade prostatic adenocarcinoma.
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PMID:Deoxyribonucleic acid ploidy analysis as a predictor of recurrence following radical prostatectomy for stage T2 disease. 785 49


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