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)

Of 393 patients with squamous-cell carcinoma in the thoracic esophagus, 60 were found by histologic examination to have intramural metastasis. Metastases in 50 of these were identified by gross inspection. There appeared to be no preference for location proximal to the primary lesion. Eighteen patients had metastasis to the gastric wall, which suggested the existence of communicating lymphatic channels between the wall of the esophagus and the stomach. All 60 primary tumors invaded beyond the submucosa. These 60 patients (group A) were compared with a group of matched control patients without intramural metastasis (group B). The tumor size in group A was significantly larger than in group B (p less than 0.01). The number of patients with lymph-node metastasis was significantly higher in group A (p less than 0.01), and the average number of positive nodes in group A was greater than in group B (p less than 0.01). Recurrent disease in the mediastinal lymph nodes and in the liver is characteristic of group A. The survival curve for patients in group A was significantly lower than that for group B (p less than 0.001). Conventional radiotherapy or chemotherapy after surgery were ineffective in improving prognosis. These results indicate that the presence of intramural metastasis is an important factor to consider when evaluating the prognosis of patients with squamous-cell carcinoma of the esophagus.
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PMID:Intramural metastasis of thoracic esophageal carcinoma. 172 12

Between 1967 and 1974, 371 patients with carcinoma of the cervix have been treated by a combination of external beam radiotherapy and fractionated high dose rate brachytherapy using the Cathetron. A retrospective review was undertaken in 1986 and median follow-up time was 6 years. Life table analysis of survival and complications to 16 years was undertaken. International Federation of Gynaecology and Obstetrics (FIGO) stage distribution was 26%, 46% and 28% for Stages I, II and III, respectively, and 5 year survival was likewise 94% 63% and 37%. Age and histological type or grade were not found to influence survival. Recurrent disease was recorded in 142 patients; the first site was within the pelvis in 25% and as distant metastases in 17%. Following development of pelvic recurrence median survival was 28 weeks. Salvage surgery was performed in 32 patients, of whom five probably obtained survival benefit. Significant late morbidity was seen in a total of 71 patients (19%); in seven patients this was at more than one site. Late morbidity to the small bowel was recorded as Grade 2 in 10 patients and Grade 3 in 13; to the rectum, Grade 2 in 10 patients and Grade 3 in two patients; to the bladder, Grade 2 in 15 patients and to the vagina Grade 2 in 29 patients. Median time to onset for small bowel morbidity was 14 months, for rectum 18 months, for vagina 20 months and for bladder 52 months. 82% of all late morbidity had been seen by 5 years of follow-up, no case of late morbidity of recurrence was seen between 11 and 18 years of follow-up. These results are comparable to those reported for other methods in use at the time the patients were treated.
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PMID:Long term results of Cathetron high dose rate intracavitary radiotherapy in the treatment of carcinoma of the cervix. 174 85

We report a prospective study in two groups of colorectal cancer patients carried out by radio-immunolocalization (RIL) with F(ab') fragments of monoclonal antibodies against CEA and CA 19.9 labeled with 131-I. Twenty-two patients were studied before radical surgery and 12 patients after initial surgery, when progressive increase in CEA was registered. Scintigraphic images obtained in vivo in RIL studies were compared with scintigraphic images of the corresponding surgical specimens. Results were compared with known serum marker levels and with the presence and localization of markers in the excised specimens. RIL images correctly identified 13 of 23 (52%) primary tumors, with only one false positive image. Scintigraphy of surgical specimens correlated with RIL findings in 14 of 19 cases (74%). Four specimens which showed antibody uptake had not been visualized preoperatively in the RIL study. Two of them were retrovesical and were obscured by residual activity in the bladder. Nine of 13 (64%) patients with at least one elevated tumor marker were imaged. Staining pattern or intensity of antigen staining in the specimens did not correlate with RIL findings. Recurrent disease was confirmed by laparotomy or other exploration in 10 of the 12 patients with progressive CEA elevation during follow-up. Spontaneous normalization of CEA levels was observed in the remaining 2 patients. RIL studies were positive in 7 of the 10 patients with confirmed recurrent disease. Of the 3 false negative patients 2 had liver metastases and one developed clinical lung, bone and adrenal metastases 11 months later. No false positive studies were observed in this group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Radioimmunolocalization of colorectal carcinoma. A correlation among RIL results, surgical findings, serum tumor marker levels and the presence of CEA and CA 19.9 in tumor tissue: the experience of the Hospital de la Santa Creu i Sant Pau. 176 27

Recurrent disease from colorectal carcinomas is common. 25 percent of patients have apparent metastases at the time of first detection of the tumor, and at least 50% of patients die from their tumor. The aim of the postoperative follow-up of patients with carcinoma of the colon and rectum is thus to detect recurrent tumor when cure is still possible. Clinical examination and CEA-measurement is widely recommended as a reliable indicator for recurrence and metastases of colonic cancer. This may be combined with regular coloscopic surveillance for detection of anastomotic recurrences or a second colonic cancer. In case of suspicion of a recurrence or metastasis a full range of examinations should be performed to detect the site of recurrent tumor and to exclude wide spread disease. In case of a circumscribed lesion the patients may benefit from local radical resection. Patients with four or less unilateral liver metastases show a five year disease free survival reported of more than 30% and a disease free survival reported of more than 25%. Unfortunately because of wide spread misunderstanding of the potential of hepatic Rx only about 1/3 of potentially curatively resectable patients with liver metastases finally undergo liver surgery. A more active policy towards patients with colorectal disease concerning surveillance may lead to a better survival in selected cases.
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PMID:[Colorectal cancers: therapy of recurrences and metastases]. 192 5

Serum CA 125 levels were normal preoperatively in 123 of 125 (98.4%) patients with clinical and surgical stage I or II endometrial adenocarcinoma, and remained so in all patients who remained without evidence of either isolated vaginal recurrence or postoperative radiation enteritis. Recurrent disease developed in 13 patients. All of those who had pelvic (1), abdominal (4), or pulmonary (2) metastases had elevated serum CA 125 levels. None of the six patients with isolated vaginal recurrences had elevated CA 125 levels. Four patients had small bowel obstruction as a result of postoperative pelvic radiation, and all had elevated CA 125 levels during these episodes, although no evidence of recurrent disease was found during exploratory laparotomy for intestinal bypass. Serum CA 125 levels may have a role in the posttreatment surveillance of patients with early-stage endometrial carcinoma, but may be falsely elevated in the presence of severe radiation injury and at a normal level in the presence of isolated vaginal metastases.
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PMID:Use of serum CA 125 measurement in posttreatment surveillance of early-stage endometrial carcinoma. 230 25

Malignant melanoma in children and adolescents is a rare phenomenon. During a retrospective computer-aided chart review, 78 patients less than 20 years of age were identified who had the diagnosis of malignant melanoma. This accounted for 1.8 per cent of all the melanomas registered at the University Melanoma Clinic. Fifty-one per cent were females, and all the patients were white. Most of the lesions were found on the primary areas of the trunk and extremities. Sixty-seven per cent of the melanomas were of the superficial spreading type, and 82 per cent were invasive to Clark level III and IV. The range of tumor thickness was 0.32 to 5.22 millimeters, with a mean of 1.76 millimeters. Similar population characteristics were noted in the adult and juvenile populations. Controlling for the two most powerful prognostic factors for Stage I melanoma, that is, ulceration and tumor thickness, the actuarial survival times between the two population groups were similar. The median survival times in the adult and juvenile population were 12.9 and 11.9 years, respectively (p = 0.54). There was a trend toward a shorter disease-free interval in the juvenile population. The five year disease-free interval was 65 per cent for adults with melanoma compared with 57 per cent for juveniles with malignant melanoma (p = 0.16). Multiple regression analysis failed to reveal age less than 20 years to be an independent prognostic factor for the development of metastases or over-all survival time. Recurrent disease was observed in 46.2 per cent of juveniles with melanoma who were initially Stage I at diagnosis. Eighty per cent of the relapses occurred in either the local skin or regional lymph nodes. Although malignant melanoma is rare in populations of patients younger than 20 years of age, clinicians should be aware that melanoma does occur in juveniles. With an aggressive approach to surgical therapy, survival rate is comparable with that of the adult population.
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PMID:Juvenile malignant melanoma. 291 54

The results of computed tomography (CT) and other imaging techniques performed on 70 patients who were investigated for suspected recurrent carcinoma of the cervix are reported. Recurrent disease was present in 39 patients. In 29, there was local recurrence with or without distant metastases and there was distant recurrence only in 10. Computed tomography correctly assessed the presence of local recurrent disease in 85% of patients. Six equivocal, two false positive and two false negative CT examinations in the assessment of local recurrence were due either to difficulty in differentiating recurrent disease from changes following radiotherapy, or to the failure of CT to detect small areas of local recurrent disease. Ultrasound and lymphangiography each detected recurrence in one patient which was missed by CT, but this was the most reliable technique for the detection of both local and distant recurrent disease.
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PMID:The value of CT in the diagnosis of recurrent carcinoma of the cervix. 305

To evaluate the clinical significance of elevated carcinoembryonic antigen (CEA) titers in the follow-up of patients with breast cancer, 282 patients were analyzed retrospectively. All patients showed elevated CEA titers, ie, titers equal to or above 5 ng/ml on at least one occasion. The time interval from mastectomy ranged from 3 months to 7 years. Recurrent disease became clinically evident in 52% with a mean lead time of 5 months. No recurrence was found in the remaining patients despite a mean observation time of 20 months and repeated intensive search for metastases. However, taking into account the height and the further course of the titers, CEA measurement was helpful in predicting recurrent disease at an early stage. CEA titers above 30 ng/ml and constantly elevated or increasing titers were associated with a high frequency of recurrence. Although no correlation was found between site of recurrence and course of CEA, patients with soft tissue metastases exhibited lower CEA titers as compared with patients with visceral or osseous lesions. Furthermore, CEA titers encountered before clinical detection of recurrence were of prognostic value with regard to survival. Titers above 50 ng/ml and an increasing course of CEA were associated with diminished life expectancy. By summary, serial CEA assays were a helpful laboratory tool for early diagnosis of recurrent breast cancer.
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PMID:Elevated serum carcinoembryonic antigen and prognosis of breast cancer patients postmastectomy. 339 Aug 52

The efficacy of the barium enema examination and abdominal computed tomography (CT) was investigated in 81 patients who had undergone operation for colorectal carcinoma. Recurrent disease was found in 52 patients and was divided into local (anastomotic and perianastomotic) and remote (distant and hepatic metastases) types. In 32 patients with locally recurrent carcinoma, the sensitivity of the barium enema examination was 88%; for CT it was 69%. Conversely, the barium enema examination was not useful for detecting remote metastases shown on CT, which disclosed disease at one or more sites in 47 (90%) of the 52 patients. CT best evaluated recurrences remote from the anastomosis, pelvic recurrences in patients with colostomies, and hepatic metastases. Barium enema examination and CT were therefore found to be complementary modalities.
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PMID:Recurrent colorectal carcinoma: evaluation with barium enema examination and CT. 356 10

Data were obtained retrospectively on 1005 patients with histologically proven endometrial carcinoma from January 1960 to December 1976 inclusive. The 5- and 10-year actuarial survivals for all stages were 83 and 80% respectively. Recurrent disease developed in 14% of patients. The site of first recurrence was vaginal vault in 2.5%, lower vagina in 1.1%, pelvis in 5.7%, and lungs in 1.9%. Thirty-eight patients (27%) had multiple sites of metastatic disease at the time of first relapse. The only significant independent prognostic variables for clinical Stage I adenocarcinoma treated with surgery and radiation were no myometrial penetration and poorly differentiated tumors.
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PMID:Prognostic variables in endometrial carcinoma. 359 47


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