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)

Chest-wall resection can be performed with low morbidity and mortality rates and remains the primary treatment for most chest-wall tumors. However, some lesions are best treated with a multimodality approach including preoperative chemotherapy. Therefore, pretreatment tissue diagnosis is essential in planning. The biopsy should be done at the medical center where the definitive treatment will be undertaken, and frequently, a needle biopsy will be sufficient. Osteosarcoma, rhabdomyosarcoma, Ewing's sarcoma, and other small-cell sarcomas are sensitive to chemotherapy, which should be given preoperatively, continued postoperatively, and modified according to the tumor response. Chondrosarcomas and most adult soft-tissue sarcomas are well controlled by primary excision and selective use of adjuvant irradiation. Better systemic and local therapy is needed for the recurrent soft-tissue sarcomas and the aggressive unclassified sarcomas. Chest-wall resection continues to play a primary role in the management of locally and regionally recurrent breast cancer but is best combined with systemic chemotherapy. Chest-wall resection can provide a long disease-free survival in patients with isolated metastases from sarcomas or carcinomas. In addition, significant palliation can be afforded patients with symptomatic chest-wall metastases and a shortened life expectancy.
 ...
PMID:Current management of chest-wall tumors. 267 48

Although patients with recurrent breast cancer are not curable with presently available treatments, the duration of survival after the development of metastases has increased to about three years. This has been due to optimal supportive care as well as the use of endocrine therapy, chemotherapy and radiotherapy for symptom control. With these methods quality of life can usually be maintained for much of this period.
 ...
PMID:Management of patients with advanced breast cancer. 275 28

A case of recurrent breast cancer with metastases to the lung and bone responding well to cisplatin and vindesine in a 45-year-old woman was reported. She had a radical mastectomy for the right breast cancer (pT2N0M0) at 28 years old. She was well until March 1985, when right iliac bone pain appeared. Osteolytic changes were noted on her pelvic roentgenogram. A biopsy obtained from the right iliac bone revealed metastatic adenocarcinoma. She was admitted to our hospital in December 1985 because of chest pain and swelling of the left axillary lymph nodes. Lymph nodes also showed metastatic adenocarcinoma with positive estrogen receptor. Her chest roentgenogram demonstrated a coin lesion in the left hilum and also left pleural effusion. Cytology of the effusion revealed adenocarcinoma. She was first treated with Adriamycin, 5-FU and Cyclophosphamide, but no significant response was noted. But, after two courses of chemotherapy containing cisplatin (80 mg/m2) and vindesine (3 mg/m2), the coin lesion of the lung and pleural effusion disappeared. The osteolytic bone change of the pelvic bone also improved. The serum CEA level decreased from 34.2 ng/ml to 4.2 ng/ml. These results suggest that cisplatin and vindesine were effective for lung and bone cancers metastatic from adenocarcinoma of the breast.
 ...
PMID:[A case of breast cancer with multiple metastases to the lung and bone responding well to cisplatin and vindesine]. 281 11

Tamoxifen, an antiestrogen, is a competitive inhibitor of estradiol, blocking its effects on the target organs. During the 10 years it has been used in the United States it has become preferred over estrogens for treating postmenopausal women with metastatic breast cancer. Recently, tamoxifen has been used in treating premenopausal women with recurrent breast cancer, and its efficacy has been proved equal to that of ovarian ablation. In comparative trials, tamoxifen has been as effective as alternative endocrine treatments, and has greatly reduced toxicity and no irreversible side effects. Because of the high risk for systemic relapse in patients with breast cancer with regional lymph node metastases, (stage II), tamoxifen has been evaluated as adjuvant therapy after local treatment of the tumor. The results of these trials have shown a significant increase in the disease-free survival of postmenopausal women treated with tamoxifen, particularly in patients with hormone-receptor-positive tumors. Tamoxifen has not been as useful as adjuvant treatment in premenopausal women, for whom combination chemotherapy is the treatment of choice.
 ...
PMID:Tamoxifen in the treatment of breast cancer. 329 59

Some adjuvantly treated patients develop recurrent breast cancer and little is known about the effect of prior adjuvant chemotherapy on subsequent response rates to systemic therapy or on overall survival. We describe our retrospective comparison of 179 patients who received doxorubicin containing adjuvant chemotherapy and developed recurrent breast cancer on University of Arizona Cancer Center clinical trials with 202 non-adjuvantly treated patients entered onto clinical protocols for recurrent or metastatic breast cancer during the same period. Adjuvant failures had a shorter median survival from the date of onset of recurrent disease (18 months versus 28 months, P less than 0.001), a lower response rate to initial combination chemotherapy (38% versus 69%, P = 0.001), and a high incidence of CNS involvement at the time of relapse (11%). In patients having recurrent or metastatic breast cancer, a history of prior adjuvant chemotherapy appears to identify a subgroup who will have a higher incidence of CNS involvement, a lower response rate to chemotherapy and a shorter survival with metastatic disease. These findings may help explain the failure of improved relapse free survival seen in many adjuvant chemotherapy trials to result in improved overall survival.
 ...
PMID:The effect of prior adjuvant chemotherapy on survival in metastatic breast cancer. 334 39

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.
 ...
PMID:Elevated serum carcinoembryonic antigen and prognosis of breast cancer patients postmastectomy. 339 Aug 52

Metastatic bone disease was evaluated in 380 consecutive patients at the time of first metastasis of breast cancer. Studies included radiographic examination, radionuclide examination, and bone marrow biopsy. Radiographs of the skeleton demonstrated metastases in 120 patients (32%), and in 40 of these patients (13%) the bone was the only site of metastases. The diagnostic efficiency was 82% for bone scanning, 80% for pain evaluation, 59% for s-calcium analyses, and 77% for s-alkaline phosphatase analyses. Bone scanning is an effective method to exclude metastatic bone disease (sensitivity: 96%). A positive scan, however, requires radiologic confirmation (specificity: 66%). Bone scanning of the skeleton should be the initial staging procedure in all patients with recurrent breast cancer with no clinical or biochemical signs of bone metastases. Bilateral posterior iliac crest bone marrow aspirations and bone biopsies were positive in 82 out of the 320 patients who underwent biopsy. The frequency of positive bone marrow biopsy was significantly correlated with both the site of radiographic metastases and with the total number of involved bone regions. Routine bone marrow biopsies are indicated in patients with a positive bone scan, but a negative x-ray examination. In these cases biopsies should be performed bilaterally.
 ...
PMID:Clinical and radiologic characteristics of bone metastases in breast cancer. 366 34

The effect of age as a prognostic factor in recurrent breast cancer was studied in 1,168 patients treated on Eastern Cooperative Oncology Group (ECOG) protocols. Survival was significantly shorter in patients less than 35 years of age (P = .03). This was true even when other good prognostic factors were present. Eighteen prognostic factors were analyzed, and the effect on survival in each of six age groups was studied. Patients with better performance status, less than three sites of metastases, and without visceral or nodal metastases had a better survival time. A Cox proportional hazards model of survival showed that younger age groups, irrespective of menopausal status, had shorter survival times. The predicted median survival times after the first recurrence were 491 days for patients less than 35 years of age, 590 days for patients 36 to 45 years of age, and 700 days for those greater than 45 years of age.
 ...
PMID:Age as a prognostic factor in recurrent breast cancer. 375 72

A multimodal treatment strategy for recurrent breast cancer is described. Occasionally, there are a few patients who have no other detectable distant metastases at the time of locoregional recurrence or of appearance of solitary lung metastasis. In such cases, curative results may be obtained with surgical treatment. In cases too extensive for surgical resection, irradiation is the treatment choice for local control. Radiotherapy is also helpful for painful bone lesions. The important basis for the multimodal approach to recurrent breast cancer is a well-balanced combination of local therapy with surgery or irradiation and systemic polychemoendocrine therapy or polychemotherapy followed by maintenance therapy, to improve the quality of life and survival of patients. Concerning the combined chemoendocrine therapy, many investigators have reported an improved effect with simultaneous or sequential use, but not all of these studies have confirmed the advantage of combination therapy over endocrine- or chemo-therapy alone, either in response rate or survival time. Further prospective randomized studies correlating ER status are needed to evaluate this approach. Immunotherapy used as a maintenance therapy may prolong the duration of remission and survival time.
 ...
PMID:[Therapy for recurrent breast cancer]. 389 Jul 57

Mitoxantrone (Novantrone; dihydroxyanthracenedione) is an anthraquinone previously shown to be active in human breast cancer. It appears to have less toxicity than doxorubicin. Results of this phase II-III randomized cross-over trial to determine the relative efficacy and toxicity of mitoxantrone in comparison to doxorubicin, are presented. Patients with measurable, recurrent breast cancer with limited prior chemotherapy with or without radiotherapy for metastatic disease, and who had not been exposed to prior doxorubicin, were randomized to receive either mitoxantrone or doxorubicin every three weeks with cross-over on progression. Response rates, duration of remission, time to treatment failure, and drug toxicity, including cardiac toxicity evaluated with serial radionuclide angiocardiography, were evaluated. Differences in the response rates for the two groups were not statistically significant. Neither time to treatment failure nor duration of response are significantly different (p greater than 0.05). With respect to toxicity, mitoxantrone treated patients consistently exhibited a lower incidence and less severe drug toxicity as compared to their doxorubicin-treated counterparts. Cardiac toxicity was carefully monitored and thus four patients on doxorubicin have had drug related congestive heart failure, as compared to none on mitoxantrone. In summary, mitoxantrone appears to be as active as doxorubicin in patients with stage IV breast cancer previously treated with chemotherapy; however, mitoxantrone causes significantly less nausea, vomiting, stomatitis and alopecia at doses which induce equal or greater myelosuppression than doxorubicin, and appears to be less cardiotoxic.
 ...
PMID:A randomized trial comparing mitoxantrone with doxorubicin in patients with stage IV breast cancer. 389 78


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