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)

A patient with recurrent gastric cancer which infiltrated the pelvic muscle after the treatment of paraaortic lymph node and ovarian metastases was successfully managed by a novel oral anticancer drug, TS-1. TS-1 was administered at a dose of 80 mg/day. One course consisted of two repetitions of consecutive administration of TS-1 for 14 days and withdrawal of TS-1 for 14 days. Adverse reactions were mild and the patient did not request hospitalization after two courses had been completed. Subjective symptoms such as difficulty in walking improved after one week and a partial response was obtained after 2 weeks of treatment. At the end of 4 courses we could remove an indwelling pyelocatheter for the ureter stricture. As of 14 months after the beginning of administration of TS-1, the patient is being treated as an outpatient and has attained a better QOL than before.
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PMID:[A case of recurrent gastric cancer successfully treated with TS-1]. 1132 92

The causes, incidence of, and the time of occurrence of cancer of the stomach resected for benign diseases are analyzed. The outcomes of 384 operations for recurrent gastric cancer, including 174 radical ones, are presented. The highest resectability was noted in late recurrence and following Bilroth-II gastrectomy with long-loop forward colonic anastomosis. The late outcomes depend on the time of recurrence, its location in the remaining part of the stomach, and the presence of lymphogenic metastases. Experience of 16 extirpations of esophagojejunal anastomosis was used to show whether recurrent gastric cancer after gastrectomy with satisfactory immediate and long-term outcomes can be surgically treated. The fate of 292 patients with gastric cancer in whom tumor cells were detected along the line of resection is traced. Preventive resurgery in this group of patients is not unjustifiable as in 80.8% of them recurrence fails to occur at all or is followed by late metastases.
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PMID:[Basic directions in studying cancer of the resected stomach]. 1167 61

We experienced a case of recurrent gastric cancer with a long-term survival. A 64-year-old man was admitted to the hospital for advanced gastric cancer in the upper stomach. Abdominal CT scan revealed para-aortic lymph nodal metastases. The patient underwent total gastrectomy, distal pancreatectomy, splenectomy, left adrenectomy, and left nephrectomy with D4 lymph node dissection, in what was a curability B resection. Conclusive findings were t2 (ss), n4, H0, P0, M0, and stage IVb. One year after the operation, para-aortic lymph node recurrence was evaluated. The patient was treated with low-dose cisplatin-5-FU therapy, and a partial response was observed and continued for over 2 years with an administration of UFT-E (300 mg/day). He died of repeated aggravation of para-aortic lymph node metastases 6 years and 2 months after the operation. We considered that the long-term survival of this patient was attributable to a 3-year tumor dormancy induced by low-dose cisplatin-5-FU therapy and administration of low-dose UFT.
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PMID:[Dormant chemotherapy by low-dose FP and low-dose UFT-E in recurrent gastric cancer with long-term survival--a case report]. 1186 37

This retrospective study was designed to assess the accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in diagnosing recurrence of gastric cancer. Thirty-three patients who had received surgical treatment for gastric cancer with curative intent and who had subsequently undergone FDG-PET for suspected recurrence were retrieved from the PET database. All patients were reviewed with full knowledge of prior conventional diagnostic work-up. Results were compared with a gold standard, consisting of histological confirmation or radiological and clinical follow-up. The gold standard established disease recurrence in 20/33 patients (prevalence 61%). Sensitivity and specificity of FDG-PET for the diagnosis of recurrence were 70% (14/20) and 69% (9/13), respectively. Positive and negative predictive values were 78% (14/18) and 60% (9/15), respectively. Of the six false-negative cases, all had intra-abdominal lesions (three had generalised abdominal metastases, one liver metastasis, one local recurrence and one ovarian metastasis). In the subgroup with previous signet cell differentiation of the primary tumour ( n=13, disease prevalence 62%), sensitivity was 62% (5/8) and specificity, 60% (3/5). Survival analysis for the entire patient group using Kaplan-Meier statistics yielded a longer survival in the PET-negative group (mean+/-SD, 21.9+/-19.0 months) than in the PET-positive group (mean+/-SD, 9.2+/-8.2 months) ( P=0.01). In the patient group with proven recurrence ( n=20), the mean survival for the PET-negative group was 18.5 (+/-12.5) months, as compared with 6.9 (+/-6.5) months for the PET-positive group ( P=0.05). Because of its poor sensitivity and low negative predictive value, FDG-PET is not suited for screening purposes in the follow-up of treated gastric cancer. However, FDG-PET appears to provide important additional information concerning the prognosis of recurrent gastric cancer.
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PMID:Whole-body PET with FDG for the diagnosis of recurrent gastric cancer. 1191 91

Today, no effective chemotherapy regimen has been established for non-resectable or postoperative recurrent gastric cancer, and most such therapy seems to be palliative. Thus, a highly effective chemotherapy that allows good patient QOL is desired. We report three gastric cancer patients responding to chronomodulation chemotherapy (tegafur + cisplatin + Isovorin) based on circadian rhythms plus a new antitumor drug, CPT-11. The treatment protocol was tegafur 1,200 mg/body, days 1-12 (continuing 16 h, intravenously with 800 mg/body from 16 to 24 h, 400 mg/body from 24-8 h, for non-uniform administration), cisplatin 10 mg/body, days 1-5, 8-12, (16 h, one shot infusion), Isovorin 25 mg/body, days 1-5, 8-12 (16 h, one shot infusion), followed by CPT-11 100 mg/body, days 13 (one shot infusion). We performed 1 or 2 courses, and with 2 courses the CPT-11 dose was increased to 150 mg/body. The first patient was a 54-year-old female with advanced type 3 gastric cancer with liver metastasis (H3). After chemotherapy (2 courses), there was a 30% reduction in the advanced gastric cancer and a 95% reduction in the liver metastasis. The second patient was a 73-year-old male with recurrent type 1 gastric cancer in the remnant stomach 24 months after partial gastrectomy. After chemotherapy (1 course), there was a 45% reduction in advanced gastric recurrent cancer. The third patient was a 67-year-old male with advanced type 2 plus 3 gastric cancers with liver (H3) and abdominal lymph node metastases. After chemotherapy (1 course), there was a 70% reduction in the type 2 and 55% reduction in the type 3 advanced gastric cancer, and a 50% reduction in the liver metastasis and 35% reduction in the abdominal lymph node metastasis. The only adverse effect was grade 2 pancytopenia, gastrointestinal disorder, and alopecia. In conclusion, this regimen resulted in good intrachemotherapeutic QOL and was highly effective in advanced gastric cancer patients.
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PMID:[Three patients with advanced nonresectable and recurrent gastric cancer responding to chronomodulation chemotherapy with tegafur + cisplatin + isovorin followed by CPT-11 administration]. 1221 74

A 54-year-old man suffering from Borrmann type 4 advanced gastric cancer with pancreatic invasion and paraaortic lymph node metastases underwent a total gastrectomy, which was a radical C operation. From postoperative month 4, he visited our hospital with multiple liver metastases and increased lymph node metastases. After chemotherapy with CDDP and 5-FU, CDDP and UFT was administered on an outpatient basis. The effect of this therapy was PD, therefore, docetaxel and 5'-DFUR combination chemotherapy was performed as second line therapy. After 2 courses of this therapy, the size of liver and lymph node metastases was reduced and the effect of this therapy was PR. The patient has undergone 4 courses of this therapy and is maintaining a clinical PR. It is conceivable that docetaxel and 5'-DFUR combination chemotherapy is useful for patients with advanced and recurrent gastric cancer, even if they had been treated with 5-FU administration as first line therapy.
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PMID:[A case of recurrent gastric cancer that responded dramatically to docetaxel and 5'-DFUR combination chemotherapy]. 1235 54

In Western literature, there are few studies investigating the predictors of early versus late recurrence after curative gastrectomy for gastric cancer. The current study analyzed (1) patients who died of recurrent gastric cancer and (2) prognostic factors, which can be applied to timing of death from tumor recurrence. Of 492 patients who underwent curative resection (R0) for gastric cancer in the Department of Surgery, Medical Faculty of Istanbul between 1994 and 2000, 142 patients who died of recurrence were included into study. None of the patients had received postoperative adjuvant treatment. The patients were divided into 2 groups: an early recurrence group that included 102 patients who recurred and died within 2 years after surgery, and a late recurrence group, which included 40 patients who died of recurrence more than 2 years after surgery. Clinicopathologic findings were compared between the early and late recurrence groups. Multivariate analysis was performed to investigate the independent factors, which are predictive for early versus late recurrence, and prognostic factors independently associated with the survival period. In multivariate analysis, the early recurrence group, when compared with the late recurrence group, was characterized by lymph node metastasis (N1-3 versus N0; P = 0.002). Overall survival was influenced by nodal status (N1-3 versus N0; P = 0.003), type of operation performed (radical total versus radical subtotal gastrectomy; P = 0.003), Eastern Cooperative Oncology Group performance status (PS 3-4 versus PS 1-2; P = 0.004), and tumor localization (cardia versus corpus and antrum; P = 0.046). In contrast, T stage of the disease was not prognostic for survival, although it was close to statistical significance (P = 0.066). Multivariate analysis showed that poorer performance status at initial presentation (P = 0.001) and lymph node metastasis (P = 0.032) independently correlated with overall survival (P = 0.002). Lymph node status was the most important factor predictive for early versus late recurrence and patients with lymph node metastases were at more risk of death within 2 years after curative operation for gastric cancer. Postoperative chemoradiotherapy should be especially recommended for patients at high risk of recurrence of adenocarcinoma of the stomach or who have undergone curative resection.
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PMID:Timing of death from tumor recurrence after curative gastrectomy for gastric cancer. 1505 62

We report 2 patients with recurrent gastric cancer treated by combined chemotherapy of TS-1 and low-dose cis-platinum (TS-1/LCDDP). Who both obtained long-term survival while maintaining good QOL. Case 1: A 60-year-old man underwent total gastrectomy for gastric cancer (pT3, pN2, Stage III B). Three months after surgery, multiple liver metastases were identified, for which TS-1/LCDDP therapy (TS-1 100 mg/body/day, CDDP 10 mg/body/week; 1 course for 4 weeks) was started without hospitalization. After CR was obtained after 4 courses, an additional 4 courses were carried out. At present, 1 year and 11 months have passed since the initial treatment, and CR has been maintained. Regarding adverse events, only grade-1 pigmentation was observed. Case 2: A 65-year-old man with gastric cancer (pT3, pN1, Stage III A) underwent distal gastrectomy. One year after surgery, CT showed both multiple liver and pulmonary metastases. Twelve courses of TS-1/LCDDP therapy have been carried out for 2 years and 4 months. Therapeutic effect was NC, but the patient was able to tolerate the treatments as an outpatient without any subjective symptoms. Leukopenia (grade 2), pigmentation, stomatitis and nausea (grade 1) were observed. Both patients received TS-1/LCDDP therapy as outpatients with good QOL and performance status (0). Recently, chemotherapy for recurrent cancer has been focusing on long-term survival and maintenance of QOL, instead of tumor shrinkage. These results suggest that TS-1/LCDDP treatment is useful as a first-line chemotherapy for patients with recurrent gastric cancer.
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PMID:[Two cases of recurrent gastric cancer treated by combined chemotherapy of TS-1 and low-dose cis-platinum]. 1517 Sep 89

A case of recurrent gastric cancer with metastases to the skin and lung was treated successfully with low-dose paclitaxel after oral TS-1 administration. The patient was a 73-year-old man who underwent total gastrectomy for gastric cancer on April 3, 2000. Two years and four months after the operation, an increasing CA19-9 concentration and metastases to the skin and both lungs were observed. Oral TS-1 was given, but had to be stopped because of diarrhea. The metastatic lesions of the skin were resected, and low-dose paclitaxel (100 mg) was given once a week for 6 weeks. Five months later, the metastatic lesions of the right and left lung had decreased in size by 62% and 100%, respectively. CA19-9 fell to below the cut-off value 2 months after starting therapy. A decrease in the hemoglobin level of grade 1 was observed. Low-dose paclitaxel for recurrent gastric cancer after TS-1 therapy causes few side effects and may well be effective.
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PMID:[A case of recurrent gastric cancer with skin and lung metastasis treated by low-dose paclitaxel therapy]. 1562 69

A 69-year-old man underwent total gastrectomy for advanced gastric cancer in August 2001. After surgery, he was treated daily with UFT 300 mg. In October 2002, the tumor marker (CEA) increased in value, and CT revealed multiple liver metastases. Because there were no extrahepatic metastases, we attempted to use hepatic arterial injection chemotherapy. A reservoir was placed in the hepatic artery on November 12. Thereafter, intra-arterial injection of paclitaxel at 120 mg (80 mg/m2) was administered over one hour to the reservoir. This arterial injection chemotherapy was administered once weekly for 3 weeks followed by 1 week rest. After 3 courses, CEA decreased markedly and CT revealed remarkable tumor reduction which was thought to show a partial response (PR). After 6 courses, PR was continued. Adverse effects were only grade 1 alopecia and leukopenia. No major adverse effects were observed. These results suggest that hepatic arterial injection therapy with weekly paclitaxel is effective against recurrent gastric cancer with liver metastases.
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PMID:[A case of postoperative liver metastases from gastric cancer successfully treated with hepatic arterial infusion of paclitaxel]. 1567 90


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