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)

Fifty-three patients with metastatic osteogenic sarcoma were treated with vincristine, high-dose methotrexate with citrovorum factor rescue, and cisplatin. Metastases were surgically removed in most patients, either prior to chemotherapy or following initial response to therapy. Among 29 previously treated patients, responses to initial chemotherapy included two complete remissions, six partial remissions, and eight patients with stable disease. Twenty-three patients were disease-free, six for greater than 12 months. Toxicity was moderate, but usually reversible. There were two toxic deaths and one unexplained death 48 hours following a dose of cisplatin.
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PMID:Treatment of patients with metastatic osteogenic sarcoma: a report from the Children's Cancer Study Group. 637 Apr 29

The case of a 25-year-old man who had periosteal osteogenic sarcoma with intravascular metastases in unusual locations is reported. The patient presented with acute renal failure, unilateral pulmonary edema, functional mitral stenosis, and low cardiac output. After successful surgical removal of a left atrial metastasis with subsequent improvement in cardiac output, renal function improved only transiently and urinary output varied markedly. At autopsy, metastatic osteogenic sarcoma was discovered within the lumen of the abdominal aorta obstructing both renal arteries. The case is the first report of a neoplasm metastatic to the aorta causing intermittent bilateral renal arterial obstruction; it illustrates the diagnostic difficulties presented by intravascular metastatic disease.
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PMID:Metastatic periosteal osteosarcoma causing cardiac and renal failure. 657

A report of the demonstration of an asymptomatic intracardiac osteogenic sarcoma metastasis by computed tomography. This metastasis was successfully excised along with associated pulmonary metastases. Intensive chemotherapy and aggressive surgical excision of metastatic osteosarcoma lesions have resulted n 40%-60% long-term survival in these patients.
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PMID:Computed tomographic diagnosis of an intracardiac metastasis from osteosarcoma. 657 95

From July, 1974, to July, 1979, 36 patients with osteogenic sarcoma and 25 patients with soft tissue sarcoma underwent a total of 95 thoracotomies for resection of isolated pulmonary metastases. In only 6 patients could all palpable disease not be resected, although it was certain that microscopic disease remained in some patients. Twenty-six patients underwent more than 1 thoracotomy. The pulmonary lesions were found not to be metastases in 4 patients with osteogenic sarcoma and 4 with soft tissue sarcoma. The four-year survival for patients with nonsynchronous metastases from osteogenic sarcoma was 44%, not significantly different from a survival of 35% for patients with soft tissue sarcoma. The 6 patients with synchronous osteogenic sarcoma metastases all died within 16 months. Survival following thoracotomy did not correlate statistically with time from primary tumor resection to lung recurrence, unilateral versus bilateral disease, or number of nodules. For the 33 patients in whom tumor doubling time could be calculated, survival with either type of sarcoma was significantly better in patients with a tumor doubling time greater than 40 days versus a tumor doubling time less than or equal to 40 days. Any patient with metastatic osteogenic sarcoma or soft tissue sarcoma confined to the lungs should be considered for resection in conjunction with chemotherapy.
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PMID:Aggressive pulmonary resection for metastatic osteogenic and soft tissue sarcomas. 658 7

Factors that influence recurrence and survival following thoracotomy for metastatic osteogenic sarcoma are not well defined. We examined the clinical and pathological material from 51 patients who had no metastases at the time of operative treatment of osteogenic sarcoma at the University of Michigan from 1962 to 1982. Ages ranged from 2 to 30 years (mean, 15 years). Metastases developed in 37 patients (72.5%) at a mean of 8 months after initial operation. Thirteen patients were treated with chemotherapy only; 12 of them died after a mean survival of 7 months. Twenty-four patients were treated with chemotherapy and 45 thoracotomies (mean, 1.9 per patient; range, 1 to 5) during which 120 wedge resections or lobectomies were performed. Follow-up is available on 22 of these 24 patients, 11 (50%) of whom are alive (9, tumor free) at a mean of 51 months after thoracotomy. Eleven patients died after a mean survival of 27 months (p less than or equal to 0.001 compared with the group having chemotherapy only). Microfoci of tumor (tumor cells separate from the gross tumor nodule) were found in resection specimens in 12 patients at the first thoracotomy; in 11 of these 12 patients, new metastases subsequently developed resulting in 10 reoperations. Twelve patients had no microfoci at the first operation; new metastases developed in 5; 3 underwent reoperation. Overall, microfoci were found at 29 operations; in patients with this finding, new metastases developed twenty-seven times (93%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The influence of tumor microfoci on recurrence and survival following pulmonary resection of metastatic osteogenic sarcoma. 659 81

In a series of 18 consecutive non metastatic osteosarcoma patients, metastases developed in 12 and successful metastatectomies could be performed in 6. No adjuvant chemotherapy was given. Four of these 6 patients survived. The importance of length of disease-free survival is described. Radiotherapy and chemotherapy as adjuvants to prevent or postpone the development of metastases are mentioned and an EORTC-SIOP trial on this subject is briefly discussed.
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PMID:Role of metastatectomy without chemotherapy in the management of osteosarcoma in children. 692 15

Review of the reported use of high-dose methotrexate (HDMTX) with citrovorum factor rescue (CF) for treatment of primary and metastatic osteosarcoma indicates the rarity of responses in clinical situations other than treatment of the primary tumor or isolated pulmonary metastases with doses of 7.5 g/m2 or greater delivered on a weekly basis for 4 to 6 weeks. Adjuvant chemotherapy using HDMTX-CF at triweekly intervals has led to 2-year disease-free survival rates that are inferior to those obtained with combinations of agents including HDMTX-CF Adriamycin (Adria), with or without vincristine, cyclophosphamide, phenylalanine mustard, bleomycin, and dactinomycin. We concluded that although HDMTX-CF has a role in the treatment of primary and metastatic osteosarcoma, its use in combination with other active agents offers greater potential advantage to affected patients.
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PMID:Selected applications of methotrexate alone and in combination in osteosarcoma. 697 28

We studied the use of video-assisted thoracoscopic (VAT) surgery in the management of metastatic osteosarcoma. From September 1993 to March 1994, we performed a total of 11 VAT wedge resections of pulmonary metastatic osteosarcoma in seven patients (six males, one female, age 12 to 46 years). Three patients had bilateral procedures performed either under the same anaesthesia or in stages. One patient had two operations on the same side. The average number of nodules excised was three. Two patients subsequently required formal lobectomies when the metastatic tumours were either too big or too close to the hilum for safe wedge resections. There was one death on postoperative day 3 due to dysrhythmia. One patient died 5 months later from a progression of his underlying disease. Two patients remained disease free up to 8 and 12 months, respectively, from their first operations. The average postoperative chest drain duration was 1.4 +/- 0.7 days and hospital stay 2.3 +/- 1.1 days. The procedure was well tolerated and postoperative morbidity was minimal. We conclude that although VAT wedge resection of pulmonary metastatic osteosarcoma is feasible technically and is associated with a short hospital stay and minimal morbidity, this approach cannot be recommended when complete resection of all metastases is the goal as the technique relies heavily on computed tomographic scans to detect nodules. Recurrence of metastasis from 4 to 6 months in three of seven patients argues against VAT surgery being an adequate procedure. The high cost of the staplers, in addition, is a secondary consideration.
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PMID:Video-assisted thoracoscopic wedge resections of pulmonary metastatic osteosarcoma: should it be performed? 748 15

Renal metastases from primary osteosarcomas are rather uncommon and rarely diagnosed early because the patients are asymptomatic and frequently die from other metastatic involvement before renal symptoms develop. The authors present a patient with two clinically silent renal metastases from primary osteosarcoma of the right femur 2 years after surgery of the primary lesion that was first detected on radionuclide bone imaging. Subsequently, a CT scan and a CT guided needle biopsy were performed for confirmation. The patient underwent a left nephrectomy and two separate lesions were proven to be metastatic osteosarcoma. The clinical importance of the nuclear bone scan in the initial management, as well as in the subsequent follow-up of patients after surgery, cannot be overemphasized.
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PMID:Clinical utility of bone SPECT scintigraphy in renal metastases from primary osteosarcoma. 787 11

A significant proportion of children presenting with pediatric solid tumors will have disease distant from the primary site at diagnosis while still more will develop metastases. In this article an appropriate role for the surgical oncologist was determined by extracting surgical and survival data from the literature. It is concluded that aggressive pulmonary metastasectomy is indicated in metastatic osteogenic sarcoma but not in most embryonal soft tissue sarcomas. Wilms' tumor pulmonary metastases are probably best treated by chemotherapy and whole-lung irradiation except for very young children with solitary or localized metastases. However, resection of hepatic metastases from Wilms' tumor may result in long-term disease-free survival. Finally, available data support resection of hepatoblastoma metastases to lung. Surgery maintains an important role in the treatment of metastatic disease but surgeons must remain objective in the reporting and interpretation of results.
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PMID:The surgical management of metastases in pediatric cancer. 806 25


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