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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one women with biopsy proven aortic node metastases from previously untreated carcinoma of the uterine cervix were treated with high dose irradiation to the pelvis and para-aortic areas. The majority received 6000 rads to the pelvis and para-aortic nodes by split course therapy plus 2500 rads by intracavitary radium to point A; 57.1% sustained severe complications to the stomach, small intestine or colon. Only 14.2% are surviving over 2 years free of recurrence. Though approximately 40% of women with Stages III and IV cervical cancer will have metastases to the para-aortic nodes, to date there is no satisfactory therapy that results in a significant number of such women surviving free of recurrent cervical cancer.
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PMID:High dose irradiation to biopsy confirmed aortic node metastases from carcinoma of the uterine cervix. 91 57

An analysis of the results of treatment in 231 patients with recurrences of cervical cancer is presented in relation to 5-year survival criterion ("dynamic analysis"). An actual 5-year survival rate was 16.0%. The most important factors determining the prognosis include the stage of the primary process, localization of the secondary tumor, terms of the recurrence and the absorbed dose of radiation given to the recurrence. Standardized rates showed a 3-5 fold improvement of the results of treatment in the presence of favourable prognostic factors. In combinations of favourable prognostic factors the 5-year survival rate of patients with recurrent cervical cancer reached 67.0%. The amount of the absorbed local dosage of radiation is of practical value for improvement of the results of treatment. Radiotherapy is the method of choice in treatment of patients with local recurrences of uterine cervix cancer.
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PMID:[Prognosis in radiotherapy of patients with local recurrence of cervix neoplasms]. 101 92

There were 289 radical hysterectomies performed at Roswell Park Memorial Institute for Stage IB, IIA, and recurrent cervical cancer from 1957 to 1967. The prognostic significance of cervical lesion size, pelvic node metastases, and type of radical hysterectomy have been evaluated. Excellent 5-year survival rates for women with Stage IB cervical carcinoma were associated with cervical lesions measuring less than 3 cm and resected pelvic lymph nodes which did not contain metastatic cancer. In addition, 31% of women with recurrent cervical cancer treated by radical hysterectomy survived 5 years without recurrence.
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PMID:Prognostic significance of cervical lesion size and pelvic node metastases in cervical carcinoma. 119 52

This study reports the experience at the Ellis Fischel State Cancer Hospital with the use of scalene node biopsy for the pretreatment evaluation of patients with carcinoma of the cervix uter. The study was stimulated by a report from the National Cancer Institutes which stated that impalpable scalene nodes contained metastatic cancer in 13 per cent of a series of 84 cases. By a meticulous biopsy technique, we were unable to confirm this high incidence, In a series of 73 cases, no impalpable lymph nodes were found to contain metastatic cancer regardless of the clinical stage of the cancer. Consequently, we have terminated the use of scalene lymph node biopsies in the staging of cervical cancer for primary treatment. The study is still in progress to evaluate patients with recurrent cervical cancer who may possibly require pelvic exenteration. Also, the procedure will be continued in patients referred for further treatment in whom carcinoma was first diagnosed as an unsuspected finding in a hysterectomy specimen.
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PMID:Scalene node biopsy in the pretreatment staging of carcinoma of the cervix uteri. 127 19

Articles on early-stage squamous cell and adenocarcinoma of the cervix published between August 1990 and July 1991 are reviewed. A new monoclonal antibody used to distinguish endocervical from endometrial differentiation is described, as well as a histochemical means of distinguishing in situ from invasive adenocarcinoma. In vitro and in vivo studies of cell lines immortalized with human papillomavirus DNA are described with a discussion of the mechanism of the development of malignancy. An animal model to test and develop an anti-human papillomavirus vaccine is presented. The epidemiology of adenocarcinoma is also reviewed, and the development of invasive carcinoma after conservative therapy or conization for dysplasia is discussed. Computed tomography scanning has been found to be no more accurate than examination for staging of early cervical cancer. Several studies in the review period have evaluated risk factors for recurrent disease in patients treated for early-stage cervical cancer, including a prospective surgical pathologic study by the Gynecologic Oncology Group. The optimal treatment of early stage I adenocarcinoma of the cervix is discussed, comparing the efficacy of primary surgical therapy with the efficacy of radiation therapy. The risk of ovarian metastases in patients with early-stage cervical cancer is very low for both squamous cell and adenocarcinoma. The surgical technique and efficacy of laparoscopic pelvic lymphadenectomy for patients with early-stage cervical cancer are discussed. Lateral transposition of the ovaries at the time of radical hysterectomy for cervical cancer has significant potential benefits but also risks. Finally, surveillance methods that detect recurrent cervical cancer after treatment for early-stage disease are discussed.
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PMID:Early-stage squamous cell and adenocarcinoma of the cervix. 131 65

Twenty-three patients with nonresectable, recurrent cancer of the cervix were treated with a combination of cis-platinum and Mitomycin C. The overall response rate was 35% in 20 evaluable patients. Four patients (20%) achieved a complete response with a median duration of 9 months. Three patients (15%) achieved a partial response with a median duration of 11 months. The objective response rate was 33.4% for tumors within previously irradiated sites and 45% for distant metastases. The overall median survival was 10.3 months, and median progression-free interval was 6.7 months. Toxicity with this regimen was acceptable and consisted of nausea, vomiting, marrow suppression, and peripheral neuropathy. We conclude that this regimen is well tolerated with a low incidence of toxicity and can be safely administered on an out-patient basis. However, the superiority of this combination over cis-platinum alone remains to be determined.
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PMID:Treatment of recurrent cervical cancer with cis-platinum and mitomycin C: a phase II study. 250 64

From 1982 to 1987, 24 patients with recurrent carcinoma of the cervix underwent scalene lymph node biopsy prior to exploration for exenteration. Patients with palpable nodes were excluded from the study. There was no significant morbidity associated with the procedure. None of the 24 patients was found to have metastases to the scalene lymph nodes. From this study it would seem unjustifiable to perform this procedure on all patients undergoing evaluation for exenteration.
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PMID:Scalene lymph node biopsy in the preoperative evaluation of patients with recurrent cervical cancer. 272 59

Between September 1969 and January 1, 1986, 143 pelvic exenterations for recurrent cervical cancer were performed by the gynecologic oncologists at the University of Alabama at Birmingham. Of this group, 78 patients underwent total pelvic exenteration, 63 patients had anterior exenteration, and two had posterior exenteration. The overall operative mortality rate was 6.3%, mostly associated with total pelvic exenteration. The 5-year survival rates were 50% overall, 63% with anterior exenteration and 42% with total exenteration. Univariate and multivariate analyses were performed to identify clinical and histopathologic factors predictive of prolonged survival. Using three clinical factors (duration from initial radiation therapy to exenteration, size of the central mass, and presence of preoperative sidewall fixation), low-, intermediate-, and high-risk groups were constructed; the 5-year survival rates for these groups were 82, 46, and 0%, respectively. Inclusion of one histopathologic factor (margin status of the surgical specimen) added to the ability to predict 2- and 5-year survival rates. The best candidates for cure by pelvic exenteration were those with recurrent small (less than 3 cm), mobile central masses who were a year or longer from the time of their previous radiation therapy. Attempts to resect bulky pelvic recurrences that impinge on the pelvic sidewall, especially in the case of persistent or early recurrent disease (within 6 months), or continuation of exenterative procedures in women known to have nodal metastases or extrapelvic spread, are generally futile. For those women falling between the two extremes, sound clinical and operative judgment is imperative in regard to selecting the treatment offering the best quality of life.
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PMID:Clinical and histopathologic factors predicting recurrence and survival after pelvic exenteration for cancer of the cervix. 272 6

From June 1977 to June 1987 74 patients were treated with cisplatin for recurrent squamous cell carcinoma of the cervix as the primary chemotherapeutic agent. Sixty-eight patients were evaluable for response or survival. Patients with disease confined to the chest had a 53% complete response rate with an overall response rate of 73%. Patients with localized pelvic recurrences or persistence demonstrated no complete responses and a 21% overall response rate. Isolated chest metastases are more likely to respond to cisplatin than pelvic recurrences (P = 0.0007); however, location of recurrence did not significantly alter survival (mean 22.7 months versus 14.1 months; P = 0.24.). Concomitant disease in other locations reduced the likelihood of response in the chest (P less than 0.05) by virtue of lack of response in those other sites. Lesion size, clinical stage, patient age, and duration from primary treatment to recurrence were not of significance with regard to response or survival. When evaluating response to chemotherapy in recurrent cervical cancer, location of metastasis and effect on survival must be considered.
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PMID:Factors affecting the response of recurrent squamous cell carcinoma of the cervix to cisplatin. 292 Mar 57

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


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