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)

Survival factors of 86 patients with metastatic renal cell carcinoma were studied by computer analysis. Cumulative survival was 53 per cent at 6 months, 43 per cent at 1 year, 26 per cent at 2 years and 13 per cent at 5 years. Survival was influenced favorably by confinement of metastases to the lungs, by the absence of local recurrence or persistence of tumor and by a longer interval free of disease after removal of the primary tumor. Medical therapy improved survival during the first year after diagnosis of metastases but no objective regression of tumor was observed. Excision of metastatic foci significantly improved survival for up to 5 years (p less than 0.05 and p less than 0.02) after which most patients died of recurrence. Palliative or adjunctive nephrectomy in patients with metastases was associated with a 6 per cent mortality rate but it increases survival over other patients with metastases at the time of diagnosis of renal carcinoma who did not undergo nephrectomy. This difference was owing to patient selection and survival of those who had adjunctive nephrectomy was no greater than that of the study population as a whole. However, based on the factors that were associated with improved survival palliative nephrectomy may be beneficial when a limited number of metastases treatable by excision or radiation therapy are present, when effective systemic therapy exists or when the primary tumor produces severe symptoms.
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PMID:The natural history of metastatic renal cell carcinoma: a computer analysis. 7 92

A 65-year-old man with 6 osseous metastatic lesions was successfully treated by nephrectomy. Five of 6 metastatic tumors, 2 of which were histologically proved, dramatically regressed and disappeared roentgenographically. The other metastasis was removed by amputation 4 years prior to the nephrectomy. No apparent complication was found after the nephrectomy and the patient is in very good health. The factors responsible for regression of osseous metastatic renal cell carcinoma cannot be fully explained. The only common treatment given to 4 patients whose osseous renal cell cancer regressed, was nephrectomy. Since every therapy for metastatic renal cell cancer is unreliable, palliative nephrectomy seems to be justified as a treatment of choice even when osseous metastases are noted and there is a possibility of regression of metastatic lesions. Regression of osseous metastasis from renal cell carcinoma is extremely rare and only 3 cases have been reported.
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PMID:Regression of multiple osseous metastatic renal cell carcinoma. 22 Nov 43

Patients with metastatic renal cell cancer have an overall 5-year survival rate of only 28% to 40% in spite of aggressive surgical treatment. A prospective randomized study conducted by the Eastern Cooperative Oncology Group used methyl--CCNU (meCCNU), vinblastine, and meCCNU-medroxyprogesterone acetate (MPA) to treat 165 patients with advanced renal cancer. The antitumor activity of the single-agent and/or combination therapy is analyzed. Patients were classified (as to grade of anaplasia of tumor; age; performance status; primary site of metastatic disease; and previous treatment with a progestational agent) and randomly assigned to various treatment protocols as described. Crossover randomization to one of alternate single-agent or combination regimens was carried out after failure with initial therapy. 2 meCCNU regimens were associated with severe hematologic toxicity, vinblastine regimens with neurotoxicity. All regimens except the vinblastine-MPA resulted in substantial vomiting. Response rate is low (11%) with each regimen. There were no statistically significant differences in treatment variables or factors among the various regimens. Patients capable of normal activity had a significantly higher response rate and longer survival period than nonambulatory or poor performance status patients. A relatively long symptom-free interval from primary tumor to metastatic disease was also associated with better survival rate. More than 50% of patients exhibited disease progression with 3 months of initiating the regimens.
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PMID:Phase II study of vinblastine, methyl-CCNU, and medroxyprogesterone in advanced renal cell cancer. 35 71

Antibodies against renal carcinoma cells were detected by a microcomplement fixation assay in the sera of 94 per cent of 75 patients with recently resected, localized or metastatic disease, and in 20 per cent of normal controls. Absorption of sera with pooled normal kidney cells abrogated reactivity against normal kidney cells but did not decrease reactivity significantly against the renal carcinoma cells. Analyses of sequential serum samples revealed that after nephrectomy in 9 of 10 patients free of tumor but a high risk for recurrence antibody levels decreased or disappeared by 1 year. However, these levels remained elevated in 2 patients who subsequently were found to have occult persistent tumor. Antibody titers in patients with metastatic renal cell carcinoma declined as the disease progressed. Patients with persistently elevated titers had the longest survival. Although the antibodies detected by this assay may not be specific for renal cell carcinoma, their detection may be of clinical significance with regard to the prognosis of the disease.
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PMID:The detection and clinical significance of antibodies to tumor-associated antigens in patients with renal cell carcinoma. 46 98

A 62-year-old man presented with a 17-month history of a slowly enlarging biceps muscle mass. A diagnosis of metastatic renal cell carcinoma was made in the outpatient department using a soft tissue biopsy needle. Despite the rarity of muscular metastases in renal cell carcinoma, early definitive diagnosis of soft tissue masses is recommended.
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PMID:Renal cell carcinoma presenting as a skeletal muscle mass: a case report. 53 79

Thirty-one patients with locally extensive and metastatic renal cell carcinoma were observed over an eight year period. At onset of the disease, symptoms due to metastatic deposits were the most frequent mode of presentation, followed by manifestation of local tumor growth (hematuria, flank pain or palpable mass) and paraneoplastic syndromes. Hormonal therapy with testosterone propionate, a progestational agent or both was assessed in 21 cases. Five instances of tumor regression, two involving recalcification of lytic osseous metastases, were documented. Endocrine studies to elucidate possible mechanisms of hormonal effectiveness were carried out in seven cases. Median survival from diagnosis was ten months. Following the rapid early mortality, a very gradual decrease in survival occurred, with 25% alive at ten years. Factors influencing survival include the duration of the interval between diagnosis of the primary tumor and appearance of metastases and the association of certain paraneoplastic syndromes.
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PMID:Renal cell carcinoma: analysis of 31 cases with assessment of endocrine therapy. 61 Apr 16

Improved modalities to treat metastatic renal cell carcinoma will require an aggressive surgical and chemotherapeutic approach. Nephrectomy with hormonal and non-hormonal chemotherapy does improve median survival and 3-year survival significantly. The use of xenogeneic specific immune ribonucleic acid and Bacillus Calmette-Guerin offers promising immunotherapeutic modalities that may be combined with surgical and chemotherapeutic regimens. Early diagnosis of metastatic disease is important to evaluate properly the results of various modalities of treatment and possibly to improve the efficiency of these modalities. The management of solitary metastatic nodules should involve aggressive resection of the primary and metastatic nodule. Adjuvant hormonal and non-hormonal chemotherapy should be considered in all stages of the disease.
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PMID:Aggressive versus conservative management of stage IV renal cell carcinoma. 89

Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eighty-six consecutive UCLA patients with metastatic renal cell carcinoma served as retrospective controls. Survival between subpopulations in each group matched by computer according to extent and location of metastases, age, sex, and interval between nephrectomy and occurrence of metastases were compared by Life Table Analysis. Survival was significantly greater in RNA-treated patients (P < .05) who had multiple metastases limited to the lungs when compared with matched controls. RNA therapy did not influence survival of patients with metastases to other sites (bone, brain, liver, lymph nodes, or skin) or multiple organ involvement. All nine MRD patients treated with RNA remained free of recurrence for a mean observation period of 18 months, range ten to 34 months. No significant toxicity was observed. Changes in skin test responses were related primarily to tumor burden. Increased lymphocyte mediated cytotoxicity in RNA recipients was associated with a somewhat improved survival period. Changes in absolute lymphocyte counts had no correlation with clinical course, and complement fixing antibody generally decreased after excision of tumor, was absent in patients with progression, and was present in low levels in patients with a favorable clinical response. RNA therapy may be of value in selected patients with metastatic renal cell carcinoma, and as an adjunct to definitive surgery.
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PMID:Immune RNA therapy for renal cell carcinoma: survival and immunologic monitoring. 90 90

Though renal cell carcinoma may metastasize to unusual sites via hematogenous spread, ovarian metastasis is very uncommon. This is explained by atrophy of the ovaries with decreased blood perfusion in most postmenopausal patients who are at the age of peak incidence of renal cell carcinoma. We report a 28-year-old woman with metastatic renal cell carcinoma to the ovaries. Special attention to the differential diagnosis and the management should be taken.
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PMID:Solitary metastasis of renal cell carcinoma to the ovaries: a case report. 132 76

The behavior of renal cell carcinoma remains one of the most unpredictable of the genitourinary neoplasms. Once this disease has spread beyond the confines of the kidney, it is extremely difficult to control. This year, emphasis has focused on the characteristic cytogenetic and chromosomal changes that are seen in this tumor that help to explain partially its enigmatic behavior. Immunotherapy remains the mainstay of nonsurgical therapy. Recent studies have examined the efficacy of using combinations of interferons, interleukin-2, or specific subpopulations of lymphoid cells to control metastatic renal cell carcinoma. The role of surgery in metastatic disease, tumor extending into the vena cava, and parenchyma-sparing operations continues to be examined. This review examines the most recent literature on each of these aspects in the treatment of this difficult and challenging tumor.
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PMID:Renal cell carcinoma. 137 30


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