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)

Surgery is considered the mainstay of diagnosis and treatment in early ovarian carcinoma. Only accurate staging laparotomy can detect subclinical metastases remote from the ovary, thus allowing the identification of the truly early tumors. However the complete macroscopic removal of neoplastic disease is not synonymous with cure. Many postoperative treatments have been carried out in order to improve the prognosis of patients with stage I-II ovarian carcinoma. The present paper reviews the main clinical trials on the employment of external radiotherapy, intraperitoneal radioisotope instillation and systemic chemotherapy in the management of early ovarian carcinoma. The patients appear to benefit from adjuvant treatment, with the exception of those with stage I Ai-I Bi well differentiated tumor, even if there is no agreement in literature about the superiority of a particular therapeutic approach. However the high response rates obtained in patients with advanced ovarian carcinoma with DDP containing combination chemotherapy have suggested to clinicians the use of such treatment also in early stage tumors. In our experience none of the 11 stage I ovarian cancer patients, who received 6 courses of DDP-based combination chemotherapy, have developed recurrent disease after a median follow-up of 54 months (with a range from 24 to 72 months).
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PMID:Adjuvant treatment of early stage ovarian carcinoma. 229 41

The computed tomography (CT) scans of 78 patients with stage II, stage III and relapsed stage I ovarian carcinoma were reviewed in order to identify the incidence of enlarged paracardiac lymph nodes in this disease, recognize their association, if any, with peritoneal metastases and establish whether they had any bearing on progression free interval and survival. Twenty-two patients (28%) were found to have enlarged paracardiac nodes, nine at initial presentation and a further 13 during the course of follow-up. The association between paracardiac node enlargement and peritoneal metastases was found to be highly significant. Thirty per cent of 27 patients with peritoneal metastases at presentation were found to have enlarged paracardiac nodes whereas of the 51 patients without peritoneal dissemination only 2% had enlarged paracardiac nodes (P < 0.001). In order to determine whether paracardiac nodal status had any independent prognostic value, multivariate analysis using Cox's regression was performed. When status at presentation was considered, the presence of enlarged paracardiac lymph nodes was found to be an independent predictor for survival. (Hazard ratio 3.70, 95% confidence interval (1.18-11.6), P < 0.04.) The hazard ratio for paracardiac nodal status with respect to progression free survival was not significant but in the expected direction. (Hazard ratio 1.85 (0.65-5.25).) When time-dependent covariate analysis was applied, paracardiac nodal status and peritoneal metastases status were found to be independent predictors for both progression free survival and overall survival. The presence of peritoneal metastases indicated a poorer prognosis than the presence of paracardiac lymph nodes, the hazards ratios for progression free survival were 12.9 and 2.58, respectively, and those for survival were 20.7 and 3.62, respectively. We have demonstrated that the presence of paracardiac lymph node enlargement is a significant adverse prognostic factor for both progression free interval and survival. The diagnosis of involved paracardiac lymph nodes is important as it can define patients having stage IV as opposed to stage III disease.
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PMID:The significance of paracardiac lymph node enlargement in ovarian cancer. 931 35

Endometrioid carcinoma simultaneously involving ovaries as well as the uterine corpus may present a diagnostic dilemma because of the difficulty in determining whether the lesions are separate primary tumors or metastases. It has been reported that the detection of clonality using microsatellite markers may be useful in solving this dilemma. To determine the usefulness of this technique, we compared the genetic alterations in microsatellite markers present in matched pairs of ovarian tumors from 12 patients. The study includes four ovarian cancer FIGO stage I and eight stage III/IV patients, and four patients also with independent endometrial carcinoma of the uterus. DNA from paraffin-embedded tissue was extracted and amplified using a multiplex polymerase chain reaction, after which the status of microsatellite instability and loss of heterozygosity in four microsatellite loci (BAT25, BAT26, D17S250, and D5S346) were determined. In the four patients with stage I ovarian cancer, four microsatellite markers were identical in one patient and three were identical in the remaining three patients. In high-stage patients, three markers were identical in at least 4/8 cases. In three of four patients with uterine involvement, three of the four markers were identical in the uterine tumor and one of the corresponding ovarian tumors. These results suggest that genetic discordance does not indicate independent origin or metastasis of the tumor but instead a progression of genetic changes at separate sites probably due to the marked genetic instability existing in these tumors. Because of these discordant genetic changes, great caution should be taken when distinguishing between primary and metastatic tumors on the basis of microsatellite markers.
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PMID:Discordant genetic changes in ovarian and endometrial endometrioid carcinomas: a potential pitfall in molecular diagnosis. 1644 30

Ovarian cancer is one of the main gynecological malignancies including cervical cancer and endometrial cancer. Epithelial ovarian cancer generally presents with already advanced disease at the time of diagnosis and is accompanied by poor prognosis. However, stage I ovarian cancer defined as lesions confined to the ovary is usually considered to have a good prognosis, illustrated by a 5-year survival rate of greater than 70-80%. Also, recurrences tend to be late and are usually in the abdominopelvic cavity. Metastases to the skeletal structures are rare. We report a rare case of early stage IA ovarian cancer, in which the first recurrent lesion was bone metastasis.
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PMID:Rare case of stage IA epithelial ovarian cancer with bone as the first site of recurrent metastasis. 1651 14