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)

The concept of intraoperative in vivo diagnosis and selective resection of infiltrated lymph nodes in ovarian cancer has not been evaluated despite the increased morbidity associated with pelvic and paraaortic lymph node dissection and its questionable therapeutic value. Fluorescence photodetection is based on the application of a photosensitizer relatively selective for malignant tissue, which after light activation of appropriate wavelength, shows fluorescence. Six hours after oral application of 10 mg/kg body weight 5-aminolevulinic acid, the abdominal cavity of a patient with suspicion of recurrent ovarian cancer was inspected using a laparoscope and blue light at 380-440 nm. Spectral measurements at a wavelength of 635 nm, multiple peritoneal biopsies, and lymph node excisions were performed. White light inspection and porphyrin fluorescence photodetection revealed no intraperitoneal metastases and multiple biopsies were negative. Fluorescence-positive lymph nodes were visible only in the left common iliac region and a specific porphyrin fluorescence peak could be detected. In contrary, no increased porphyrin fluorescence of intraperitoneal tissues or skin was seen. Fluorescence microscopy showed the characteristic red fluorescence in the infiltrated parts of the lymph node tissue by the papillary ovarian cancer. Histology of the other sites was negative. No systemic or cutaneous side effects were recorded. This data is a proof of the concept that porphyrin fluorescence-guided lymph node metastasis detection is possible in ovarian cancer and should stimulate further research in this field.
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PMID:Lymph node metastasis detection of ovarian cancer by porphyrin fluorescence photodetection: case report. 1721 77

Recently, several authors have reported that optimal primary cytoreduction of both hepatic and extrahepatic disease is not only feasible but improves survival. However, the role of hepatic resection in combination with secondary cytoreduction for epithelial ovarian cancer is unclear. Patients with recurrent ovarian cancer and metachronous intrahepatic metastases are often evaluated by a multidisciplinary team at the Mayo Clinic comprising pelvic and hepatobiliary surgeons for consideration of cytoreductive surgery. The purpose of this report is to update the outcome of cytoreductive surgery including hepatic resection for patients with metastatic ovarian carcinoma.
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PMID:Hepatic resection for metachronous metastases from ovarian carcinoma. 1833 53

Ovarian cancer which is the most common cause of death among all gynecological malignancies tends to metastasize through peritoneal cavity. Skin metastasis, however, is a very rare clinical entity and related with poor prognosis. We report a 43-year-old patient with recurrent ovarian cancer presented with extensive abdominal skin metastasis approximately 6 years after the initial diagnosis. Patient was treated with radiotherapy with electrons to a total dose of 37.5 Gy given in 2.5 Gy per fraction per day. Skin metastasis showed good response to radiotherapy, and the patient has been alive for 7 months after radiotherapy with no recurrences on abdominal skin. Radiotherapy might be considered as an efficient palliative treatment option for the skin metastasis of ovarian cancer.
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PMID:Palliative radiotherapy for the skin metastasis of ovarian cancer: a case report and review of the literature. 1953 57

One of the most significant developments in medical oncology practice has been the approval of various antiangiogenic drugs for the treatment of a number of different malignancies. These drugs include bevacizumab (Avastin), the anti-VEGF monoclonal antibody. Thus far, bevacizumab appears to induce clinical benefit in patients who have advanced metastatic disease only or primarily when it is combined with conventional chemotherapy. The reasons for the chemo-enhancing effects of bevacizumab are unknown, and this is a subject that we have been actively studying along with additional ways that antiangiogenic drugs may be combined with chemotherapy. In this respect, we have focused much of our effort on metronomic low dose chemotherapy. We have been studying the hypothesis that some chemotherapy drugs at maximum tolerated doses or other cytotoxic- like drugs such as acute "vascular disrupting agents" (VDAs) can cause an acute mobilization of proangiogenic cells from the bone marrow which home to and colonize the treated tumors, thus accelerating their recovery. These cells include endothelial progenitor cells. This systemic process can be largely blocked by a targeted antiangiogenic drug, e.g. anti-VEGFR-2 antibodies. In addition, metronomic chemotherapy, i.e., close regular administration of chemotherapy drugs at low non-toxic doses with no breaks, over prolonged periods of time not only prevents the acute CEP bone marrow response, but can even target the cells. This potential antiangiogenic effect of metronomic chemotherapy can also be boosted by combination with a targeted antiangiogenic agent. Treatment combinations of metronomic chemotherapy and an antiangiogenic drug have moved into phase II clinical trial testing with particularly encouraging results thus far reported in metastatic breast and recurrent ovarian cancer. Oral chemotherapy drugs such as cyclophosphamide (CTX), methotrexate are the main chemotherapeutics used for such trials. Oral 5-FU prodrugs such as UFT would also appear to be highly suitable based on long term adjuvant therapy studies in patients. Recent preclinical results using metronomic cyclophosphamide and metronomic UFT in models of advanced metastatic breast cancer suggest that this type of combination might be particularly promising for metronomic chemotherapy in this indication, particularly when combined with a targeted antiangiogenic drug.
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PMID:Improving conventional or low dose metronomic chemotherapy with targeted antiangiogenic drugs. 1974 37

Although uncommon, ovarian cancer cells may spread to the rectal lymph nodes. However, few reports have described how to detect and treat such metastases. We report a case of a 59-year-old woman with mesorectal and pararectal lymph node metastases in recurrent ovarian carcinoma, detected conclusively using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), and treated by low anterior resection with total mesorectal excision aiming for macroscopic complete resection. The treatment goals for the patient were gradually changed from curative to palliative chemotherapy; she survived for 45 months without rectal obstruction after secondary debulking surgery, and was followed up until autopsy. Thus, 18F-FDG PET/CT may be valuable for detecting rectal lymph node metastasis and can play an essential role in planning treatment for recurrent ovarian carcinoma.
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PMID:Rectal lymph node metastasis in recurrent ovarian carcinoma: essential role of 18F-FDG PET/CT in treatment planning. 2393 43

Herein, we describe our experience with a recurrent ovarian cancer patient who was treated safely with bevacizumab and who achieved a complete response despite receiving nine prior chemotherapy regimens. The patient was a 54-year-old woman with stage IIIC recurrent ovarian serous adenocarcinoma (grade 3). Computed tomography (CT) revealed that no evidence of ascites, multiple intraperitoneal dissemination, or intrapelvic lymph node metastases was present. The absence of bowel obstruction and disseminated lesions involving the intestinal tract was confirmed by CT. Performance status was 0, and a blood test also indicated preservation of major organ function. In our hospital, weekly paclitaxel plus bevacizumab therapy (paclitaxel at 80 mg/m(2) on days 1, 8, and 15; bevacizumab at 15/mg/kg on day 1 and every 21 days thereafter) was started. Eight cycles were administered, with no signs of gastrointestinal perforation, and the antitumor effect was evaluated as a complete response. The observed adverse events included grade 1 hyponatremia and grade 1 hypochloremia, and there was one grade 1 sensory peripheral neuropathy. These adverse events neither delayed treatment nor necessitated any dosage reductions. This case suggests that bevacizumab can be safely administered even to patients with recurrent ovarian cancer who have received three or more prior chemotherapy regimens if there are neither symptoms of bowel obstruction nor lesions suggestive of intestinal invasion on diagnostic imaging.
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PMID:A recurrent ovarian cancer patient with a history of nine prior chemotherapy regimens who was safely treated with weekly paclitaxel plus bevacizumab and achieved a complete response: a case report. 2631 78

Metastasis of ovarian cancer to the breast (MOCB) is a rare event. Clinical presentations of MOCB vary and surgery is the mainstay of treatment. The current study presents two cases of MOCB in women with recurrent ovarian cancer first diagnosed in April 2011 and October 2013, respectively. The patients presented to the clinic with a localized, palpable, painful mass in the upper outer quadrant of the right breast and a centrally localized, palpable, painful mass of the left breast, respectively. Breast sonography and mammography showed a singular, round, homogenous tumor with irregular borders in each case. An ipsilateral enlarged axillary node was palpable in one case. Tumor biopsy revealed an undifferentiated adenocarcinoma of unknown origin in one case and a moderately-differentiated adenocarcinoma suspected to be breast cancer in the other case. Tumor cells were positive for estrogen receptor and paired box 8, and negative for GATA binding protein 3 in the two cases. Palliative mastectomy was performed in one case and lumpectomy with ipsilateral axillary sentinel node biopsy in the other case, and the final histology revealed MOCB in each. The post-operative course of the disease was uneventful and the patients continued with their ovarian cancer-specific chemotherapy. One patient succumbed to disease progression 2 months after breast surgery. The other patient remains alive and is currently undergoing systemic chemotherapy. The current study also presents a review of 110 cases of MOCB identified in a literature search of Pubmed. Data from these studies, including the clinical and histological characteristics of MOCB, and the clinical management and prognosis are discussed. Overall, MOCB is rare, with distinct clinical and histological features. The disease is usually treated with local surgical excision or mastectomy and has a poor prognosis.
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PMID:Metastasis of ovarian cancer to the breast: A report of two cases and a review of the literature. 2731 31

Angiogenesis plays a major role in tumor growth and metastatic spread of cancer, and therefore inhibition of angiogenesis seems a promising therapeutic strategy. In order to grow beyond microscopic size, tumors need a better delivery of nutrients and oxygen so neovascularization must occur. Vascular endothelial growth factor [VEGF] pathway is the most important factor in promoting angiogenesis. This pathway may be blocked by either extracellular interference with VEGF itself (bevacizumab [BEV] or aflibercept), or intracytoplasmic inhibition of VEGF receptor (pazopanib, nintedanib, cediranib, sunitinib and sorafenib). Approximately 97% of ovarian tumors over express the VEGF ligand and this is correlated with early metastases, ascites formation and poor prognosis. The addition of antiangiogenic agents to standard chemotherapy in ovarian cancer is a rational therapeutic option for primary or recurrent ovarian carcinoma but it does not represent a new standard treatment until the subset of patients who benefit the most is identified.
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PMID:Antiangiogenic Treatment in Ovarian Cancer in the Era of Evidenced-Based Medicine. 2846 43

The creation of new blood vessels from existing ones, which is a mechanism called "angiogenesis", is essential in cancer to supply cancerous growth. Moreover, the development and the progression of the tumor and its metastases are the result of an efficient vascular response. Cancer cells release and activate different angiogenic growth factors and their receptors in the tumor microenvironment to promote the angiogenic process. The most important pro-angiogenic factor is the "Vascular Endothelial Growth Factor" (VEGF) because of its mitogen activity on vascular endothelium. Bevacizumab is a monoclonal antibody that obstructs the binding of circulating vascular endothelial growth factor to its receptors and has been approved for the treatment of primary and recurrent ovarian cancer but also for many other solid tumors.
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PMID:Biological Pathways Involved in Tumor Angiogenesis and Bevacizumab Based Anti-Angiogenic Therapy with Special References to Ovarian Cancer. 2890 27

We describe a case of the first successful treatment of platinum refractory clear cell ovarian cancer with secondary cytoreductive surgery and placement of Calypso transponders to facilitate post-operative volumetric arc radiation therapy. In the setting of both primary and recurrent disease, patients with clear cell ovarian cancer are less responsive to standard chemotherapy and those treated with radiation therapy may have improved outcomes compared to the use of other treatment modalities. Volumetric arc radiation therapy with implantable transponders is feasible, and allows for the targeted treatment of sites of metastatic disease while limiting toxicity to surrounding structures and can be considered for patients with recurrent ovarian cancer and oligometastatic disease.
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PMID:Successful treatment of platinum refractory ovarian clear cell carcinoma with secondary cytoreductive surgery and implantable transponder placement to facilitate targeted volumetric arc radiation therapy. 3055 84


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