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)

Forty-seven patients with squamous cell carcinoma of the esophagus were treated with a combination of cis-dichlorodiammineplatinum (II) (cis-DDP) and bleomycin by infusion. cis-DDP at a dose of 3 mg/kg with mannitol and prehydration was given on Day 1. On Day 3, bleomycin was started as a 10--15-unit/m2 loading dose followed by a 10--15-unit/m2 24-hour infusion for 4--7 days. Three groups of patients were treated: group 1 (no clinical evidence of metastatic disease) included 25 patients, all with no prior therapy; group 2 (measurable metastatic disease) included 13 patients, eight previously treated with surgery and/or radiation; group 3 (known nonmeasurable metastatic disease) included nine patients, all previously treated with surgery and/or radiation and/or chemotherapy. A second course of therapy was given on Day 28 to groups 2 and 3, and as soon after surgery as possible in group 1. Nineteen percent of patients had complete or partial responses with another 44% having minor regressions. Toxic effects were mainly renal effects, alopecia, nausea and vomiting, and stomatitis. There were two drug-related deaths. The combination of cis-DDP and bleomycin is useful in the treatment of patients with squamous cell carcinoma of the esophagus.
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PMID:cis-Dichlorodiammineplatinum(II) and bleomycin in the treatment of esophageal carcinomas. 8 Feb 69

Eighty-two patients underwent curative resection for squamous cell carcinoma of the esophagus. The 5-year actuarial survival rate was 33 per cent. Sixteen of 34 patients who developed secondary nodal metastases of the neck and mediastinum were irradiated with a dose of 40 to 60 Gy over 4 to 6 weeks (81 in average TDF), which probably prolonged the survival.
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PMID:Radiation therapy of secondary nodal metastases in the neck and mediastinum after resection of esophageal carcinoma. 11 40

172 patients underwent curative resection for squamous cell carcinoma of the esophagus. The five-year actuarial survival rate was 38%. 21 of 27 patients who developed nodal metastasis of the supraclavicular lymph node were irradiated with a total dose of 40 to 70 Gy over four to seven weeks. This retrospective study showed the following results: 1. Complete response by radiation therapy was obtained 4/4 in tumor size within 2 cm, 7/10 in 2.1 to 5.0 cm with a total dose of 60 to 70 Gy, while 1/5 with a total dose of 40 to 56 Gy. 2. There were statistically significant differences of survival curves between multiple metastases and single metastasis of the supraclavicular lymph node (p less than 0.01).
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PMID:Radiation therapy for the supraclavicular lymph node metastasis after curative resection of the esophageal carcinoma. 154 50

The use of ultrasound combined with ultrasound-guided fine-needle aspiration biopsy (UGFAB) of supraclavicular lymph nodes in the pretreatment staging of 37 patients with squamous cell carcinoma of the esophagus is described. All patients underwent computed tomography (CT) scans of the chest and the abdomen and ultrasound of the abdomen and supraclavicular regions. Supraclavicular lymph node metastases (Stage IV disease according to the tumor nodes metastasis [TNM] classification) were cytologically diagnosed in seven (18.9%) of the 37 patients. In two of these patients, no other metastases were found. In the other five patients, UGFAB replaced more invasive diagnostic procedures. Due to their superficial location, ultrasound and UGFAB of the supraclavicular lymph nodes was relatively simple to perform, and contributed to an improved staging of squamous cell carcinoma of the esophagus.
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PMID:Ultrasound and ultrasound-guided fine needle aspiration biopsy of supraclavicular lymph nodes in patients with esophageal carcinoma. 198 52

Results of surgical treatment for squamous cell carcinoma of the esophagus are not satisfactory. The relatively low resectability rate, extensive surgery associated with a relatively high morbidity and mortality as well as the high risk for local recurrence and distant metastases influence the unfavorable prognosis. The improvement of these risk factors has been attempted through multimodality therapy such as preoperative radiotherapy and/or chemotherapy. Even with the advantages of such a treatment plan which was documented in different phase II studies, it has not been possible to prove in randomized studies its advantage in comparison to immediate surgery. But there is some evidence that multimodality therapy may benefit some patient groups. The definition of these groups has to be the task of future studies. Important selection criteria may be tumor size, tumor localization and response to preoperative chemo- and/or radiotherapy. Before these questions are answered in further studies, the best treatment for non metastatic localized, esophageal carcinoma is still radical surgical resection.
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PMID:Results of surgery in multimodality therapy of esophageal cancer. 205 71

Eight patients with untreated squamous cell carcinoma of the esophagus accompanying distant metastases who were treated by one to five cycles of chemotherapy consisting of Cisplatin and 120 hour infusion of 5-Fluorouracil were reported. Two patients showed complete response (CR), four partial response (PR), one minor response, and one no response. High response rate of 75% (6 of 8) was obtained. Radiation therapy was then administered to six of the patients. After definitive treatment, CR was obtained in four, and PR in two of the cases. However, relapses were noted in all four of the CR cases, with four at distant sites, and one locally. Five of the eight patients (62.5%) survived one year and two survived three years (25%). Two patients could not receive radiotherapy because of uncontrollable lung metastases or death from duodenal ulcer. Although the follow-up period is still short, the combined treatment of radiation and pre-radiation chemotherapy appears to be an effective treatment, and has made a major impact upon survival time in cases of disseminated esophageal carcinoma.
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PMID:[Combined radiotherapy and pre-radiation chemotherapy with cisplatin and 5-fluorouracil for advanced esophageal carcinoma. I. Clinical evaluation in cases with distant metastases]. 223 Apr 43

Although an abnormal amount of cellular DNA content is known to occur in squamous cell carcinoma of the esophagus, the significance and clinical relevance of this finding have yet to be elucidated. Paraffin-embedded blocks from 77 patients with squamous cell carcinoma of the esophagus were dewaxed and made into a suspension by mechanical mincing and enzymatic digestion. The nuclei were stained with propidium iodide, and the DNA content evaluated with flow cytometric study. The DNA index (DI) and the coefficient of variation were determined and the results were compared with other pathologic prognostic features. DNA aneuploidy was identified in 70.1% of the specimens and found to correlate significantly with both histologic grading (P less than 0.025) and the incidence of postoperative recurrence (P less than 0.05). Although the 5-year survival was slightly better in the euploid group than in the aneuploid group (28.8% and 19.1%, respectively), this difference was not statistically significant (P greater than 0.1). There was no correlation of the DI with the extent of wall penetration by the tumor, the incidence of lymph node metastases, or the surgical staging, features previously shown to correlate with prognosis in patients with esophageal carcinoma.
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PMID:Flow cytometric DNA analysis of squamous cell carcinoma of the esophagus. 230 66

The serum levels of Carcinoembryonic antigen, CA 19-9 and CA 50 were assessed in 60 patients with squamous cell carcinoma of the esophagus during the course of the disease. In 53 patients, the effect of preoperative or final treatment on tumor marker levels could be analysed, and the change in tumor marker levels discriminated significantly the patients who showed tumor mass/symptom regress from the patients who displayed progress or undecided change. Progress later in the course of the disease was reflected by a statistically significant increase in all three tumor marker assays, and in 8/18 (44%) patients the tumor marker increase was seen prior to other signs of tumor progression. The appearance of distant metastases was associated (11/12) with increase in CEA levels.
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PMID:Carcinoembryonic antigen, CA 19-9 and CA 50 in monitoring human squamous cell carcinoma of the esophagus. 236 87

Twenty-one consecutive patients with squamous cell carcinoma of the esophagus (EC) were referred, with advanced Stage III disease in nine patients, severe pulmonary/cardiac disease in five patients, and postsurgical recurrences or metastatic disease in seven patients. They were treated with one to four courses of 5-fluorouracil (5-FU) + mitomycin C, alternating with 5-FU + cisplatin (5-FU: 1,000 mg/m2/24 X 96-h infusion; Mitomycin C: 10 mg/m2 i.v.; cisplatin: 75 mg/m2 i.v.) simultaneously with 3,000-5,000 cGy of local radiotherapy (RT) in 3.5-5.5 weeks. These doses of chemotherapy (CT) and RT were generally well tolerated except for prolonged thrombocytopenia in two patients, pancytopenia in one, pulmonary fibrosis in one, and acute renal failure in one. Six patients were alive and free of disease 8-40 months (median, 16 months; mean, 21.5 months) after initiation of treatment. Two additional patients died of unrelated causes without evidence of viable disease at autopsy. Our experience confirms the rapid and sustained palliation of dysphagia and pain obtained within 7-14 days after initiation of treatment. Mean survival of patients receiving one to two courses of CT and less than 4,000 cGy RT was 3.4 months compared to 16 months in patients receiving more than 2 courses of CT with RT. Five of six patients who are alive and free of disease received 4,000 cGy or greater. This experience suggests that escalated and concurrent doses of RT (greater than 4,000 cGy) and CT (three to four cycles) are tolerated with acceptable morbidity and could provide good palliation and sometimes prolonged disease-free status in those patients with EC who are considered inoperable because of advanced disease or medical reasons.
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PMID:Inoperable esophageal carcinoma: results of aggressive synchronous radiotherapy and chemotherapy. A pilot study. 244 91

In 93 out of 201 patients (46%) with squamous cell carcinoma of the esophagus who underwent radical resection (excluding death within 30 days after operation), the site of recurrence could be identified by means of X-ray, CT, ultrasonography, and biopsy. Recurrence was found in 55% of 93 cases within 12 months after surgery and in 86% of 93 cases within 24 months. Of 93 patients with recurrences, lymph node recurrences were present in 44 cases, visceral recurrences in 32 cases, both lymph node and visceral recurrences in 11 cases and others in 6 cases. Neck and/or upper mediastinal lymph node recurrences were found in 10 out of 15 patients who had recurrences within 3 months after surgery. Careful examination should be made in the left recurrent nerve chain and extended lymph node resection of upper mediastinal region should be performed under the adequate indication. Esophageal squamous cell cancer has a tendency to recur in the lymph nodes initially, and visceral metastases may occur thereafter. The incidence of visceral recurrence increased remarkably, when neck and/or upper mediastinal lymph nodes were involved at the time of operation. Accordingly, both irradiation and chemotherapy should also be applied for improving the prognosis of esophageal carcinoma.
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PMID:[Clinicopathological studies of the recurrence of esophageal squamous cell cancer--with special reference to the mode of recurrence and operative procedure]. 320 46


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