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

Case reports are given of 37 patients treated between 1964 and 1976 because of carcinoma of the anus, and clinical signs and symptoms, therapy and prognosis are discussed. Most of the patients were 50-70 years old, women being more often afficted then men. Often the carcinoma was misdiagnosed as a benign disease. Hemorrhage and pain were the presenting symptoms in most of the case. Therapy depends upon the localization and the stage of the tumor. Carcinoma localizad distally of the linea dentata were excised locally; infiltrating carcinomas received radiotherapy postoperatively. Abdominal amputation of the rectum was performed if the linea dentata or regional lymph-nodes were involved. Bilateral dissection of inguinal lymph-nodes was performed only if inguinal metastases were suspected. No patients surviving 5 years were observed in the group with lymph-node metastases. On the contrary all patients survived, if carcinoma was localized distally to the linea dentata and had been excised locally. Recurrent malignancy was found only in 3 of these cases. On the basis of these findings it can be concluded that local excision is the therapy of choice in selected cases.
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PMID:[Carcinoma of the anus - clinical signs and symptoms, therapy and prognosis (author's transl)]. 6 37

From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the intial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95%. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28%) to the clinical inspection (6%) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.
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PMID:[Reliability and value of diagnostic lymphography in carcinoma of the sigmoid, rectum and anus (author's transl)]. 120 46

Endorectal ultrasound examination is a valuable method for detection and monitoring of pelvic diseases. The authors record their clinical experience in endorectal ultrasonography with Bruel & Kjaer ultrasound scanner. One hundred patients with diseases of the pelvic organs were examined, mainly before and after operation of ano-rectal cancer. There were 59 patients with rectal cancer, 8 patients with relapse after rectal resection, 3 patients with anal cancer, 2 patients with insufficiency of the anastomoses after rectal resection with formation of pelvic abscesses, 2 patients with metastases of bladder cancer, 2 patients with rectal cancer invading the prostate gland, 1 patient with vaginal cancer invading the rectum, 1 patient with rectal cancer invading the bladder and both ureters leading to bilateral hydronephrosis and 2 patients with extrauterine pregnancy. Another group of 20 patients was examined for detecting early postoperative recurrences. EU is an obligatory method of diagnosis of rectal cancer. It is part of the complex approach to the choice of operative method and helps to make short- and long-term prognosis after the operation. The method is also essential for the diagnosis of inflammatory processes in the pelvis and in-lying organs.
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PMID:[Endorectal ultrasonography]. 184 84

In six patients with hepatically metastasised gastrointestinal tumours of neuro-endocrinal origin, including one each islet cell carcinoma and gastrinoma of the pancreas, one cloacogenic carcinoma (a rare type of anal cancer), and three carcinoid tumours of the small bowel, spontaneous liquefaction inside echogenic liver metastases was demonstrated by ultrasound. The hepatic lesions were classified as being of "bull's-eye-" shape without "badge" pattern. Chemotherapy had no effect on their ultrasonographic imaging. With regard to our observations, liquefying processes were far more common in these well-differentiated tumour metastases than in poorly differentiated fast-proliferating malignancies (about 1:40). Assessment of liquefaction, however, has obviously no influence on the prognosis of progress speed. Ultrasonographic differential diagnosis includes focal inflammatory disease of the liver, if there is no evidence of a primary tumour.
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PMID:[Spontaneous regression of liver metastases in neuroendocrine tumors of the abdomen]. 205 55

Epidemiologic and clinical evidence has suggested a possible association between anal cancer and human papillomavirus (HPV) types that are known to be associated with cervical and other genital cancers. Using Southern blot and dot blot analysis, the authors examined 45 primary anal malignancies for HPV DNA types 6, 11, 16, and 18. HVP 16, DNA was detected in 23 of 41 (56 percent) anal squamous-cell carcinomas (SCC) and in the lymph-node metastases of two of these tumors. In addition, HPV 18 DNA was detected in 2/41 (5 percent) anal SCCs. Anal SCC contained no detectable HPV 6 or 11 DNA. The remaining four primary anal malignancies were not squamous carcinomas and did not contain any detectable HPV DNA. Nonmalignant anal epithelium and malignant rectal mucosa obtained from surgical patients undergoing hemorrhoidectomy and abdominoperineal excision of the rectum did not contain any detectable HPV DNA. HPV 16 DNA in anal cancer was predominantly integrated into the host cell DNA. In situ hybridization was used to demonstrate that HPV 16 DNA in anal SCC tissues is confined to the nuclei of carcinoma cells. The results of this investigation closely parallel similar studies of cervical cancer and lend support to the concept of the involvement of HPV 16 and 18 in the development of anal and genital squamous-cell carcinoma.
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PMID:Anal cancer and human papillomaviruses. 255 52

Using flow cytometric DNA analysis of paraffin embedded tissue, DNA histograms were successfully obtained from the anal cancers of 117 patients. DNA diploid patterns were given by 82 cancers (70%) and DNA non-diploid patterns by 35 cancers (30%): 15 DNA aneuploid, 20 DNA tetraploid. Well differentiated squamous cell cancers were mainly DNA diploid, while a larger proportion of poorly differentiated and small cell cancers were DNA non-diploid. The large majority of stage A cancers were DNA diploid. A greater proportion of tumours that had invaded through the anal sphincter or had lymph node metastases or distant spread were DNA non-diploid. Prognosis was slightly poorer for patients with DNA non-diploid cancers when compared to patients with DNA diploid tumours (P = 0.08) and significantly poorer for individuals with DNA aneuploid anal cancers (P = 0.037). However, in a multivariate analysis model, the DNA ploidy pattern of an anal cancer was not of independent prognostic significance alongside tumour histology and tumour stage.
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PMID:Carcinoma of the anal canal and flow cytometric DNA analysis. 280 16

The frequency of gastrointestinal (GI) cancers mandates innovative and individualized therapies. Chemotherapy used as sole treatment for these diverse malignancies has not been generally successful in providing palliation or improving patient survival. Radiotherapy has been more successful at controlling local manifestations of disease, but the high incidence of systemic metastases in most malignancies limits the impact of this modality on curability. Combinations of radiotherapy and chemotherapy may prove to be more valuable than single modality treatment in improving local control of tumors, decreasing systemic disease, and improving patient tolerance to treatment. A model for this approach is the current management of anal cancer, in which combined modality therapy has largely supplanted primary surgery. Data from trials in other primary tumor sites strongly suggest further exploration of combined treatments--surgical, radiotherapeutic, and chemotherapeutic--in GI malignancies. Nearly 25% of all malignancies diagnosed in the United States each year involve the GI tract; thus, there is a powerful imperative for the development of new therapeutic strategies in these diseases. Any discussion of the role of chemotherapy in GI cancers must necessarily be broad, because assessment must include diseases with highly variable surgical curability, histologies, and sensitivities to chemotherapeutic agents. In addition, whereas it has been quite easy to perform standard phase II trials in colorectal cancer, other disease sites, such as the esophagus, the pancreas, and the biliary tract, have been much less extensively studied. In spite of these limitations, there is a wealth of data in the literature concerning the use of chemotherapy in GI malignancies. This article, while not exhaustive, describes the current status of chemotherapy for these diverse diseases, with emphasis on the role of mitomycin C.
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PMID:Chemotherapy in gastrointestinal malignancies. 329 19

Sixty-seven of 100 (67 percent) and 24 of 58 (41 percent) apparently radically treated patients with squamous-cell carcinoma of the anal canal (AC) and the anal margin (AM) developed recurrent disease during a median observation time of ten years (range, 0 to 38 years). A significantly higher number of patients treated for AC tumors with local excision had recurrent disease compared with patients treated with abdominoperineal resection (P less than .05). Twenty patients with AC tumors had local recurrence, 21 regional recurrence, and 26 visceral metastases. Eighteen patients with AM tumors had local recurrence, five regional, and one brain metastases. The latest recurrences among AC and AM tumor patients were diagnosed 11 and nine years after primary treatment, respectively. The estimated cure rate by the actuarial method after 15 years was 26 percent and 53 percent for AC and AM tumors, respectively. Thus, if recurrent carcinomas of the anus are to be detected early, frequent life-long control examinations are necessary. It is obvious from this study that, in order to reduce recurrent disease of carcinoma of the anus, new treatment regimens must be tried under controlled circumstances. Surgical therapies alone are clearly insufficient in the treatment of carcinoma of the anus.
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PMID:Long-term prognosis after radical treatment for squamous-cell carcinoma of the anal canal and anal margin. 335 96

Treatment of human colonic cancer in early stages when the process is still limited to the colonic wall is primarily surgery. We wished to see if maltose tetrapalmitate (MTP) immunotherapy alone or in combination with radiotherapy (R) and cyclophosphamide (C) chemotherapy would be effective against primary colon cancer in a fashion similar to that reported by us for primary liver cancer (Anticancer Research 6: 245-250, 1986). One hundred female CD1 mice were subjected to dimethylhydrazine (DMH) treatment once a week for 26 weeks, a period one week before which, colon cancer was histologically documented in each animal of a group that was sacrificed. Surprisingly, many of the animals harboured early anal cancer as well. At 28 weeks, 85 of the available animals were divided into 6 groups that received: Gr. 1, no treatment; Gr. 2, MTP alone (M); Gr. 3, radiotherapy alone (R); Gr. 4, cyclosphophamide alone (C); Gr. 5, R + C; Gr. 6, M + R + C. Criteria of treatment efficacy were: number, size and staging of colorectal tumors and the incidence and the size of anal tumors at death. Mean survival time was also determined although it remained a questionable criterium since most animals died due to complication (hepatic toxicity, pyelonephritis, thrombose) elicited by DMH, R and C toxicities and not as a result of colonic tumor size or metastases. As a single therapy, M appeared to be superior to either R or C alone. However, R + C combination was effective and was further improved upon by its association with M. With the triple combination, (M + R + C), lesions of both cancers decreased in size and/or number and the colon cancer histologically eclipsed from 46% of the treated animals.
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PMID:Antitumor efficacies of maltose tetrapalmitate immunotherapy alone and in combinations with radiotherapy and with cyclophosphamide chemotherapy against dimethylhydrazine induced colon and anal cancers in CDI mice. 338 53

Malignant disease of the anus is uncommon. Possible predisposing causes include chronic inflammation and a transmissible agent. Epidemiologic studies suggest an increased incidence in homosexuals. With the exception of mucoepidermoid and small-cell carcinoma, the morphology of anal carcinoma has little influence on treatment and prognosis. Site, size of the primary lesion, and the presence of groin metastases are the crucial factors in prognosis. There is no satisfactory method for staging anal carcinoma--the symptoms are nonspecific. Diagnosis is based on histologic examination of biopsy material or tissue obtained from anal operations. The treatment of infiltrating, recurrent, or residual malignant anal lesions is a radical abdominoperineal resection. The addition of a limited obturator and hypogastric lymphadenectomy may be worthwhile. Inguinal lymphadenectomy provides palliation in the treatment of synchronous groin metastases, whereas in cases of metachronous metastases, groin dissection may result in an occasional cure. Small, noninfiltrating, low-grade anal lesions are best treated by either adequate local excision or supervoltage radiotherapy. If borne out, the promising results obtained with the combined chemoradiotherapy for anal cancer followed by local excision of the residuum will radically alter the future management of carcinoma of the anus.
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PMID:Current concepts and controversies concerning the etiology, pathogenesis, diagnosis, and treatment of malignant tumors of the anus. 354 35


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