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

A detailed histologic study has been completed on 125 patients with squamous cell carcinoma of the cervix invading to a depth no greater than 5 mm. Depth of invasion was 3 mm or less in 73% and 3.1 to 5 mm in 27%. The median width was 4.8 mm (range 0.08 to 20 mm). Most of the lesions were multifocal (82%); the number of invasive foci correlated well with increasing width and depth of invasion. Lymphvascular space invasion was found in seven patients, none of whom had lymph node metastases, although in one a single focus of carcinoma was present in the parametrium. Therapy consisted of radical hysterectomy and pelvic lymphadenectomy in 55% of the women, including 43 patients with lesions invading less than 3 mm. There was tumor metastatic to lymph nodes in only one of 69 patients with dissected nodes (1.4%). The mean follow-up time was 5.0 years; there was one recurrence (cervical intraepithelial neoplasia only). This study and a survey of the recent literature imply that tumor pattern, width, and confluence can be ignored in lesions invading to 5 mm, and that the most important factor to consider in therapy planning is depth of invasion. The following guidelines are proposed. In lesions without lymphvascular space invasion, those invading the stroma to no more than 3 mm may be treated with a total abdominal or vaginal hysterectomy. In lesions invading between 3 and 5 mm, a total abdominal hysterectomy and a pelvic lymphadenectomy seem adequate therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Study of superficially invasive carcinoma of the cervix. 372 54

Of 120 patients with FIGO stage IIA-IVB squamous cell carcinoma of the cervix treated with standard radiotherapeutic techniques, 41 (34.2%) relapsed with hematogenous or serosal metastases. Development of such metastases was individually associated with patient age less than or equal to 55, bilateral bulky parametrial extension, and histologically positive paraaortic nodes. Poor histologic differentiation exerted significant negative influence only in patients age less than or equal to 55. Neither surgical staging nor vascular injury predisposed to hematogenous dissemination. Radiotherapy techniques differed only in increased time to completion, from 84 to 100 days in clinical IIB and IIIB patients developing metastases. Local or regional pelvic recurrences, although associated with an increase in hematogenous or serosal metastases, were not accompanied by concomitant relapse in extrapelvic nodes. Twenty-six of 41 metastases were limited to single organ systems, with pulmonary sites most common (43.9%). A direct (non-nodal) route of hematogenous dissemination of 31% was documented within clinical stages IIA and IIB. One hundred percent concordance between bilateral bulky parametrial involvement and positive pretreatment paraaortic nodes occurred in clinical stage IIIB and IVA patients with metastatic relapse. Our data from the period 1976-1985 do not substantially differ from earlier reports on the incidence or distribution of hematogenous or serosal metastases, despite our implementation of contemporary local/regional radiotherapy prescriptions. The potential for hematogenous and serosal metastases in high-risk patients with advanced squamous cervical carcinoma merits consideration of alternative treatment protocols and precise definition of the role of pretreatment surgical staging procedures.
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PMID:The influence of hematogenous and serosal metastases on advanced (FIGO IIA-IVB) squamous cell carcinoma of the cervix. 382 88

Various methods of tissue sampling are used to verify histologically a clinical carcinoma of the cervix. The question arises whether or not diagnostic cone biopsy has any influence on the treatment and/or the clinical course of this disease. The clinical and histological data and the follow-up of 185 patients with squamous cell carcinoma of the cervix were statistically evaluated. We found no difference between patients with or without cone biopsy in respect of complications, frequency of metastases or recurrences, and survival. However, our deliberations permit the following statement: cone biopsy is an appropriate method to diagnose cervical intraepithelial neoplasia (CIN) or microcarcinoma of the cervix and may--under certain conditions--even be the adequate therapy. However, cone biopsy lacks any advantage over other diagnostic methods if it is employed merely for the purpose of histological verification of clinical carcinoma of the cervix.
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PMID:[Diagnostic conization in clinical cervix cancer]. 384 29

Between 1959 and 1980, 590 evaluable patients received a full course of radiation therapy as primary treatment of invasive epidermoid carcinoma of the cervix. At follow-up visits conducted between 1 and 3 months after the completion of radiation, 72 patients had physical or biopsy findings indicative of persistent disease (PER), whereas an additional 36 had findings suggestive of tumor (SUS). The remaining 482 demonstrated a complete response (CR) by 1 month after the administration of treatment. The lower the stage, the more likely was a CR by 3 months (Stage I, 94.4%; Stage II, 86.2%; Stage III, 62.7%). A higher proportion of CR was obtained in patients with tumor of less than 5 cm in diameter than in those with tumors greater than 5 cm in diameter (82.4% versus 76.3%, respectively; 0.1 greater than P greater than 0.05). CR patients enjoyed a marked survival advantage over those with PER, whereas women with SUS demonstrated intermediate 5-year survival (76.0%, 41.5%, and 7.4%, respectively; P less than 0.0001). The same survival gradient of CR greater than SUS greater than PER was demonstrated when tumors of each stage were analyzed separately. There was no difference in survival between patients with PER or SUS at 1 month and those with PER or SUS at 3 months. The proportion of recurrent tumors diagnosed as exclusively distant metastases decreased from CR to SUS to PER. Analysis of dosimetry data suggests that the likelihood of CR was not a function of treatment variability. It was concluded that tumors that do not regress promptly are likely to recur, most with distant metastases. Such poor-prognosis patients should be targeted for early adjuvant or salvage therapy.
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PMID:Short-term persistence of carcinoma of the uterine cervix after radiation. An indicator of long-term prognosis. 394 29

This study was undertaken to identify histopathologic risk factors in 100 women with stage IB squamous cell carcinoma of the cervix treated surgically. Histologic factors included maximum depth of stromal invasion, presence of lymph-vascular invasion, mitotic activity, nature of the tumor-stromal borders, plasma cell-lymphocyte stromal response, histologic grade, and metastases to regional lymph nodes. Using a multifactorial analysis, the maximum depth of stromal invasion was found to be the most important prognostic indicator (P less than .0001). The depth of invasion also correlated significantly with the presence of nodal metastases (P less than .0001), lymph-vascular space invasion (P = .0003), and "spreading" versus "pushing" borders (P = .0315). The number of mitoses, grade of tumor, or plasma cell-lymphocyte stromal response did not correlate significantly with depth of stromal invasion. Lymph-vascular involvement, although present in 59% of the patients, did not significantly affect survival. Depth of stromal invasion and lesion diameter were combined to constitute three risk groups: Patients with small size cervical tumors (less than 2 cm), regardless of depth of stromal invasion, as well as patients with intermediate size lesions (2.1 to 3 cm) with stromal invasion less than or equal to 1.5 cm, constituted a low-risk group; the intermediate-risk group was comprised of those patients with cervical lesions between 2.1 and 3 cm in size and deep stromal invasion (greater than 1.5 cm), as well as those patients with large cervical lesions (greater than 3.0 cm) and stromal invasion less than or equal to 1.5 cm.2+ (greater than 3 cm) and deep stromal invasion (greater than 1.5 cm).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Identification of histopathologic risk groups in stage IB squamous cell carcinoma of the cervix. 404 45

A combination chemotherapy regimen containing mitomycin-C (10 mg/m2, day 2), vincristine (0.5 mg/m2, days 1 and 4), bleomycin (30 U QD, days 1--4 as a continuous intravenous infusion during courses one and two only), and cis-platinum (50 mg/m2, days 1 and 22) was administered every 6 weeks to 14 evaluable patients with advanced (i.e., Stage IVB) and/or recurrent squamous cell carcinoma of the cervix. Four patients (29%) achieved a complete response, lasting 8, 9.5+, 17+, and 21+ months. Three of these patients have had complete disappearance of their pulmonary metastases and one has had resolution of a large left-sided pelvic wall mass. Two additional patients (14%) had a partial response to therapy, each lasting 1.5 months. The median survival for these 14 patients was 9.0 months. The chemotherapy regimen was well tolerated. There were no drug-related deaths and no instances of severe or irreversible renal dysfunction or peripheral neuropathy. The mean lowest white blood cell and platelet counts were 4540 and 205,000 per mm3, respectively. Although severe or life-threatening thrombocytopenia occurred in only 36% patients, it appeared to be the dose-limiting toxicity of this drug combination.
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PMID:Mitomycin-C, bleomycin, vincristine, and cis-platinum in the treatment of advanced, recurrent squamous cell carcinoma of the cervix. 616 65

This study was designed as a Phase II clinical trial in advanced recurrent or metastatic squamous cell carcinoma of the cervix with a combination of bleomycin (B: 10 u/m2/d) and cisplatin (P: 20 mg/m2/d) administered for five consecutive days in intravenous infusion for 7 hours and vincristine (V: 1 mg/m2) and methotrexate (M: 40 mg/m2) administered only on day one of each cycle which was repeated every 28 days up to a maximum of 6 times. Over a period of 2 years, 15 evaluable patients with measurable disease received at least 3 courses of therapy. Six had recurrent disease and nine had distant metastases. All had previous radiation therapy. There were two dropouts after the first course due to nausea and vomiting which was practically universal. Other side effects included: mild paresthesias of the extremities (89%), stomatitis (41%), diarrhea (17%), moderate pancytopenia and hypomagnesemia which was reduced from 65% to 17% when magnesium sulfate 10% was administered with cisplatin. Sixty-six percent of the evaluable patients achieved remission (7 partial and 3 complete) usually before the fourth course of therapy. The disease-free interval was of 29.7 +/- 15 weeks in all responders (40.6 +/- 15.5 weeks in complete responders). The mean survival from the start of BPVM therapy was of 55.8 +/- 33.3 weeks in responders and of only 14 +/- 2.9 weeks in nonresponders (P less than 0.01). It is concluded that BPVM is an effective combination chemotherapy in advanced squamous cell carcinoma of the cervix. These results should be confirmed in a Phase III trial.
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PMID:Effective chemotherapy for advanced carcinoma of the cervix with bleomycin, cisplatin, vincristine, and methotrexate. 619 75

The authors present a single but unusual case of metastases from a squamous cell cancer of the cervix which had been treated radically 35 months previously; the metastases occurring in the digestive tract as well as the peritoneum. They try to explain the physiopathological mechanisms, which are probably not unequivocal, as to how theses metastases could have occurred. They point out that further studies should be carried out with a view to seeing whether prophylactic chemotherapy should be given even in very early cancers.
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PMID:[Distant metastases of cervical cancer. Apropos of an unusual case. Review of the literature]. 649 Nov 94

A case of invasive squamous cell carcinoma of the cervix with aortic lymph node metastases in the absence of pelvic lymph node metastases is described. The spread of squamous cell carcinoma of the cervix is briefly reviewed.
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PMID:Aortic node metastases with negative pelvic nodes in cervical cancer. 668 99

Fifty-six patients with squamous cell carcinoma of the cervix were staged by exploratory laparotomy. Twenty-eight of them received radiotherapy with 32 MeV Betatron and intracavitary radium. Twenty-one patients with Stage IB or IIA had a radical hysterectomy, five had post-operative pelvic irradiation, and two had primary exenteration. An overall 23.2% of patients had metastases in the paraaortic fields. Four patients with paraaortic node disease received extended field irradiation: 4500 rad in 5 weeks to paraaortic nodes. Two of them are alive and disease-free at 5.5 to 6.5 years.
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PMID:Carcinoma of the cervix: surgical staging and radiotherapy with 32 MeV betatron. 681 41


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