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)

Biopsies from 64 patients with transitional cell carcinoma of the bladder (World Health Organization grade 3 and undifferentiated) were studied with deoxyribonucleic acid flow cytometry of fresh tissue and immunohistochemical staining on the histopathological slides for the presence of neuron specific enolase and human chorionic gonadotropin. No correlation was found among the presence of neuron specific enolase or human chorionic gonadotropin and T category, deoxyribonucleic acid ploidy, percentage of cells in the S phase, presence of metastatic disease or response to therapy. The prognosis for patients with muscle invasive disease and tumors positive for neuron specific enolase or human chorionic gonadotropin was similar to that for patients with tumors negative for these substances. When a possible new marker or prognostic factor is evaluated, it is important to investigate whether the new marker adds information on prognosis to what already is known by established standard methods. Further studies are needed to evaluate the clinical importance of human chorionic gonadotropin (and neuron specific enolase) as a marker in urothelial cancer with regard to prognosis and response to therapy.
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PMID:Human chorionic gonadotropin, neuron specific enolase and deoxyribonucleic acid flow cytometry in patients with high grade bladder carcinoma. 231 95

Twenty patients with advanced transitional cell carcinoma of the bladder were treated with radiation and concomitant continuous infusion of 5-fluorouracil with or without Mitomycin. Nineteen of 20 patients were assessed for response. Fourteen of 19 patients (74%) obtained a complete response within 3 to 6 months. An additional three patients (15%) acquired and maintained a complete response after local transurethral resection of the tumor and intravesical chemotherapy, raising the overall complete response (CR) rate to 17/19 (89%). Of the two patients with persistent disease, one is alive and well after salvage cystectomy. Eighteen of 20 patients were evaluated for survival with a median follow-up of 38 months. Seven patients remain alive and well 51 to 78 months, whereas three patients died from intercurrent disease. Eight patients died of either distant metastatic disease (7 patients) or regional disease (1 patient). An adjusted survival calculated by the Life Table Method was 53.6% at 5 years, whereas the overall survival was 39%. The combined modality therapy was well tolerated with no need for treatment interruption or reduction in dose. Late bladder complications include one patient with hemorrhagic cystitis, two patients with dysuria, and two with symptoms of irritable bladder. One patient required a colostomy for a chronic hemorrhagic proctitis. Bladder preservation was achieved in 19/20 patients.
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PMID:Treatment of advanced transitional cell carcinoma of the bladder with irradiation and concomitant 5-fluorouracil infusion. 234 21

The clinical features of a new prostate tumor marker, prostate-specific antigen (prostate antigen, PA), has been reviewed. Although PA cannot be used in early detection of prostate cancer, simultaneous determination of PA and PAP yields an additive clinical value in immuno-diagnosis of prostate cancer. At the present stage of development, PA is most useful as a prognostic marker for monitoring disease recurrence and treatment response. Also, PA is an effective immunohistologic marker for differential diagnosis of metastatic carcinomas with unknown primary, especially in the identification of metastatic prostate tumor in distant metastases and in the differentiation of primary prostate carcinoma from poorly differentiated transitional cell carcinoma of the bladder. Unequivocal evidence is not yet available on the role of circulating PA-binding globulin as an auto-antibody or an anti-tumor antibody as a result of patient's immune response. This observation is of clinical value for investigation of prostate cancer biology. The intriguing protease activity as detected in PA may provide new avenues for prostate cancer research.
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PMID:What's new in tumor markers for prostate cancer? 242 64

Metastatic poorly differentiated carcinomas often represent diagnostic difficulties in surgical pathology. Therefore, the expression of cytokeratins of different molecular weights (54, 57, and 66 kd) were compared in paraffin sections of 37 primary carcinomas with their lymph node metastases by an avidin-biotin complex (ABC) method, using monoclonal antibodies. The epithelial tumors consisted of 16 squamous cell carcinomas (SCCs) and 17 adenocarcinomas with different degrees of differentiation (well, moderately, or poorly differentiated), a renal cell carcinoma, a hepatocellular carcinoma, a transitional cell carcinoma of the bladder, and a carcinoid tumor of the stomach. The primary and metastatic tumors showed the same cytokeratin profiles. All SCCs and their metastases were positive for 57-kd cytokeratin and negative for 54-kd cytokeratin. All adenocarcinomas and their metastases were positive for 54-kd cytokeratin and negative for 66-kd cytokeratin. The extent of reactions varied with the differentiation of the carcinomas, with well-differentiated tumors showing more diffuse staining. Cases of lymphoma, sarcoma, and melanoma were negative for the three types of cytokeratins. The results indicate that identification of different molecular weight cytokeratins may be used to distinguish poorly differentiated SCCs from poorly differentiated adenocarcinomas, even in metastatic tumors. In addition, demonstration of these cytokeratins is useful in substantiating presence and identity of small foci of metastases in lymph nodes.
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PMID:Comparison of cytokeratin expression in primary and metastatic carcinomas. Diagnostic application in surgical pathology. 243 26

Invasive transitional cell carcinoma of the bladder is known to extend directly to other organs in the pelvis. When metastases occur they almost always adhere to a rather consistent pattern of dissemination. We present an unusual case of partial obstruction of the sigmoid colon due to a metastatic transitiocellular bladder tumour four months after transurethral resection of the tumour complicated with a perforation into the peritoneal cavity. Direct implantation of the tumour with the resectoscope is the most possible explanation, but seeding on an intact serosa cannot be excluded either.
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PMID:Partial obstruction of the sigmoid colon by surgical implantation. 261 78

Thirty patients with bulky T3 or T4 transitional cell carcinoma of the bladder, clinically determined to be without nodal or distant metastases, were treated with a 48-hour hypogastric artery infusion of cisplatin (CDDP) 75-150 mg/m2 1 month before tumor resection. Complications of the CDDP infusions were milder than those with intravenous (IV) infusion or rapid intraarterial (IA) infusion, although three lower extremity neuropathies were seen. The CDDP infusions reduced the primary bladder mass effectively, and seven of 16 cystectomy specimens were rendered PO. However, patient survival was clearly predicted by the nodal status. Of 15 T3-4N + MO patients, 11 died at 15 +/- 3 months. Methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) chemotherapy was given if residual transitional cell carcinoma was found after IA CDDP. Of 12 P3NOMO patients undergoing cystectomy, eight are alive with no evidence of disease (NED) at 28 +/- 8 months and no patient has died of transitional cell carcinoma. IA CDDP can effectively reduce bulky bladder cancer masses, but has no demonstrable effect on survival in N+ disease. It appears that adjuvant IA CDDP favorably affects survival in T3NOMO transitional cell carcinoma of the bladder.
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PMID:Intraarterial cisplatin infusion in the management of transitional cell carcinoma of the bladder. 273 84

Although much has been written on transitional cell carcinoma of the bladder, little has been reported on its metastasis. We reviewed the records of 175 patients, 4 of whom died postoperatively. All patients had been followed until their death and the surviving patients recently evaluated. Sixteen patients were lost after a long follow-up. Most of the metastases were diagnosed within 18 months after the cystectomy. Sixty-one percent of the patients presented bony metastases. The risk of metastasis is greater for sessile tumors, and increases with the degree of vesical wall infiltration, anaplasia and lymph node involvement. Evidence of lymph node involvement is not necessary for metastasis to exist. There were significantly fewer patients who died with metastasis in the patient group that did not receive preoperative radiotherapy in comparison with the other two patient groups. Of the 11 patients who revealed no evidence of tumor in the surgical specimen, 2 metastasized, indicating that metastasis was present prior to cystectomy. Treatment with cytostatic agents is the only effective therapy against distant metastasis. In our view, all patients with a tumor invading perivesical fat or who present lymph node involvement, regardless of tumor stage, should receive chemotherapy after cystectomy as early as patient condition permits.
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PMID:[Transitional infiltrating carcinoma of the bladder. Local recurrence and metastases. Analysis of 175 cases treated with radical cystectomy]. 278 63

In the past decade, there has been an increasing awareness of central nervous system metastases as a frequent complication of some malignancies, particularly in lung, breast and hematologic cancers. However, the central nervous system remains an uncommon location for metastases from certain primary tumors including those from the genitourinary system. We report on a patient with transitional cell carcinoma of the bladder who was treated with combination chemotherapy, and during the course of his disease developed carcinomatous meningitis. We anticipate this unusual complication of bladder transitional cell carcinoma will be seen more frequently, especially in the light of available data from effective chemotherapeutic regimens. We report this patient to alert physicians to this complication and to consider using prophylactic measures in responding patients as is the case in other malignancies.
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PMID:Carcinomatous meningitis from transitional cell carcinoma of the bladder: case report. 279 19

Two cases of transitional cell carcinoma of the bladder with cutaneous metastases are reported. In one patient, multiple nodular metastatic lesions appeared simultaneously with urethral recurrence after total cystectomy. In another patient, diffuse inflammatory metastatic lesion was generated after radiotherapy for pelvic lymph nodes. The pathways of metastatic dissemination from the transitional cell carcinoma of the bladder are discussed.
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PMID:[Cutaneous metastases from transitional cell carcinoma of the bladder]. 280 94

From 1984 to 1987, 49 patients with transitional cell carcinoma of the bladder underwent radical cystectomy during which intraoperative autotransfusion was used. Thirty-three patients were observed for a minimum of one year postoperatively; the mean and median follow-up periods in this group were 23.8 and 26.0 months. Twenty-nine of these 33 patients were alive at the time of reporting; 25 were alive with no evidence of disease, and seven had postoperative recurrence of disease, and seven had postoperative recurrence of tumor. Diffused metastatic disease compatible with intravascular dissemination of tumor during autotransfusion did not develop in any of the patients. Intraoperative loss of blood ranged from 400 to 4,000 milliliters; the mean was 1,497, and the median, 1,300 milliliters. The mean volume of autotransfused blood was 492 milliliters. Autotransfusion accounted for 40 per cent of the total transfusion requirements of the patients and proved to be cost effective for the entire study group. Fear of dissemination of tumor has limited the use of intraoperative autotransfusion during surgical procedures for carcinoma. Analysis of our data failed to define any evidence for dissemination of tumor caused by autotransfusion in patients who underwent radical cystectomy.
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PMID:Intraoperative autotransfusion in radical cystectomy for carcinoma of the bladder. 292 4


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