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)

Five hundred and ninety-one of 889 patients with T1 to T4 transitional cell carcinoma of the bladder had persistent or recurrent cancer after radical radiotherapy. Durable local control was significantly poorer for patients with grade 1 or T4 cancer before radiotherapy. Three hundred and twenty-two patients received additional surgical treatment: 211 were endoscopically managed and 111 had secondary cystectomy. The survival of patients with residual or recurrent cancer after radiotherapy was significantly improved by secondary local treatment (P less than 0.0001). A comparison was made between endoscopic treatment and cystectomy after radiotherapy. Patients having secondary cystectomy were younger (mean age 60.0 years) than those managed endoscopically (66.8 years). The 5-year actuarial survival rate (from the date of radiotherapy) for patients who had endoscopic treatment was 47.1% compared with 62.5% for those who had cystectomy (P = 0.16). After both treatments survival was significantly correlated with the T category of the tumour before radiotherapy. Local tumour control was better after cystectomy; 85.6% of patients were locally tumour-free at the end of follow-up compared with 44.5% of those managed endoscopically. There was no overall difference in the subsequent risk of metastases between the two forms of surgery. However, seven of 12 patients managed endoscopically prior to secondary cystectomy died of their cancer. Five of these patients died from metastases even though they were locally disease-free. There was a significantly increased risk of metastases in patients managed endoscopically who were not locally disease-free after treatment (P = 0.0003). Caution is advised in persisting with endoscopic treatment after radiotherapy if local control is not readily achieved.
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PMID:Results of surgery following radical radiotherapy for invasive bladder cancer. 375 9

Forty-three consecutively diagnosed patients with widely metastatic transitional cell carcinoma of the bladder (TCCB) were treated with a high-dose intensity, chronobiologically timed combination of doxorubicin and cisplatin, followed by Cytoxan (Mead Johnson Pharmaceuticals, Evansville, IN), 5-fluorouracil (5-FU), and cisplatin maintenance for up to 2 years. Fifty-seven percent of the 35 evaluable patients with widespread metastatic cancer responded objectively. Twenty-three percent had complete disappearance of all cancer. Median survival from first treatment for complete responders (CRs) was more than 2 years, and 1 year for partial responders (PRs). Three of the CRs were alive without evidence of cancer more than 2 years after stopping all therapy. High-dose intensity combination chemotherapy can induce durable CRs of widespread bladder cancer.
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PMID:High-dose intensity systemic therapy of metastatic bladder cancer. 381 9

We report the efficacy and toxicity of combined cisplatin, methotrexate and vinblastine for the treatment of metastatic transitional cell carcinoma of the bladder in 50 evaluable patients. Of these 50 patients 17 had not undergone cystectomy and had residual invasive bladder cancer. Of these 17 patients 11 had complete response of the bladder lesions following cisplatin, methotrexate and vinblastine for metastatic disease, including 6 of 12 treated by cisplatin, methotrexate and vinblastine alone, and 5 of 5 treated with cisplatin, methotrexate and vinblastine plus palliative or preoperative pelvic irradiation. Complete response was confirmed in 10 of the 11 patients by endoscopy and biopsy, and in 1 by cystectomy. One patient whose liver metastasis responded to cisplatin, methotrexate and vinblastine had conversion to complete response by cystectomy for persistent bladder cancer. Of these 17 patients 7 are alive, including 5 without disease, 4 to 41 months after treatment. The bladder appears to be responsive to this combination chemotherapy for invasive transitional cell carcinoma. This experience underscores the need for regular pathological re-staging of the bladder cancer in patients receiving chemotherapy.
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PMID:The fate of the bladder in patients with metastatic bladder cancer treated with cisplatin, methotrexate and vinblastine: a Northern California Oncology Group study. 390 23

Recent enthusiasm for the use of intensive regimens of intravesical chemotherapy in the management of various forms of superficial transitional cell carcinoma of the bladder prompted us to examine retrospectively a group of patients with carcinoma in situ treated by such regimens who failed with progressive and metastatic cancer. Of 8 patients with flat carcinoma in situ treated with thiotepa 5 presented initially with concomitant solitary stage T1 papillary tumors that were resected successfully at initial presentation. Six patients had diffuse or multifocal carcinoma in situ, while 2 others had only a solitary focus of in situ disease. All patients had persistently positive urinary cytology studies during treatment, prompting 3 of them to receive intravesical mitomycin C following their course of thiotepa. Involvement of the prostatic urethra developed during therapy in 3 patients and 3 had muscle-infiltrative disease. At cystectomy 3 of 7 patients had positive pelvic lymph nodes and 4 died of distant metastases at an average of 8 months after cystectomy. These results suggest that despite the apparent advances that have been made in the control of recurrent superficial transitional cell bladder cancer, the intrinsic behavior of some forms of the disease may determine cancer progression. Identification of such patients is indicated for the institution of early aggressive treatment, which in the end may actually be the more conservative therapeutic approach.
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PMID:Intensive intravesical chemotherapy in the treatment of flat carcinoma in situ: is it safe? 393 86

The following case report presents a patient with transitional cell carcinoma of the bladder referred to this medical center after carcinomatous meningitis developed. Previously he had undergone surgical resection of the primary lesion and had received cis-platinum chemotherapy for lung metastasis. This unusual presentation of metastatic disease (carcinomatous meningitis) seems to alert the surgical and medical communities to new complications.
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PMID:Carcinomatous meningitis from transitional cell carcinoma of bladder. 399 79

This is a case report of transitional cell carcinoma of the bladder which metastasized to lymph nodes, bone, and the penis. The penile metastases were demonstrated by cavernosography. Secondary tumors in the penis are rare. They presage a bad prognosis and a rapid demise; the patients survive an average of four months.
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PMID:Cavernosography in diagnosis of penile metastases secondary to bladder cancer. 407 72

Recently, the study of the physiological role of the essential trace elements is being emphasized. Some environmental and disease factors has been demonstrated to perturb trace element homeostasis. A number of recent studies have described alterations in serum copper levels (SCLs) and serum zinc levels (SZLs) in human cancer patients and the relationship between the magnitude of their perturbation and disease activity. This report describes SCLs, SZLs and SCL/SZL ratios in patients with malignant neoplasms of the urogenital tract at various clinical stages and the relationship of the levels of these trace elements to disease activity. According to SCLs before treatment, patients with renal cell carcinoma appeared to be separated into two groups, normal SCL group and higher SCL group. In the higher SCL group, patients generally displayed increased erythrocyte sedimentation rate, CRP, alpha 2 globulin, beta 2 microglobulin, ferritin and CEA. In this group, SCL was a useful index of disease activity. In the normal SCL group, SCLs remained within normal limit even in patients with advanced disease. In renal cell carcinoma, SZLs did not reflect disease activity. In transitional cell carcinoma of the upper urinary tract, patients with metastasis had significantly elevated SCLs and significantly decreased SZLs, compared with normal controls or patients without metastasis. In transitional cell carcinoma of the bladder, no distinct relationships were observed between these trace elements and extent of malignancy. But there was a trend toward increasing SCLs and decreasing SZLs with progressing stage and SCL/SZL ratios fairly reflect stage of disease. Patients with prostatic cancer had nearly normal SCLs and SZLs, although there were a few exceptions. Testicular cancer patients with distant metastasis had significantly elevated SCLs and initially high SCLs decreased in patients responding to therapy and increased again in relapse. SZLs and, hence, SCL/SZL ratios had no relationship to activity of testicular cancer. Currently there is no satisfactory way of following the progress of malignancies of the urogenital tract except prostatic cancer with elevated acid phosphatase and non-seminomatous testicular tumors until the secondary tumor can be detected radiographically. Our study suggests that these trace element might be a useful indicator of disease activity of some of the urogenital malignancies.
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PMID:[Serum copper and zinc levels in patients with malignant neoplasm of the urogenital tract]. 408 94

Sex chromatin studies on squash preparations of a well differentiated transitional cell carcinoma of the bladder without evidence of invasion from a female aged 63 revealed a single body in some regions, but two to four bodies in others. All regions were near diploid according to DNA estimations. Previous observations on a variety of invasive tumours of females showed that the presence of more than one sex chromatin body is generally associated with a high chromosome number. The pattern of two or more bodies in near-diploid cells seen in this non-invasive tumour may therefore characterize an intermediate stage of clonal evolution, eventually resulting in malignancy, when the cell line has not yet achieved the ability to invade or metastasize.
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PMID:Variable sex chromatin pattern in an early carcinoma of the bladder. 469 31

Results in a series of 60 patients with recurrent or metastatic transitional cell carcinoma of the bladder confirm that methotrexate is active as a single agent. Over-all, 43 per cent of the patients with measurable metastases and 28 per cent with recurrent primary tumors responded for an average of 6 months. Response rates in both groups were influenced by the stage of the primary tumor.
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PMID:Methotrexate in the treatment of metastatic and recurrent primary transitional cell carcinoma. 623 Apr 63

Certain malignant neoplasms commonly metastasize to the adrenal glands, whereas others do so only infrequently. In the latter circumstance, an adrenal mass is likely to be benign. We report 3 patients with malignant neoplasms (hepatoma, transitional cell carcinoma of the bladder, and squamous cell carcinoma of the vulva) that do not commonly metastasize to the adrenals in whom computed tomographic (CT) demonstration and guided aspiration of adrenal masses significantly affected patient management. CT guided aspiration of adrenal masses is safe and accurate and is recommended whenever a diagnosis of adrenal metastasis would alter the staging or therapy of the primary neoplasm.
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PMID:CT demonstration and guided aspiration of unusual adrenal metastases. 629 91


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