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

Fourteen patients with intractable bleeding of obstetric or gynecological origin underwent transcatheter angiographic arterial embolization. Three patients had postpartum hemorrhage associated with dilutional coagulopathy, anticoagulant therapy and placental leukemic metastases, or placenta percreta. One patient had locally advanced gestational trophoblastic tumor, one had uterine sarcoma and 8 had advanced cervical malignancy. Bleeding was completely controlled in all patients regardless of the initiating event. The embolizing material was gelatin sponge particles in 12 patients, and spring coil in 2. In experienced hands, angiographic arterial embolization is a safe, effective and less invasive alternative to surgical ligation in some clinical states of pelvic female genital tract hemorrhage.
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PMID:Angiographic embolization for control of pelvic genital tract hemorrhage. Report of 14 cases. 131 91

Long-term survival following resection of pulmonary metastases has been well documented. Variables that are believed to have an effect on survival are site of primary tumor, number and size of metastases, resectability, laterality of the metastases, doubling time, and disease-free interval. Published information regarding resection of pulmonary metastases in patients with gynecologic primary tumors is limited. We reviewed 45 patients whose pulmonary metastases from uterine sarcomas were resected at Memorial Sloan Kettering Cancer Center between 1960 and 1989. All cases met carefully defined criteria at time of thoracotomy: prior hysterectomy for uterine sarcoma, no extrathoracic tumor, known disease thought to be resectable, histology consistent with uterine sarcoma, and no medical contraindication to thoracotomy. Seventy-one percent had unilateral lesions, fifty-one percent had one lesion, and seventy percent had nodules greater than 2 cm. Thirty-six percent had incomplete resection at thoracotomy. Actuarial 5- and 10-year survival from hysterectomy for uterine sarcoma was 65 and 50%, respectively, with a mean follow-up of 89 months. Five- and ten-year survival from resection of pulmonary metastases was 43 and 35%, respectively, with a mean follow-up of 25 months. Unilateral vs bilateral disease was a significant predictor of survival after pulmonary resection (P = 0.02). Metastases size, number of metastases, disease-free interval, and patient age were not significant. Among this carefully selected group of patients undergoing resection of pulmonary metastases from uterine sarcomas, long-term survival was achieved by a substantial proportion of patients. No single risk factor is sufficiently accurate to exclude an individual patient from consideration for pulmonary resection.
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PMID:Resection of pulmonary metastases from uterine sarcomas. 159 88

One hundred patients undergoing pelvic exenteration (total 69, anterior 13, posterior 18) at the University of Michigan Medical Center from 1964-1984 are reported. All patients were followed for at least 5 years or until time of death. The overall cumulative survival was 66% at 3 years and 61% at 5 years. The age of the patients ranged from 21-74 years (median 53). The type of pelvic neoplasm included squamous cell of the cervix, 57; adenocarcinoma of the cervix, nine; squamous cell carcinoma of the vulva, 12; squamous cell carcinoma of the vagina, eight; vaginal sarcoma, four; adenocarcinoma of the vagina, one; adenocarcinoma of the endometrium, four; uterine sarcoma, four; and adenocarcinoma of the ovary, one. The cumulative 5-year survival was significantly related to the presence of metastatic disease to the regional lymph nodes (8% 3-year and 0% 5-year survival), time interval from primary diagnosis to exenteration (within 1 year 44%, 1-10 years 60%, and over 10 years 95%), and cell type (squamous cell 68%, sarcoma 62%, and adenocarcinoma 26%). Patients with squamous cell carcinoma of the cervix (N = 57) had a cumulative 5-year survival of 73%, compared with nine patients with adenocarcinoma of the cervix, who had a 22% 5-year survival. No significant difference in survival existed for the type of exenteration, original stage of squamous cell cervical carcinoma, size of recurrent squamous cell lesion, or age of the patient. Early or late complications occurred in 49 patients. Two patients died in the postoperative period. Small-bowel obstruction was the most common complication seen in this series.
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PMID:Pelvic exenteration, University of Michigan: 100 patients at 5 years. 258 60

Information in the literature about the incidence of nodal spread and its clinical implication in stage I sarcoma of the uterus is limited. The purpose of this study is to provide additional information derived from surgical staging of 20 patients who were treated by primary surgery to include total abdominal hysterectomy, bilateral salpingo-oophorectomy, and selective biopsy of paraaortic and pelvic nodes. Nine out of 20 patients (45%) of this small series had lymph node metastases either to both pelvic and paraaortic nodes (6) or pelvic nodes alone (3). This high rate of nodal involvement was associated with deep myometrial invasion, uteri sounding larger than 8 cm, patients older than 65 years, and leiomyosarcoma. In 12 of 20 patients, clinical staging was an underestimate. In a follow-up from 2 to 12 years, all 9 patients with positive nodes succumbed to their diseases. This result indicates that incidence of nodal spread in stage I sarcoma of the uterus is a frequent occurrence and is related to ultimate survival. Furthermore, it suggests that lymphatic permeation might precede hematogenous spread in early sarcoma of the uterus.
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PMID:Propensity of retroperitoneal lymph node metastasis in patients with stage I sarcoma of the uterus. 291 Jul 83

The autopsy findings of 73 patients with uterine sarcoma were studied to determine the sites and possible modes of metastasis. Homologous mixed mesodermal tumors were the most frequent (41%) followed by leiomyosarcoma (26%), heterologous mixed mesodermal tumor (18.3%), stromal sarcoma (12%), and endolymphatic stromal myosis (3%). The peritoneal cavity and omentum were the most frequently involved sites (59%), followed by the lung (52%), pelvic lymph nodes (41%), paraaortic lymph nodes (38%), and liver parenchyma (34%). The presence of lung metastasis was not associated with pelvic or paraaortic node metastasis or intraperitoneal disease. Metastasis to other distant sites including the brain, heart, kidney, and bone were independent of pelvic and paraaortic nodal metastasis or intraperitoneal disease. Metastatic sites were not different among various histologic types. Distant metastatic sites were statistically associated with lung metastasis. Hematogenous metastasis best explains this metastatic pattern and adjuvant systemic therapy seems indicated.
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PMID:Patterns of metastasis in uterine sarcoma. An autopsy study. 291 99

Sixty-nine cases of uterine sarcoma were reviewed histologically withhh respect to their grade of malignancy. Mitotic activity is the most important criterion of malignancy. A histological grading was performed on the basis of mitotic counts per high power field. Clinical follow-up showed that except for the local extension of the tumor, the prognosis of sarcomas depends greatly on mitotic activity. There is a good correlation in the lower stages I and II between number of mitoses and survival rate. The 5 year survival rate of patients with grades I or II is 77% compared to 41% for grades III and IV. Vascular invasion is not evident in distant metastases in our material. Adjuvant chemotherapy is recommended in clinical stages II-IV and in histological grades III and IV.
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PMID:[Sarcomas of the uterus: morphological criteria and clinical course (author's transl)]. 744 73

At the Frauenklinik Finkenau Hamburg a total of 56 women were treated for sarcoma of the uterus between 1953 and 1977. Accounting for 1.2% of all malignancies, sarcoma is a rare tumor. The different histological types are analysed with respect to age distribution, endocrine status, preceding pregnancies, etc. Treatment results over a 15 years period and a subsequent 10 years period were compared. Symptoms and local findings show great variability. Preoperative diagnostic procedures frequently did not result in final diagnosis. The mode of therapy changed over the long period of 25 years. Forty-nine patients were followed up over a period of more than 10 years. In Patients with sarcomas which had derived from preexisting myomas, the 10 year survival rate was 89% (16/18). The total 10 year survival rate was 57% (28/49). Effectiveness of different therapeutic approaches such as operation, irradiation, and cytostatic therapy is demonstrated. Local recurrences and distant metastases usually occurred within 2 years after primary treatment. One case with successful chemotherapy of pulmonary metastases of leiomyosarcoma is demonstrated showing complete remission over a period of 28 months.
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PMID:[Results of treatment on 56 sarcomas of the uterus between 1953 and 1977 (author's transl)]. 744 75

CBA female mice treated with 1,2-dimethylhydrazine (DMH) alone or in combination with oestradiol dipropionate (EP) or ascorbic acid (AA) developed, as expected, a high incidence of uterine sarcomas. In addition, sarcomatous lesions at unusual sites (mainly in the forestomach) were evident. The incidence of sarcomatous lesions at other sites was 53/220 in mice having uterine sarcomas and 0/186 in mice treated with DMH but without uterine sarcomas. The difference between the two groups was highly statistically significant (P < 0.001) and demonstrates non-coincidental association of the above sarcomatous lesions with uterine sarcomas. Uterine sarcomas which presented in association with lesions at other sites were of a larger size than those found in isolation, and the difference in weights in three out of four groups was statistically significant (P = 0.008, 0.035 and 0.011). Histologically, sarcomatous lesions were similar in structure to those of uterine sarcomas, i.e. were of a fibroblastic-histiocytic nature with admixture of giant cells. On the basis of the above data the sarcomatous lesions described appear to represent uterine sarcoma metastases rather than independent primary tumours. AA did not have any influence on carcinogenesis induced by DMH alone but inhibited the growth of uterine sarcomas (whether or not they were associated with other sarcomatous lesions) induced by DMH combined with oestradiol dipropionate.
Clin Exp Metastasis 1995 Sep
PMID:Sarcomatous lesions in CBA female mice treated with 1,2-dimethylhydrazine: independent primaries or metastases? 764 23

A retrospective review of patients treated for a uterine sarcoma in Edinburgh from 1974 to 1992 has been performed. Clinical details at presentation, tumour pathology, treatment and the outcome of treatment were all recorded. 82 patients' case notes were reviewed. 54 patients had died and 28 were alive (mean follow-up period 80.3 months). 39 patients had a malignant mixed mesodermal tumour, 12 patients had an endometrial stromal sarcoma, and 27 had a leiomyosarcoma. Using a modified FIGO staging retrospectively, 41 patients had Stage 1 disease, two patients had Stage 2, 16 patients had Stage 3, and 13 patients had Stage 4 disease. Definitive treatment of total abdominal hysterectomy and bilateral salpingo-oophorectomy was used in 69 patients, with 35 of these patients also receiving post-operative radiotherapy to the pelvis. 13 patients did not undergo surgery. Five of these patients received radical radiotherapy, three patients received palliative radiotherapy, and five patients were not treated. The overall median survival is 15 months and the 5-year actuarial survival is 31%. 25 of the 26 surviving patients had Stage 1 disease at presentation. Post-operative pelvic radiotherapy did not influence either survival or local tumour control. 51 of the 54 patients who relapsed had evidence of distant metastases. We conclude that total abdominal hysterectomy and bilateral salpingo-oophorectomy remains the treatment of choice for uterine sarcomas.
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PMID:Uterine sarcomas: a review of the Edinburgh experience from 1974 to 1992. 828 93

We report the case of a 52-year old post-menopausal woman in whom the finding of a right paravertebral mediastinal and pulmonary mass and a homolateral pleural effusion revealed the presence of a large uterine tumour. Pleural fluid cytology was in favour of an undifferentiated tumour, and biopsy of the endometrium pointed to a connective tissue tumour. Following immunohistochemical staining, hysterectomy combined with adnexectomy confirmed the diagnosis of uterine sarcoma. Later on, the patient underwent thoracoscopy which showed multiple pleural metastases. In view of concordant histological results and of the appearance of multiple spherical images at radiology, chemotherapy with adriamycin, ifosfamide and vincristine was instituted but proved to be ineffective: the patient died after two cycles of this therapeutic regimen.
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PMID:[Isolated pleuropulmonary metastases of uterine sarcoma]. 837 95


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