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)

Cure of primary liver tumours remains possible only by surgery and early diagnosis will therefore continue to be important; the value of regular screening of cirrhotic patients for development of HCC by ultrasound scanning and estimation of AFP is now established. Prognosis of irresectable HCC depends largely on the general condition of the patient at the time of diagnosis and is better in the absence of cirrhosis. Radiotherapy has little role in the management of patients with HCC, but benefit with acceptable morbidity may be obtained from parenteral chemotherapy, with doxorubicin or its derivatives used as single agents, or with a combination of 5-FU and methyl-CCNU. There may be advantage from regional therapy given via the hepatic artery and early results from the combination of embolization with arterial doxorubicin are encouraging. The use of radiolabelled antibodies to tumour-related determinants of hormonal manipulation show promise. Worthwhile results from the non-surgical management of peripheral (intrahepatic) cholangiocarcinoma and primary hepatic sarcoma remain scarce. Isolated hepatic metastases from colorectal primaries may be resectable; for those that are not, results from regional chemotherapy with 5-FU or FUDR are encouraging, but cost and high morbidity currently limit more general application.
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PMID:Chemotherapy and radiotherapy of malignant hepatic tumours. 303 57

Intra-arterial chemoembolization using mitomycin C microsphere (MMC MS) was carried out both for VX-2 tumor-bearing rabbits and for 19 patients with inoperable hepatic cancer. MMC MSs contain 5% MMC in albumin as a biodegradable drug carrier and an average diameter is 45 +/- 8 microns. VX-2 tumor, implanted into the hind legs of the rabbits, was treated intraarterially when it grew up to 2 cm in diameter. Tumor growth was compared with the other treated groups such as control, conventional MMC or blank microsphere; and MMC concentrations in the peripheral blood, femoral vein blood and muscles of the hind legs were measured after treatment. Tumor growth in the MMC MS group was remarkably retarded, but the other groups had no retardation. MMC concentrations of blood and muscle dropped below the assay limitation within 2 hours after conventional MMC injection, but in the animals treated with MMC MS, those showed the sustained drug release over for 6 hours. Fifteen patients with unresectable hepatic malignancies received intra-arterial hepatic infusion using conventional MMC, while 19 patients were treated by MMC MS infusion. Tumor regression in the 19 patients with MMC MS was seen in 42% (8/19), while that in the 15 with conventional infusion in 33% (5/15). Serum CEA levels in 12 patients with metastatic cancer decline from 57.7 +/- 72.2 ng/ml to 16.5 +/- 21.6 ng/ml 2 weeks after MMC MS treatment. However, those in 10 patients given conventional infusion dropped from 24.0 +/- 18.1 ng/ml to 17.4 +/- 18.0 ng/ml. The survival duration for patients given conventional infusion was 6.7 +/- 2.8 months, but that with MMC MS prolonged to 14.1 +/- 8.9 months. The MMC MS treatment for metastatic hepatic cancer had superiority to the conventional infusion treatment at p = 0.0040 in survival rate.
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PMID:[Intra-arterial chemoembolization with albumin microspheres including mitomycin C in inoperable hepatic cancer]. 303 95

The Liver Cancer Study Group of Japan statistically analyzed 4658 cases of primary liver cancer diagnosed from January 1, 1980 to December 31, 1981 in over 400 hospitals throughout the country. The study group comprised 2038 cases of hepatocellular carcinoma, 146 of cholangiocarcinoma, 33 of mixed carcinoma, 30 of hepatoblastoma, six of sarcoma, and 33 others. In 2286 cases (49.1%) a histologic diagnosis was available. The survey, based mostly on the histologically proven cases, describes histologic features of the tumors, grade of anaplasia and growth patterns of the tumor cells, pathology in noncancerous portions of the liver, distant metastases, medical history, frequency of hepatitis in the history, frequency of positive HBsAg and anti-HBs, age distribution, subjective symptoms, radiographic features (angiogram, scintiscan, computed tomography), ultrasonography, surgical procedures, extent of hepatic resection, and survival.
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PMID:Primary liver cancer in Japan. Sixth report. The Liver Cancer Study Group of Japan. 304 Feb 16

The causes of death and patterns of metastasis of 43 patients with primary liver cancer were studied and discussed in comparison with reports in the literature. Data from 6 recent reports of 1,673 patients showed that the 3 leading causes of death from hepatoma were liver failure (34%), bleeding (30%), and advanced cancer (24%). Distribution of sites of metastasis in 1,497 patients with hepatoma from 7 reports showed that the 3 leading sites were: lung (median 44%), portal vein (35%), and portal lymph node(s) (27%). The pattern of metastasis of hepatoma arising from cirrhotic liver is somewhat different from that of the noncirrhotic liver; the former are more likely to involve the portal vein, whereas the latter involves more regional lymph node(s). Compared to hepatoma, cholangiocarcinoma is less likely to metastasize to the lung or portal vein, but more likely to involve lymph node(s), peritoneum, and bone and/or marrow.
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PMID:Primary liver cancer: pattern of metastasis. 304 Nov 13

This phase 2 study was undertaken to evaluate the feasibility and efficiency of superselective intra-arterial chemotherapy with mitomycin C (SIAC) in patients with liver and gallbladder cancer and compare them to hepatic artery ligation (HAL) and regional chemotherapy with 5-fluorouracil (5-FU). Survival time was related to the percent hepatic replacement (PHR) of the tumour (P less than 0.01) in all patients. SIAC had no advantage over HAL +/- 5-FU as chemotherapy regimen for unresectable liver cancer. The overall response rate of SIAC was 42% (15/36), 27% (3/11) for primary liver cancer, 40% (8/20) for hepatic metastases from colorectal cancer and 60% (3/5) for carcinoma of the gallbladder. The patients who responded to SIAC survived significantly longer (P less than 0.005). The survival rate for responders at 1 year was 68% and for non-responders 26%. Chemotherapy toxicity after SIAC occurred in 16 (44%) patients requiring cessation of therapy in 6 (16%) patients. We conclude that the results of this phase 2 clinical trial were not encouraging. There is an urgent need for reliable means of predicting tumour response to chemotherapy and for a more careful patient selection.
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PMID:Superselective intra-arterial chemotherapy with mitomycin C in liver and gallbladder cancer. 312 85

This study was undertaken to define the MR appearance of splenic tumors in 16 cancer patients with focal splenic lesions; 50 volunteers and liver cancer patients without splenic abnormalities served as controls. In 14 patients with focal splenic lesions, differences between splenic and lesion signal intensities permitted detection of splenic lesions on MR images, either because of cystic or necrotic areas lengthening T2 within the tumor, because of T1 shortening from tumor-associated hemorrhage, or because of T2 shortening of surrounding spleen in two cases of suspected transfusional iron overload. In one spleen, a lesion appeared isointense on both T1- and T2-weighted pulse sequences and was detected only by gross splenic deformity. In one other case, CT defined splenic metastases not visible on MR images. Measurements of signal intensity of normal spleens and tumor are so similar that spin-echo MR imaging can underestimate the size and extent of focal splenic disease or may miss lesions entirely. We conclude that MR imaging is a less sensitive technique for detecting focal lesions of the spleen than for detecting focal hepatic lesions.
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PMID:MR imaging of focal splenic tumors. 327 35

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

Recent technical and clinical advances in MR of the liver are reviewed with special reference to the role of MR as a primary screening technique for detection of space-occupying lesions, especially metastases. The major current problem in upper abdominal MR imaging is physiologic motions, and this appears to have been effectively solved by newly introduced pulse-sequence and timing-parameter strategies. Short-TR/TE spin-echo sequences with extensive signal averaging and heavy T1-weighting produce images with exceptional anatomic detail and liver-cancer contrast differences. With this sequence superior sensitivity for liver-cancer detection has been shown in quantitative signal-difference to noise comparisons with other pulse sequences and in clinical comparisons with CT. MR discovered 14% more individual metastases and 3% more patients with liver cancer than CT in a blinded comparative study of 142 patients undergoing both exams. MR also showed greater specificity (98%) than CT (91%) in distinguishing patients without liver metastases. Differentiation of hemangioma from metastases was possible with greater than 90% specificity by using heavily T2-weighted sequences. Use of a fast-scan, gradient-recalled echo technique can also produce good-quality, multislice, T1-weighted studies of the liver in 20 sec--a breath-hold. MR contrast agents (such as gadolinium-DTPA and reticuloendothelial-system-specific, superparamagnetic ferrite-iron-oxide particles) offer further promise for enhanced sensitivity for liver-cancer detection. When optimal pulse sequences are employed, MR can now be appropriate as a primary screening method for detecting liver neoplasms.
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PMID:Leo J. Rigler lecture. MR imaging of the liver. 349 Jul 43

To date, systemic chemotherapy for melanoma metastases appears to be of only limited benefit since tumoricidal drug concentrations can hardly overcome primary or secondary drug resistance of melanoma cells. Recently, intraarterial infusion techniques with or without regional venous drug hemofiltration have been shown to provide high cytotoxic levels at the target region, thus subsequently using persistent (chemo-embolization) or transient (microspheres, liposomes) blocking techniques may optimize the pharmacological advantage of regional drug delivery. In a pilot series in metastatic liver cancer a significant increase of drug concentration within the target tissue could be achieved while systemic levels were found to be reduced during angio-occlusion. The rationale of angio-occlusive approaches in melanoma offers the possibility of focusing the anti-tumor action directly at the target so that improved response rates can be expected.
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PMID:Angioocclusive chemotherapy in melanoma: rationale and technical considerations. 363 1

A total of 45 patients, after surgical resection of colorectal liver cancer metastases, were retrospectively analyzed to define areas of failure, to identify some possible prognostic factors (site of primary, stage, site, number of metastases, preoperative carcinoembryonic antigen, differentiation of the primary, type of surgery), and to seek a new rationale for a multimodal approach. The median postoperative follow-up was 18 months (range: 4-45 months). Survival rate was calculated by the actuarial method, and statistical significance was tested by the Mantel-Haenszel test. Twenty-eight patients had a relapse. These recurrences were hepatic in 11 patients, extrahepatic (intra- and extra-abdominal) in 12 patients, and intra- and extrahepatic in five patients: The stage (classification of the Istituto Nazionale Tumori of Milan) was the most important parameter related to the overall recurrence rate (47% in stage I, 62% in stage II, and 81% in stage III) and to the overall and disease-free survival. Stage was significantly related to hepatic relapse but not to extrahepatic relapse. In stage I the failure rate of 18 months was similar in hepatic and extrahepatic relapses (one third to one fourth of the patients); in stages II and III the hepatic failure rate was always higher than the extrahepatic rate. These data indicate that surgery alone is an inadequate form of therapy in cases of colorectal cancer metastases of the liver, and an adjuvant therapy, including alternate regimens of intraperitoneal and systemic chemotherapy, should be considered.
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PMID:Patterns of failure following surgical resection of colorectal cancer liver metastases. Rationale for a multimodal approach. 382 62


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