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)

One hundred patients with pancreatic cancer were evaluated between March 1981 and December 1989. This study showed that 61 were not candidates for definitive surgery because of nonoperability (28 patients) or nonresectability (33 patients). An additional 25 patients had cancers that were unresectable because of metastases (13 patients) or local spread of disease (12 patients) discovered at laparotomy. Fourteen patients had resectable cancers. Ten were treated by total pancreatectomy, three by distal pancreatectomy and one by pancreatoduodenectomy (Whipple). There were two operative mortalities. The median patient survival time was 20.5 months. Two patients survived 5 years. Five patients are alive at 3, 14, 18, and 47 months. Palliative surgical procedures performed in 18 patients included 10 biliary bypasses, 9 gastrojejunostomies, and 6 T-tube placements. This was associated with an operative mortality rate of 11%. The median survival time was 5 months. Other palliative measures included endoscopic placement of biliary and pancreatic stents (47 patients, 2.7% mortality rate), endoluminal radiation therapy, interstitial radiation therapy and external beam radiation therapy. The median survival time of patients so treated was 4.5 months.
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PMID:Carcinoma of the pancreas: a personal experience with 100 cases. 171 78

Locally advanced unresectable pancreatic cancer is sometimes encountered without manifest distant metastases. Twenty patients with histologically proven unresectable pancreatic cancer without distant metastases were treated with radiotherapy and 5-fluorouracil (5-FU). Radiotherapy consisted of 50 Gy external upper abdomen radiation in two courses, concomitant with intravenous 5-FU 375 mg/m2 given as a bolus injection 4-6h before radiation on the first 4 days of each treatment course. The treatment protocol was completed in 18 patients without complications. The median survival time was 10 months which compares favourably with a 3-5 months median survival time when treatment is withheld. Nine patients (45 per cent) were alive at 1 year, two patients at 2, 3 and 4 years. A second-look operation was performed in four patients 6, 11, 12 and 22 months after completion of radiotherapy. In two patients the tumour could be resected. It appears that treatment with radiotherapy and 5-FU may benefit patients with locally advanced unresectable pancreatic cancer.
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PMID:Treatment perspectives in locally advanced unresectable pancreatic cancer. 176 Jun 97

This study was performed in order to evaluate the role of various local and systemic alterations in influencing serum glycoproteic markers in patients with pancreatic cancer, and in healthy and diseased controls. Cancer antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and ferritin were determined in the sera of 23 control subjects, 30 patients with pancreatic cancer, 27 with chronic pancreatitis, and 27 with extra-pancreatic diseases mainly of gastrointestinal origin. A number of acute-phase proteins and indices of liver function and cholestasis were also assayed. The three antigens increased only in patients with pancreatic cancer. Higher CA 19-9 and CEA, but not ferritin, levels were found only in patients with hepatic metastases. Acute-phase proteins and synthetic functional indices were found to be higher and lower, respectively, in patients with pancreatic malignancy when compared with controls. Multiple regression analysis documented the dependence of circulating ferritin, but not of CA 19-9 and CEA, on the systemic indices. Canonical correlation showed a similar trend for CA 19-9 and CEA, which differed from that of ferritin. Ferritin was found to depend on the presence of systemic and hepatic alterations, especially of cholestasis. We can conclude that the variations of serum glycoprotein markers in patients with pancreatic cancer depend on various regional and systemic factors. CA 19-9 and CEA are related mainly to the extent of the neoplasia. The influence of a decreased liver function capacity associated or not to cholestasis and the interrelation with the acute-phase response may also be suggested. Ferritin, on the other hand, is related to a higher degree than CA 19-9 and CEA to hepatic dysfunction and also behaves similar to an acute-phase protein.
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PMID:Role of local and systemic factors in increasing serum glycoprotein markers of pancreatic cancer. 177 Mar 22

The general biologic behaviour of exocrine pancreatic cancer was examined retrospectively in a total of 840 autopsies (382 males, aged 31-86 [average 66.5] and 458 females, aged 2-90 [average 72]). 95 % of autopsies showed definable tumours (caput 64%, corpus 17%, cauda 14%), in 5% the gland was diffusely permeated by cancer tissue. 19.5% had no metastases, whereas in 80.5% carcinomatosis was diagnosed. In 7% only locoregional metastases of the lymph nodes could be found. Tumour sizes were observed in the range of 0.3 to 14 cm. All carcinomas below the size of 1 cm were free of metastases. In tumours larger than 2 cm, the formation of metastases increased sharply. In sizes more than 3 cm complications were important for the prognosis. Carcinomatosis proceeds cascade-fashion with high first rate metastatic spread into the liver. 6% of liver metastases were solitary ones, 94% were multiple. In 171 cases malignancy grading was performed. Free of metastases were 50% of the decreased with grade-I-carcinomas, 21% with grade-II-carcinomas and 7% with grade-III-carcinomas. These data comment on the possibilities and limitations of curative cancer resection from a morphological view.
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PMID:[The biological behavior of exocrine pancreatic carcinoma from a pathological-anatomical viewpoint. A contribution to the problems of surgical therapy]. 177 73

The aim of this study was to measure the serum level of the tumour markers CA 195 and CEA in patients with either colorectal or pancreatic cancer both before and at serial intervals after operation. CA 195 and CEA were measured in 199 patients with colorectal cancer and 52 patients with pancreatic cancer. The median concentrations of CA 195 were 3.0 u/ml (interquartile range 3.0-4.5 u/ml) in patients with a Dukes' stage A lesion, 5.8 u/ml (3.0-18.2 u/ml) in patients with a Dukes' stage B lesion, 6.1 u/ml (3.0-24.7 u/ml) in patients with a Dukes' stage C and 23.8 u/ml (11.1-409.0 u/ml) in patients with metastatic disease (normal range 0-7 u/ml). The median levels of CEA were 2.6 ng/ml (1.7-3.3 ng/ml) for Dukes' stage A, 3.3 ng/ml (1.7-7.2 ng/ml) for Dukes' stage B, 3.7 ng/ml (2.2-7.9 ng/ml) for Dukes' stage C and 34.5 ng/ml (13.3-289.4 ng/ml) for metastatic disease. A rising level of CA 195 or CEA after operation suggested recurrence of the tumour. In none of these patients was the recurrence operable. In patients with pancreatic adenocarcinoma, the level of CA 195 was significantly higher in patients with metastatic disease but it did not discriminate between resectable and unresectable disease. The duration of survival correlated with the initial level of CA 195 (Rs = -0.66, p less than 0.001).
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PMID:The tumour marker CA 195 in colorectal and pancreatic cancer. 179 32

A retrospective study was performed of all patients diagnosed as having pancreatic cancer in Iceland during the period 1974-85 (12 years). The incidence of the disease during the period according to this study was 10.7 per 100,000 males and 9.8 per 100,000 females, with age-adjusted world standard incidences of 9.0 per 100,000 males and 6.7 per 100,000 females. A total of 301 patients were identified; adequate information could be obtained for 281 patients, and 225 (74.8%) had the diagnosis histologically confirmed. Two hundred and five patients with adenocarcinoma were accepted for detailed analysis. Of the patients with adenocarcinoma 139 (67.8%) were diagnosed at laparotomy, and 33 of them had the tumour resected, with an operative mortality of 12.1%. The cancer was located in the head of the pancreas in 102 patients (49.8%), and in 159 (77.6%) metastases were found at the time of diagnosis. The median survival time for the patients with adenocarcinoma was 95.4 days (SD +/- 11.1 days), although there were two patients in this group who were alive 5 years after diagnosis. The median survival for the total group of 281 patients was 98.3 days (SD +/- 11.0 days), although 6 of these patients lived for more than 5 years. The percentage of histologically confirmed tumours in Iceland is high compared with many previously reported studies.
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PMID:Cancer of the pancreas in Iceland. An epidemiologic and clinical study, 1974-85. 189 15

In order to improve therapeutic efficacy for metastatic liver cancer, intermittent transarterial administration of BRM in combination with anticancer drugs was performed by use of reservoir apparatus. A total of 22 patients (12 cases of gastric cancer, 6 of colon cancer, 2 of pancreas cancer, 1 of gall bladder cancer and 1 of biliary tract carcinoid) were treated according to the following schedule: both 10 mg of ADM (or MMC) and 0.5 KE (or 1.0 KE) of OK-432 were administered on day 1 and 40 x 10(4) JRU of recombinant interleukin 2 (r-IL 2) on day 4, 7 and 11. The treatment was repeated as many times as possible. In terms of direct antitumor effect and decrease of tumor marker, the response rate was 43% (6 cases out of 14) and 75% (9 cases out of 12), respectively. As for performance status, improvement, no change and deterioration were seen in 4 cases, 8 cases and 3 cases, respectively. Even though 13 patients died, 8 of them survived more than 300 days. In the case of gastric cancer patients with liver metastasis, 50% survival time of 12 cases was 334 days, while that of 30 cases, who were administered anticancer drugs only systemically, was 144 days. In 3 cases the decrease in the size of tumors located in both liver and the other metastases also was seen. Every case developed high grade fever, but an antifebrile was effective. Otherwise severe side effects were not seen. These results indicated that intermittent arterial infusion immunochemotherapy was feasible for the treatment of metastatic liver cancer.
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PMID:[Therapeutic effect of transarterial infusion immunochemotherapy for metastatic liver cancer]. 190 65

A retrospective study of survival results for pancreatic cancer was performed. The study had two objectives: 1) to relate the extent of disease and management to survival, and 2) to determine whether newer treatment combinations have altered prognosis. Cancer registrars from 88 Illinois hospitals reviewed original medical records and submitted standardized report forms on 2,401 patients diagnosed between 1978-84. Three-year survival time was longer after laparotomy/bypass plus radiation/chemotherapy than for laparotomy/bypass alone (P less than .02). But the difference in survival between resection versus resection, radiation, and chemotherapy was not significant (P = .16). After resection, the median survival for 78 Stage I patients was 12.5 months, whereas for 181 Stage I patients after laparotomy/bypass it was 6.8 months (P less than .00001). For patients without metastases, 3-year survival was significantly better for 249 patients in whom cancer was resected versus 568 unresected patients (P less than .001). Survival was longer for 568 unresected patients without gross metastases than for 954 patients with metastatic disease found at laparotomy (P less than .05). From this study the authors concluded that: 1) since 3-year survival results were higher than expected after resection for localized cancers, resection is still desirable when it can be done with acceptable complication risks, and 2) the use of multiple treatment modalities for pancreatic cancer warrants further study in organized trials.
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PMID:Pancreatic cancer in Illinois. A report by 88 hospitals on 2,401 patients diagnosed 1978-84. 192 91

The study demonstrated that adenocarcinoma was the most common form of pancreas cancer. In the majority of cases it originated from the head of the gland, with the body ranking second and the tail third. Adenocarcinoma most frequently metastasized in the lymph nodes, less in the liver and rather infrequently in the lungs and intestines. When the cancer involved the entire gland or a greater part of it, metastases in the latter organs were practically obligatory. Most frequently metastases of pancreas adenocarcinoma were observed in the seventh decade, followed by the sixth and the eighth decades. This regularity as a whole matched the regularity of the age prevalence of pancreas cancer.
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PMID:[Pancreatic cancer. VII. The incidence and characteristics of the metastasis of pancreatic adenocarcinoma]. 194

In order to investigate lymphatic spread from the head of the pancreas to the para-aortic lymph nodes (No. 16 area), lymphatic metastases were reviewed in 42 cases of carcinoma of the head of the pancreas, and then activated carbon particles and 111In colloid were injected in 10 cases and 7 cases of pancreatoduodenal cancer, respectively. The main route from the head of the pancreas to No. 16 area was a lymphatic pathway through the lymph nodes in the posterior part of the head of the pancreas (No. 13), around the superior mesenteric artery (No. 14) and No. 16. The lymphatic metastases in No. 16 area were mainly seen in the area of 16b2. The carbon or 111In colloid also flowed to nearly the same lymph nodes of No. 16 area. The direction of the extent of those substances was especially toward the dorsal side of the level of the renal artery rather than from the rostral to the caudal. These results indicate that lymph nodes of No. 16 area should be dissected en bloc to the dorsal side of the level of the renal artery rather than from the rostral to the caudal in order to improve the radicality of the operation for pancreatic cancer.
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PMID:[A clinical study on metastasis to para-aortic lymph nodes in cancer of the head of the pancreas]. 194 52


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