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)

In this study, we evaluated the prognostic significance of both p53 overexpression and proliferating activity in 133 primary ductal pancreatic carcinomas and in their regional synchronous lymph node metastases by immunohistochemistry, by using DO7 and MIB1 monoclonal antibodies, respectively. Tumor samples and lymph nodes were obtained from formalin-fixed, paraffin-embedded archival material of patients operated on between 1976 and 1996. Patients had a well-documented clinical history and were given accurate follow-up. p53 accumulation was observed in 77 (54%) of 133 primary tumors and in 22 (44%) of 50 patients with nodal metastases. The p53 overexpression was directly related to proliferating activity (p = 0.01) in the primary tumors. A significant direct correlation was present between the p53 expression in the primary tumor and in nodal metastases (p = 0.01); the same occurred for proliferating activity by MIB1 (p = 0.002). The patients' overall survival was affected by the presence of nodal (p = 0.02) and distant (p = 0.0001) metastases. The p53 immunoreactivity in nodal metastases was associated with a statistically significant decrease in the postoperative survival period (p = 0.005). Multivariate analysis confirmed these results, and the only two parameters that maintained statistical significance were M1 status (p = 0.0006) and p53 overexpression in nodal metastases (p = 0.01).
Pancreas 1999 Jul
PMID:p53 overexpression in lymph node metastases predicts clinical outcome in ductal pancreatic cancer. 1041 88

A duodenal leiomyosarcoma which was resected by pancreas-sparing duodenectomy is reported. The tumor arose in the third portion of the duodenum and grew in an extraluminal direction. The tumor was huge (13 cm x 9 cm x 8 cm) but did not involve the pancreas, and there were no findings of periduodenal lymph node metastases. Because the possibility of metastasis to the lymph nodes around the root of the superior mesenteric artery (which are removed only in a pancreatoduodenectomy) was judged to be low, pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected between the second and third portions of the duodenum, and the distal end was cut in the jejunum at the portion of the first jejunal artery. Reconstruction was performed by end-to-side anastomosis between the duodenum and jejunum, using an end-to-end anastomosis instrument. Since the incidence of lymph node metastasis of leiomyosarcoma is low, resection of the head of the pancreas for extensive lymph node dissection does not always seem necessary. Pancreas-sparing duodenectomy can be a good option for a leiomyosarcoma in the third and fourth portions of the duodenum which does not invade the pancreas and is not accompanied by any apparent periduodenal lymph node metastases.
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PMID:Pancreas-sparing duodenectomy for a huge leiomyosarcoma in the third portion of the duodenum. 1066 93

The aim of this study was to determine the value and limitations of 18F-fluorodeoxyglucose (FDG)-position-emission tomography (PET) for differentiating benign and malignant pancreatic disease and for staging malignant disease. One hundred fifty-nine patients with 89 malignant and 70 benign pancreatic lesions all received PET, computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) before pancreatic surgery. The original reports were compared for all patients (group I; N = 159), for a subgroup that neither had fasting plasma glucose levels > or =130 mg/dL or known elevated levels of C-reactive protein ([CRP], group II; n = 123), and for the remaining patients (group III; n = 36). For group I, accuracy values (areas under receiver operating characteristic [ROC] curves) for differentiation of benign/malignant masses were 0.86 (PET), 0.93 (ERCP), 0.82 (CT), and 0.95 for ERCP + PET (N = 159). For group II, ROC areas increased to 0.92 (PET), 0.94 (p < 0.05; n = 123) (ERCP), 0.82 (CT), 0.97 (p < 0.05; n = 123) (ERCP + PET). The results for group III were 0.71 (PET), 0.81 (CT), and 0.93 (ERCP); (n = 36). With 54 patients of group II that either had contradictory or indeterminate/technically unsuccessful CT/ERCP, PET was correct in 43 patients (84%). Sensitivity/specificity for lymph node staging was 49%/63%, respectively. For patients with hepatic metastasis, PET was 70% sensitive and 95% specific, missing some metastasis that were <1 cm. PET detected peritoneal metastasis in 25% of patients, missing poorly localized microscopic spread. For selected patients who have indeterminate pancreatic masses but no hyperglycemia or serologic evidence of active inflammation, FDG-PET is an independent functional assay that significantly adds to the diagnostic accuracy of ERCP and CT in the differentiation of benign and malignant pancreatic disease. PET can reliably detect hepatic, peritoneal, and other distant metastases that are > or =1 cm.
Pancreas 2000 Mar
PMID:Values and limitations of 18F-fluorodeoxyglucose-positron-emission tomography with preoperative evaluation of patients with pancreatic masses. 1070 24

With a nitrosamine induced hamster pancreatic cancer cell line (HaP-T1), survival time and metastatic rates were compared between orthotopic cell implantation (OCI; n = 5) and orthotopic tissue implantation (OTI; n = 5) models. All the tumors were palpable (100% tumor take) after 1 week in both groups. Hamsters in the OCI group survived 71 +/- 2.17 days (range, 69-75 days), and in the OTI group, 73.8 +/- 4.03 days (range, 58-80 days). After necropsy, spontaneous metastases were noted in 100% of the animals. Direct invasion to adjacent organs was observed in four animals, and liver metastases, in three in the OTI group, which were significantly higher compared with the OCI group. On the other hand, peritoneal dissemination was observed only in the OCI group. Other metastatic sites showed no significant difference between the groups. All the histologically noted metastases had K-ras point mutation confirmed by polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) analysis. We conclude that the homologous OTI model may be more useful than the OCI model. The OTI model may contribute to the development of therapeutic strategies in the field of pancreatic cancer research because of the capacity for invasion to adjacent organs, higher liver metastatic rate, and similarity to the clinical picture of the disease.
Pancreas 2000 Mar
PMID:Homologous orthotopic implantation models of pancreatic ductal cancer in Syrian golden hamsters: which is better for metastasis research--cell implantation or tissue implantation? 1070 30

Useful nonsurgical treatments like chemoradiotherapy have been developed for the management of patients with unresectable pancreatic cancer. The General Rules for the Study of Pancreatic Cancer (Japan Pancreas Society) should therefore take diagnostic imaging techniques into account in order to deal with nonsurgical cases under the classification system as well as with surgical ones. The anatomic extent of disease based on preoperative dynamic CT images was evaluated in comparison with the results of pathology in a total of 35 patients with pancreatic cancer. The CT findings accurately represented the pathology for peripancreatic invasion, including vascular involvement, with a diagnostic accuracy ranging from 72% to 88%. However, it failed to detect almost half of lymphatic metastases. The staging of pancreatic cancer with dynamic CT was accurate in 66% of the patients, was underestimated in 25%, and was rarely overestimated. The detection of minute metastases is a crucial problem in the CT staging of tumors. The significant correlation of the RP factor (retroperitoneal tumor invasion) with lymphatic metastases as noted in this study offers a clue to solving this problem.
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PMID:[The general rules for the study of pancreatic cancer from the viewpoint of internal medicine]. 1073 42

We present the rare case of a solitary pancreatic metastasis of renal cell cancer being the only manifestation of tumordissemination. In 1993 the patient underwent a transperitoneal nephrectomy for removal of a clear cell renal cancer. In 1998 during follow up we detected a pancreatic tumor which was treated by pancreas resection, splenectomy and resection of the colon transversum. The histology revealed a metastasis of the previously resected renal cancer. The postoperative recovery was impaired by the development of an abcess in the former pancreatic region. During the first year of follow up we did not find any signs for local or distant tumor recurrence. Pancreas resection adapted to the location of the tumor is the treatment of choice for isolated solitary late metastases of renal cell cancer.
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PMID:[Singular late metastasis of renal cell carcinoma in the pancreas. An unusual pancreatic tumor]. 1139 49

We evaluated the efficacy of IORT for unresectable Stage IVb (Japan Pancreas Society classification) pancreatic cancer. Twelve patients were treated with IORT, 17 with external beam radiotherapy (ERT) and 17 with chemotherapy (CHT, 8 patients doxorubicin-based, 7 patients 5-FU-based). Survival, hospital-free survival and pain relief were compared among the three groups. In the IORT group, 7 patients underwent bypass surgery, 3 celiac plexus blockade, 3 ERT, 2 hyperthermia and 2 CHT. In the ERT group, 1 patient underwent bypass surgery, 7 hyperthermia and 14 CHT. Distant metastases were more frequently found in the CHT group than in the IORT group. Median survival and median hospital-free survival were 208 and 79 days in the IORT group, 125 and 32 days in the ERT group and 76 and 9 days in the CHT group, respectively. Pain relief was obtained in 45% (5/11) of symptomatic patients after IORT and in 27% (4/15) after ERT. No patient (0/13) in the CHT group experienced pain relief. In conclusion, our experience suggests that IORT can reduce pain and improve QOL in patients with unresectable pancreatic cancer.
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PMID:[Intraoperative radiotherapy (IORT) for unresectable stage IVb pancreatic cancer]. 1248 41

Lymphoepithelial carcinoma is a relatively common malignancy in the nasopharyngeal region, but it rarely occurs at other sites. We report a lymphoepithelial carcinoma in the pancreas of a 65-year-old male patient operated on for a gastric stump carcinoma 7 years previously. The solitary tumor in the pancreas presented as a circumscribed lesion and measured 5.5 cm in diameter. The tumor was densely infiltrated by lymphocytes, and the neoplastic cells fulfilled all criteria for a lymphoepithelial carcinoma. Several peripancreatic lymph node metastases were observed. Marked reactivity for Epstein-Barr virus (EBV) early RNA (EBER) was detected in the majority of tumor cells using in situ hybridization. Nuclear EBER signals were also detected in the previously operated gastric stump adenocarcinoma, which also exhibited focal lymphocytic infiltration but otherwise displayed a histology different from lymphoepithelial carcinoma and did not show local recurrence. Even though an unusually late metastasis of the gastric carcinoma cannot be ruled out, we favor the hypothesis that this patient developed an EBV-related pancreatic lymphoepithelial carcinoma as a second primary tumor, based on the considerable delay of this tumor manifestation, the unusual site, the pathologic presentation, the exclusively peripancreatic nodal spread, and the different histology of the lesion.
Pancreas 2004 Jan
PMID:Epstein-Barr virus-associated lymphoepithelial carcinoma in the pancreas. 1470 38

The aim of surgical treatment is complete resection (Ro-resection) of the tumor in all dimensions of its growth, i.e. resection of the tumor infiltrated stomach including the locoregional lymph nodes. This can be achieved by stage- or histology adapted surgery resulting in subtotal distal and total gastrectomy as complementary procedures. Local excision of gastric carcinoma in curative intent is indicated only in mucosal carcinoma of the intestinal type. The extent of lymph node dissection is still under discussion; the results depend on the experiences of the surgeon. Several studies have shown a prognostic improvement after systematic (D2) lymphadenectomy in stage II/IIIA-disease or in patients with a low incidence of lymph node metastases. Pancreas preserving splenectomy is suggested in tumors of the proximal stomach or after direct infiltration of these organs. The Roux-en-Y procedure represents the most commonly used method of reconstruction after subtotal distal or total gastrectomy. The importance of the duodenal passage as well as of the pouch construction must be investigated in prospective studies in the future. This is true for the value of perioperative multimodal treatment options.
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PMID:[From endoscopic mucosa ressection to gastrectomy. How radical must surgery be for stomach cancer?]. 1472 96

Conventional distal pancreatectomy (cDP) and total pancreatectomy (cTP) also involve removal of the spleen. The spleen, however, is an important organ in the immunologic defense of the host and is worthy of preservation if this can be safely achieved. We performed a spleen-preserving total pancreatectomy (SPTP), with good results, in a Caucasian woman, 66-year-old, affected by pancreatic metastases of renal clear cell carcinoma. This is the first report of a SPTP for pancreatic metastases to our knowledge, and we therefore wish to describe the surgical technique and to suggest the possible indications for this new technique.
Pancreas 2004 Mar
PMID:Spleen-preserving total pancreatectomy with conservation of the spleen vessels:: operative technique and possible indications. 1502 54


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