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)

Self-expanding metallic stents, frequently used in interventional radiology, were implanted into 15 obstructed ureters in 12 patients. The cause of obstruction was lymph node metastases of different malignant tumors or direct tumor compression of the ureter. Followup in 12 patients was 3 to 31 weeks. Immediately after implantation all stents drained well. During the initial 4 weeks slight obstruction occurred due to hyperplasia of regenerating urothelium. The stents were fully incorporated into the ureteral wall 8 weeks after implantation, they were covered by smooth epithelium and the hyperplasia had disappeared. Complications were hemorrhagia in 1 patient and incrustation in 2. No infection was observed. Complications due to the tumor were obstruction distal to the stent in the presence of a widely open catheter in 3 patients. Early results are presented. Late results are not yet available. The method seems to be minimally invasive and easy to perform.
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PMID:Metallic Wallstents: a new therapy for extrinsic ureteral obstruction. 163 18

With the extended use of transurethral endoscopic surgery, we modified the conventional nephroureterectomy that usually requires either a very long incision or two separate shorter incisions. From August 1983 to October 1988, 13 cases of renal pelvic tumor in this hospital were treated single-incision nephroureterectomy combined with transurethral incision of the bladder cuff. The advantages of this technique were less surgical time and a decrease in postoperative wound pain. There were no significant complications or local recurrence noted in this series. The proposed indications were urothelial tumors in the renal pelvis and upper ureter without demonstrable metastases. Tumors of an uncertain cell type preoperatively are especially indicated. The details of this technique are described.
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PMID:Single-incision nephroureterectomy combined with transurethral incision of bladder cuff for renal pelvic tumor. 168 83

Seventy-seven patients with advanced urothelial cancer were treated with methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC). Of these 77 patients, 65 could be evaluated for response and 74 for toxicity. Response rates were 65% in the primary organs (62% in the renal pelvis and ureter, 67% in the bladder), 68% in the lymph nodes, 60% in the lung, 25% in the bone and 14% in the liver. Complete responses were noted in 11 patients (17%) and partial responses in 26 patients for an overall response rate of 57% (95% confidence limits 45 to 69%). The median durations of response were 11 months for complete response patients and 7 months for partial response patients. Of the 65 patients 20 (31%) are alive, and 1-, 2-, and 3-year survival rates were 65%, 37%, and 25%, respectively. While survival rates of responders were higher than those of nonresponders with a statistical significance until 15 months, no significant differences were observed in survival rates between these two groups in the subsequent period. The M-VAC regimen was used for 15 patients as a neoadjuvant chemotherapy. Of the 15 patients, 8 responded and primary organs were preserved in 6 of the 8 responders. Histological effects classified according to Oboshi-Shimosato's criteria were G.I in 9, G.IIA in 3, G.IIB in 1, and G.IVC in 2. There were no significant differences in survival rates according to responses and histological effects. Factors related to response were analyzed with a multiple logistic regression model on 54 patients treated with intravenous administration of drugs and whose histological type was transitional cell carcinoma. The analysis results indicate that the presence of distant metastases is an important factor in predicting poor efficacy. Sixteen of 74 patients (22%) had white blood cell count of less than 1,000 cells per mm3 in the first cycle, while the decrease of platelet count was mild in degree compared with that of the white blood cell count. Patients with elevations of serum creatinine, GOT, and GPT were low in frequency, and toxic symptoms were controllable. Factors significantly related to the occurrence of side effects were sex, performance status, prior radiotherapy, prior chemotherapy, and the method of drug administration. Among these factors, prior radiotherapy was related to severe decrease of white blood cell count. While an excellent overall response rate was provided with the M-VAC regimen, disadvantages of the present regimen were low effectiveness in the bone and liver, and short duration of response.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) in advanced urothelial cancer--analysis of efficacy and toxicity]. 177 Jul 1

Cancers of the renal pelvis, the ureter and the bladder are often accompanied by bone, lung and liver metastases. The frequency of metastases, which may occur early during the course of the disease, is directly correlated with the stage. The metastatic potential can be partially evaluated using certain prognostic factors: local extent of lesions, cytogenetic abnormalities, oncogenes and suppressor oncogenes, factors secreted by the tumor, proliferative activity. Chemotherapy produces an overall response in 50-75% of patients, 10-15% of whom achieve a long term response. Several agents are active, particularly cisplatinum and methotrexate; in addition, combination regimens (especially M-VAC) have proven more effective than single agents used alone. Neo-adjuvant chemotherapy administered prior to local treatments given encouraging results, as does adjuvant chemotherapy. However, additional investigations are still required to evaluate the exact role of chemotherapy in the therapeutic strategy for these para-malpighian cancers.
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PMID:[Metastasis of cancers of the kidney calyx, the ureter and the bladder]. 179 53

Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune, ... ) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.
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PMID:[Desmoid tumor of the mesentery. An uncommon cause of ureteral obstruction]. 181 Oct 27

To determine the frequency and distribution of extrahepatic and extraskeletal metastases in patients with breast carcinoma, the abdominal CT scans of 260 consecutive patients were systematically evaluated. Extrahepatic and extraskeletal metastases were demonstrated in 26 patients (10%). Confirmation of findings was made by biopsy, autopsy, or by demonstration of progression or regression of disease. Twelve patients (4.6%) demonstrated metastases to the stomach, eleven of whom presented with a linitis plastica pattern. Retroperitoneal and/or mesenteric adenopathy was noted in 10 patients (3.8%), of whom three demonstrated associated hydronephrosis and one demonstrated associated biliary obstruction. Ascites was seen in 14 (5.4%) and peritoneal carcinomatosis in 7 (2.6%). Genitourinary involvement included metastases to the kidney (one case), ureter (one), and uterus (one). Direct invasion of the diaphragm by adjacent pleural metastases (two cases) as well as a soft tissue metastasis (one case) was also demonstrated. Metastases to the ovaries, adrenals, or pancreas could not be identified. Although lesions to the liver and skeleton account for the largest group of metastases from breast carcinoma seen in the abdomen, one should be aware of the potential for other locations of metastatic disease.
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PMID:Distribution of metastases in breast carcinoma: CT evaluation of the abdomen. 193 43

During a 6-year period, 53 patients with advanced tumors of the genitourinary tract were treated in Phase I protocols with deep regional hyperthermia in combination with irradiation (83%) or in combination with chemotherapy (11%). Primary tumors included those of bladder in 22 patients (41%), prostate in 20 patients (37%), kidney in 9 patients (17%), and ureter testicle or adrenal in 3 patients (5%). The majority (77%) had prior definitive therapy and had experienced treatment failure, and 11% had clinically important distant metastases. Treatment consisted of deep regional hyperthermia (mean of 4 sessions). In addition, 44 patients (83%) received irradiation (mean dose 39.2 Gy). The 1- and 3-year actuarial survival was 60% and 56%, respectively. Patients with carcinoma of the prostate had a 1- and 3-year survival of 82%. Complete response was observed in 7 patients (13%), partial response in 8 (15%), and nominal response in 13 (25%). Complete and partial response correlated well with histology of the tumor (adenocarcinoma), radiation dose (greater than 50 Gy), primary site (prostate, kidney), and treatment (hyperthermia-radiotherapy combination), (p = 0.02). There was no such correlation between response and thermal dose (p = 0.13). The treatment tolerance was good in 79% of patients. Treatment toxicity was limited to acute side effects, including pain during hyperthermia (47%), tachycardia greater than 140/min (7%), and blister formation in the treated area (4%). Phase II studies in previously untreated patients with locally advanced tumors of bladder, prostate, and kidney are needed for evaluation of the role of deep regional hyperthermia in the management of these cancers.
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PMID:Regional hyperthermia in patients with recurrent genitourinary cancer. 195 35

Self-expanding metallic stents were inserted into the ureters of two female patients (29 and 46 years old) with malignant ureteric stenosis, in the first patient caused by metastases of a malignant melanoma, in the second by retroperitoneal lymph-node metastases from a colon carcinoma. In the first patient the stent was introduced antegrade into the left ureter via a nephrostomy after balloon dilatation of the stenotic segment. She was subsequently without symptoms, but six weeks later the ureter got kinked just above the bladder due to continued tumour growth against the stent. After insertion of a silicon splint she had no further symptoms referrable to the kidneys until she died two months later. In the other patient in whom both ureters were obstructed they could not be catheterized percutaneously. Stents were, therefore, introduced transurethrally after previous balloon dilatation of the stenoses. Obstruction occurred in the right ureter three days after the procedure due to mucosal oedema, but it was controlled by anti-inflammatory drugs. Hydronephrosis developed again six months later, caused by circumscribed incrustations in parts of the the stent not covered by mucosa. Silicon splints were placed bilaterally and the patient has so far been free of symptoms for two months.
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PMID:[Self-expanding metallic stents in malignant ureteral stenosis]. 201 64

A new technique of electro-incision of ureteral stenoses and strictured uretero-enteric anastomoses is presented. Incision is performed with a papillotome, routinely used to achieve endoscopic retrograde sphincterotomy of the duodenal papilla. Group I: 7 ureteral stenoses were performed, on a dog model after surgical ligation of the lumbar ureter. Ten days later, through a percutaneous approach, the papillotome was placed through the stenosis, deflected, and cutting current was applied to incise the stenosis. The IVP performed one month later showed disappearance of the stenosis in 4 cases, a residual stenosis without obstacle in 2 cases and a residual stenosis with obstacle in one case. Group II: 7 strictured uretero-enteric anastomoses on 6 patients. After placement of a percutaneous nephrostomy, a wire guided papillotome was placed into the stenosis. Cutting current was then applied to cut the stenosis. A 18 F ureteral stent was subsequently placed for 8 weeks. Two patients have a patent anastomosis, 7 and 10 months after removal of the stent. One patient died from metastases of bladder tumor. The three remaining patients are still stented. An urinoma occurred in one patient the day following removal of the stent, and was surgically drained. This new technique which combines electro-incision and stenting with a large caliber stent may be proposed as an alternative to surgery or balloon dilatation for the treatment of strictured uretero-digestive anastomoses.
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PMID:[Use of papillotome for antegrade treatment of ureteral stenoses and uretero-ileal anastomotic strictures under radioscopic control. Experimental study in dogs and clinical application]. 207 28

Experience is recorded with the diagnosis and treatment of 90 patients with tumors of the kidney and its pyelocalyx system. Of all methods of diagnosis major importance is attached to computer axial tomography. It is emphasized that the approach to the kidney, the type and scope of the operative intervention should depend on the stage of tumor development. For tumors of the pyelocalyx system it is recommended to perform nephroureterectomy, since this approach rules out the hazard of appearance of tumors in the ureter. The presence of isolated metastases is no contraindication for performing nephrectomy. Indications for organ-preserving operation should be strictly specified. They should applied in patients with single kidney, patients with bilateral tumors and patients with chronic renal failure.
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PMID:[The diagnostic and treatment problems in kidney tumors]. 210 19


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