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)

Merkel cell carcinoma (Trabecular carcinoma) is a rare malignant tumor of the skin. Because these tumors tend to spread locally via the lymphatic system, very few papers have dealt with the treatment of distant metastasis. Systemic disease is uncommon and usually fatal. In this paper, we report a case of Merkel cell carcinoma with proven brain metastasis and a solid choroidal tumor. The patient responded well to radiation and chemotherapy and is alive and neurologically intact three years after diagnosis. All previous patients with metastatic Merkel cell carcinoma to the brain died within two months of the diagnosis. We use this case to discuss possible routes of metastatic dissemination and to review the treatment options in patients with distant metastatic disease. To our knowledge, this is the first reported case of presumed choroidal metastasis of Merkel cell carcinoma and the longest documented survival in a patient with brain involvement.
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PMID:Merkel cell carcinoma. Long term survival in a patient with proven brain metastasis and presumed choroid metastasis. 255 91

While it will be another decade before the results are apparent, the past decade has sown the seeds of new generation of concepts regarding the initial management of gastric adenocarcinoma. Those seeds will come to flower when we fully utilize the management tools that have been developed. Endoscopy provides the opportunity for earlier diagnosis of gastric cancer. More liberal use of gastroscopy and cytology when x-rays are not completely diagnostic should identify the still surgically curable tumor. An improved understanding of the routes of tumor spread--by invasion and metastases--have identified a number of practical alterations to the surgical procedures for the removal of gastric adenocarcinoma arising from various sites in the stomach. Suggestions for effective adjuvant therapies, based on the realization that most gastric cancer has become a systemic disease by the time of diagnosis, are apparent from the clinical trials to date: Local control of microscopic disease with radiotherapy and treatment of transperitoneal tumor spread by the intraperitoneal route are logical additions to systemic therapy. More careful and thorough pathologic examination of resected tissues, with adjuvant treatment planning based on the results of that examination, should alter what has in the past been the grim prognosis of this disease. Careful follow-up evaluation and attention to nutrition can improve the quality of the patient's life, just as carefully planned antineoplastic therapy can improve its duration.
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PMID:Gastric adenocarcinoma--management of the primary disease. 257 38

Pretreatment serum concentrations of breast carcinoma antigen (CA 15.3) and mucin-like carcinoma-associated antigen (MCA) were determined in 129 patients with breast carcinoma. Concentrations of both markers were within the normal range in patients with Stage I disease. Concentrations of CA 15.3 were elevated (greater than 40 U/ml) in 3, 11 and 48%, those of MCA (greater than 17 U/ml) in 11, 18 and 52%, and those of one or the other marker in 11, 18 and 58% of the patients with Stage II, III and IV disease, respectively. The elevation of either marker roughly paralleled the size of the tumor being normal in the patients with localized cancer, slightly elevated in a small proportion of the patients with locoregional cancer, and moderately to markedly elevated in half of the patients with distant metastases. Correlation between serum concentrations of CA 15.3 and MCA was highly significant (p less than 0.0001). It is concluded that the markers were equally sensitive and that an elevated serum level was a useful adjunct for staging, implying systemic disease.
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PMID:Pretreatment concentrations of breast carcinoma antigen (CA 15.3) and mucin-like carcinoma-associated antigen in patients with carcinoma of the breast. 259 14

Splenomegaly confirmed by surgery or necropsy in 100 dogs was diagnosed histologically as benign neoplasia (n = 1), primary splenic malignancy (n = 59), neoplastic metastases (n = 6), and nonneoplastic disease (n = 34). Dogs with known systemic disease, such as lymphoma and mast cell tumor, that caused splenomegaly were not included in the study. Hemangiosarcoma was the most common splenic disease (43 cases). Overall mean age of the dogs was 10.7 years, the most common breed was German Shepherd dog, and 72 of the dogs weighed more than 21 kg. Dogs with anemia, nucleated red blood cells, abnormal red blood cell morphology, or splenic rupture had a significantly greater chance of having splenic neoplasia (P less than 0.002). A multivariable logistic regression analysis found that the presence of anemia and splenic rupture in dogs with splenomegaly was up to 69% accurate in predicting presence of splenic neoplasia. After splenectomy, the median survival time of dogs with splenic neoplasia was 13 weeks. For dogs with nonneoplastic splenomegaly it was at least 36 weeks.
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PMID:Splenomegaly in dogs. Predictors of neoplasia and survival after splenectomy. 277 49

Treatment of locally recurrent breast carcinoma remains a significant problem. The records of 106 patients with local chest wall recurrence were reviewed. Fifty-five percent eventually developed metastatic disease, while 45% remained free of systemic disease. Size of primary tumor (greater than 2 cm), number of recurrences (multiple), and disease-free interval from primary surgery (less than 2 years) were all highly significant for the development of metastatic disease. Negative estrogen receptors also predicted bad prognosis. Both irradiation and surgery used alone had high local failure rates of 83% and 62%, respectively, but combination radiation-surgery treatment failed only in 25%. Combination radiation-surgery treatment should be considered in patients with local recurrence, but further prospective trials with more patients will be needed to prove its effectiveness. Patients with unfavorable prognostic factors should be considered for adjuvant chemotherapy.
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PMID:Treatment of locally recurrent breast carcinoma. 280 73

A case of extramammary Paget's disease is reported. The distinguishing features of the case are: (1) localization of the primary lesion to the scrotum, (2) development of metastases in the absence of a recognizable underlying carcinoma, and (3) response of the systemic disease to a combination of radiation therapy and chemotherapy. The histogenesis, clinical behavior, and treatment of extramammary Paget's disease are reviewed.
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PMID:Metastatic extramammary Paget's disease: dramatic response to combined modality treatment. 283 60

From 1974 to 1984, we have treated 70 patients with SCLC using radiotherapy (RT) alone or in combination with chemotherapy (CT). It was demonstrated that a heavy CT regimen causing a severe toxicity did not always cause good results. On the other hand, there was a long-term survivor in those patients who were treated with RT alone. Considering from our results as well as from reviews of literatures, it is evident that RT can reduce a significant number of local relapses but has little effect on systemic disease. Therefore, RT added to CT seems to improve a long-term survival specifically in those patients in whom CR is induced from CT. The characteristics of the long-term survivors treated with combined treatment are: limited disease, thoracic RT, good PS, only single site of metastases. In conclusion, there is no doubt that CT plays an important role in the management of SCLC. However, its efficacy is still far from desired, and a new type of CT is warranted.
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PMID:[The role of radiotherapy in small cell lung cancer]. 283 20

In a retrospective review of 231 patients who were referred to Princess Margaret Hospital because of a soft-tissue sarcoma in an extremity, 100 patients were identified who had no metastases when they were first seen and who had been treated by local resection and adjuvant radiation therapy. Complete data were collected for each patient for the following variables: age; sex; location of the tumor and its size, grade, depth, and compartmental status; chemotherapy; and dose of radiation. The surgical margins were characterized as positive or negative for histological evidence of disease on the basis of an independent review of the pathological and operative reports by a surgeon and a radiation oncologist who were experienced in the management of sarcoma. Cox multivariate analysis was used to determine which of these variables contributed to local recurrence and evidence of systemic disease. Adequacy of the margin of resection was the only variable that was associated with local relapse (p = 0.0004). The size of the tumor (p = 0.0008) was the major determinant of the risk of systemic disease.
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PMID:The surgical margin in soft-tissue sarcoma. 279 2

Between 1979 and 1983 56 women with stage I breast cancer underwent tumorectomy plus lymphadenectomy, postoperative irradiation and adjuvant antioestrogen therapy in cases of hormone receptor positive tumours. All patients with hormone receptor negative tumours received 6 cycles of combined CMF chemotherapy instead of antioestrogen therapy. It was possible to complete optimal dosage of CMF or tamoxifen in more than 85% of our patients. Leukopenia occurred in only 3 patients given chemotherapy, whilst intolerable gastrointestinal side effects occurred in 4 patients given antioestrogen therapy. No interference was detected between irradiation and chemo- or hormone therapy and no serious local complications with functional impairment were registered. 23% of the women had positive axillary nodes at the time of operation. The preoperative staging proved incorrect in 16% of cases, the tumour size exceeding 2 cm. After a mean follow-up period of 36 months the local recurrence rate was 3.6% and distant metastases appeared in 9% of patients, whereby there was a significant dependence on lymph node status. No patient died of cancer during the observation period. In view of the hypothesis that breast cancer is a systemic disease more attention should be paid to local cosmetic results and to systemic adjuvant therapy.
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PMID:[Experiences with an organ-saving and adjuvant-therapy concept in stage 1 breast cancers after 6 years of use within the scope of a controlled clinical study]. 300 63

Inflammatory breast cancer is the most aggressive breast neoplasm and one of the most ominous solid tumors. Because of distinct clinical characteristics, diagnosis can usually be made on clinical grounds. Biopsy including the overlying skin may demonstrate dermal lymphatic invasion, although the absence of dermal lymphatic invasions should not deter aggressive therapy. Surgery or irradiation alone has little effect on the natural history of this disease since lymphatic invasion and distant metastases are often present at presentation. Inflammatory breast cancer should be considered a systemic disease. Accordingly, aggressive combined modality therapy including multi-drug chemotherapy, surgery, and irradiation have prolonged disease-free survival and overall survival.
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PMID:Inflammatory breast cancer: advances in therapy. 307 91


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