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)

Data on 544 patients with esophageal cancer are reported. The main reasons of their refusing the radical treatment were as follows: 1) a considerable local tumor proliferation (31.8%); 2) senile age, concomitant diseases, a general poor condition of patients (25.6%); 3) the presence of distant metastases (11.4%); 4) location of a tumor in the jugular or upper thoracic esophagus for which palliative radiotherapy was performed, but in some cases a palliative surgery (9.7%); 5) fear of surgery (15.4%); 6) no reason (6.4%).
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PMID:[Analysis of the reasons for the refusal of surgical treatment among esophageal cancer patients]. 9 Apr 26

The treatment results of the Rotterdam working group on esophageal cancer during the period January 1970-January 1978 were assessed. A total number of 328 patients were treated: 230 males and 98 females. Of the 133 patients eligible for a combined treatment modality i.e. preoperative radiotherapy and surgery, 52 showed irresectable or metastatic disease during operation. The five year actuarial survival rate of the 81 patients, in whom curative surgical resection of the tumor was performed, amounted to 21%. Females fared better than males, the five year survivals being 42% and 12% respectively. This female preponderance in survival is partly explained by the considerable postoperative mortality of the male patients: 28% vs 7.4% in females. Patients who received only radiation therapy, whether curative or palliative, had a very bad prognosis. It is concluded that preoperative irradiation followed by surgical removal of the tumor should be performed in all operable-curable patients.
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PMID:Carcinoma of the esophagus: results of treatment. 9 16

The data reported support the idea on possible hematogenic metastases spread in esophageal cancer, especially in bones (in 5 of 209 examined patients). Clinical and roentgenological findings of esophageal cancer metastases in bones do not differ from the manifestations of osteolytic metastases in bones of malignant tumors of other localizations. Timely recognition of distant metastases in esophageal cancer seems to be important from the point of view of selecting the most rational and warranted method of treatment.
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PMID:[Metastases of esophageal cancer to the bones]. 119 24

124 Rhesus monkeys (Macaca Mulatta) were caught in the Taihang Mountain region, a high incidence area of human esophageal cancer in Northern China, in January 1989. Among them, two monkeys died of esophageal carcinoma in 1990. Case 1, a male monkey about 6.5 years old and weighing 14.5 kg, had symptoms of salivation, vomiting and dysphagia in February 1990. The symptoms became gradually more serious and died in March 1990. Postmortem examination revealed a huge tumor in the distal segment of esophagus, causing severe stricture of the organ. The tumor was classified as medullary type and histopathologically diagnosed as a well differentiated squamous cell carcinoma, with metastases to mediastinum and lymph nodes of right gastric group. Case 2, a female monkey about 11-year-old and weighing 10.0 kg, showed loss of appetite, tiredness, somnolence, coughing and vomiting in September and died in December 1990. Autopsy revealed an annular tumor involving the whole circumference of lower portion of the esophagus. The tumor was of ulcerative type and diagnosed as a well differentiated squamous cell carcinoma. The symptoms and pathological changes of the two monkeys showed high similarity to esophageal cancer in humans. We believe that the present findings would provide important leads for further study to clarify the etiology and pathogenesis of human esophageal cancer in this high incidence area of esophageal cancer.
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PMID:[Esophageal cancer in rhesus monkeys from the Taihang Mountain area. A preliminary report]. 130 71

High rates of esophageal cancer in advanced stages and poor short- and long-term results with surgical treatment have led to the use of combined treatment regimens. There is, however, no unanimity as to the most effective preoperative therapy or the most effective therapeutic tactics. In combined therapy we are in favor of strict compliance with the sequence of abdominal exploration, radiotherapy, and finally surgery. A differentiated approach according to the resectability of the lesion should be maintained. With regard to metastatic spread, nodes located in the paracardiac area and lesser omentum must be regarded as regional for the thoracic esophagus. Thirty percent of patients with metastases to these nodes survive more than 5 years after combined therapy. Based on our extensive experience in combined therapy plus an analysis of the literature we have formulated the features that will indicate palliative surgery. Differentiation between types of operations serves to determine more accurately the prognosis and the planning of further therapeutic tactics. With palliative surgery adjuvant treatment must always be given.
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PMID:Combined therapy of thoracic esophageal cancer. 137 86

Forty six patients with esophageal cancer underwent surgery between January 1986 and January 1990. In 14 patients (30.4%) distant metastases were recognized before surgery, whereas in 29 cases (63%) regional neoplastic lymph node infiltration was observed during surgery. Complications during and after surgery occurred in 32 (69.6%) patients and in 30 cases (65.2%) respectively. During the first 30 days after surgery 12 patients died. This represents a postoperative mortality of 26.1%. Among a total number of 51 variables analyzed in this study, 11 influenced the postoperative mortality: duration of intubation, previous history of toxic syndrome, presence of distant metastases before surgery, presence of neoplastic node involvement during surgery, tumor size greater than 4 cm, localization of the tumor at the middle third of the esophagus, respiratory insufficiency, cardiac failure, septic shock, and suture failure during the postoperative phase. However, multivariate analysis revealed that only three of these variables had an independent prognostic value on postoperative mortality: tumor size, presence of distant metastases, and development of respiratory insufficiency during the postoperative period.
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PMID:[Prognostic factors for postoperative mortality in cancer of the esophagus. Analysis of 46 cases]. 137

Esophageal cancer is an uncommon but aggressive disease with the potential for early metastasis. The majority of patients will present with metastatic disease, and treatment is usually palliative. This affects the physical and psychosocial needs of the patient and family. The nurse plays a crucial role in the care of these individuals and, therefore, needs a current and in-depth understanding of the disease, its treatment, and its nursing management.
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PMID:Nursing care of patients with esophageal cancer. 137 69

From 1984-1990, 143 patients with squamous cell or adenocarcinoma of the esophagus were enrolled in a Phase I/II study of neoadjuvant chemotherapy followed by concurrent chemotherapy plus radiotherapy with or without subsequent esophagectomy. Patients received one cycle of Cisplatin or Carboplatin plus Etoposide for squamous cell carcinoma, or Cisplatin or Carboplatin plus 5FU for adenocarcinoma, followed by two cycles of the same chemotherapy given concurrently with 44-46 Gy over 5 weeks. Operable patients then underwent esophagectomy. Inoperable patients and those with positive surgical margins received additional irradiation (16-18 Gy). Twelve percent of the surgical group received preoperative radiotherapy doses > or = 50 Gy. Seventy-two percent (103) had clinical Stage I-III tumors and 28% (40) were clinical Stage IV (1983 American Joint Committee on Cancer criteria). Only clinical Stage I-III patients were analyzed with respect to patterns of failure. Isolated local failure occurred in 19/103 (18%) of clinical Stage I-III patients. Both local and distant relapse occurred in 15/103 (15%), and distant metastases alone occurred in 25/103 (24%). The 3-year actuarial rates of local and distant failures were 45% and 60%, respectively. Among the clinical Stage I-III patients who underwent surgery (n = 58) versus those who did not (n = 45), the 3-year actuarial local and distant failure rates were 30% versus 60% and 45% versus 45%, respectively. Multivariate analysis was performed to identify significant predictors of local control. For all clinical Stage I-III patients, treatment with surgery (p = 0.001) and with three or more cycles of chemotherapy (p = 0.02) were significant predictors of improved local control. Patients who underwent surgery were significantly younger and had a better performance status than those who did not. The improvement in local control with surgery did not translate into better survival, likely on account of a high operative mortality rate in older patients and those receiving > or = 50 Gy preoperatively. We conclude that local control remains poor with concurrent chemotherapy + radiotherapy for esophageal cancer. The addition of surgery improved local control, but distant metastases remain a problem both in this group of patients as well as those treated without esophagectomy. Efforts to improve local control appear warranted, but it remains to be demonstrated that improved local control translates into improved survival in esophageal cancer because of a high rate of distant metastases in patients whose disease is controlled in the esophagus.
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PMID:Patterns of failure following combined modality therapy for esophageal cancer, 1984-1990. 142 85

In our institution, 152 cases have been treated, which are 24.3% of total 626 cases with esophageal carcinomas. Analysis of these 152 cases revealed that neither intraepithelial cancer (ep), nor mm2 cancer, in which the lesion is limited within the upper two-thirds of the proper mucosal layer, had any vessels invasion and lymph node metastases. In addition, only 25% of the cases with mm3 cancer, limited within the deeper one-third of the proper mucosal layer, had vessels invasion without lymph node metastases. The 5-year survival of the cases less than sm1 was as good as 100%. However, those of sm2 and sm3 patients were 58.9% and 54.2%, respectively. Thus, we made the treatment strategy for superficial esophageal cancer as follows: 1. For ep to mm2 cases, endoscopic mucosal resection could be applied. 2. For the cases whose lesions widely spread in the esophagus, blunt resection would be indicated. 3. For the cases with mm3 to sm3 cancer, thoracotomy and laparotomy with wide lymph node dissection from neck to abdomen should be employed. Since a radical operation for esophageal cancer has high operative risk and poor postoperative quality of life, we should properly pick up and apply more cases with mucosal carcinoma for endoscopic mucosal resection.
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PMID:[Controversy in the treatment of superficial esophageal carcinoma--indications and problems of the procedures]. 147 Jan 18

Many advancements in the imaging of gastrointestinal malignancies have been seen in the past year. Endorectal ultrasound and magnetic resonance imaging with an endorectal surface coil allow for more accurate staging of the depth of bowel wall invasion by rectal carcinoma. Monoclonal antibody imaging may detect metastases not found by other modalities while computed tomography arterial portography and intraoperative ultrasound improve our ability to identify liver metastases. Endoscopic ultrasound is also useful in the preoperative assessment of esophageal cancer and pancreatic endocrine tumors.
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PMID:Imaging of gastrointestinal malignancies. 151 Oct 29


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