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)

Fifty patients with esophageal cancer proved by means of biopsy underwent preoperative staging with endoscopic ultrasonography (US); in 42 of the patients, dynamic CT of the chest and abdomen was also performed. All results were compared with the findings at pathologic examination of resected specimens. In staging the depth of tumor growth, endoscopic US was significantly more accurate (46 of 50 tumors [92%]) than CT (25 of 42 tumors [60%]) (P less than .0003). In staging regional lymph nodes, it was more accurate (44 of 50 patients [88%]) than CT (31 of 42 patients [74%]), but this was not statistically significant. In staging distant metastases, however, CT was more accurate (38 of 42 patients [90%]) than endoscopic US (35 of 50 patients [70%]) (P less than .016). The highest concordance with surgical and pathologic findings in overall stage (36 of 42 tumors [86%]) occurred with the combined use of CT and endoscopic US, which was significantly more accurate than use of CT alone (27 of 42 tumors [64%]) (P less than .008).
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PMID:Preoperative staging of esophageal cancer: comparison of endoscopic US and dynamic CT. 192 68

Structural alterations of the p53 gene were investigated in tissue specimens of gastric and cervical cancers and in cell lines of gastric, esophageal, and cervical cancers, by polymerase chain reaction-single-strand conformation polymorphism analysis. Two of the four gastric cancer metastases and four of the eight cell lines originally established from gastric cancer metastases were found to have p53 gene alterations in the exon 5 to 11 region; point mutations and amino acid replacements were detected in a liver and an ovary metastasis at exon 7, in the TMK1 and MKN1 cell lines at exon 5, and in the OKAJIMA cell line at exon 10. The normal allele was not found in these cell lines. In the KATO-III cell line, gross deletion and rearrangement of the p53 gene were noted. However, no p53 mutations were identified in 19 primary lesions of gastric cancer, suggesting that the p53 gene abnormality preferentially occurs in the advanced stages of gastric cancer. In contrast to the gastric cancer, none of the 13 esophageal cancer cell lines, including two cell lines established from metastases, and none of the four cervical cancer cell lines showed any aberration in exons 5 to 11 of the p53 gene. During the course of the study, a novel polymorphism in intron 7 of the p53 gene was found, which can be recognized by restriction enzyme digestions of the polymerase chain reaction product.
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PMID:p53 gene mutations in gastric cancer metastases and in gastric cancer cell lines derived from metastases. 193 50

We investigated the amplification and expression of oncogenes in human malignant tumors. The survival rates of patients with c-erbB, c-erbB-2, and int-2 oncogene amplification/expression were significantly lower than those of the patients without gene amplification/expression. Many distant organ metastases were observed in esophageal cancer patients with int-2 amplification, in gastric cancer patients with c-erbB-2 over-expression, and in breast cancer patients with int-2 and c-erbB-2 amplification. These results suggest that the amplification/expression of these oncogenes may serve as good markers for determining the biological malignancy of cancers.
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PMID:[Cancer metastasis and recurrence from the standpoint of amplification and expression of oncogenes in human malignant tumors]. 194 61

In the majority of patients with esophageal cancer local tumor infiltration and/or distant metastases are responsible for the poor prognosis. Therefore to improve life expectancy additional modalities--chemotherapy alone or in combination with simultaneous radiation--have been introduced perioperatively. In spite of a possible increase of resectability convincing data are lacking which could argue for an uncontrolled introduction of the neoadjuvant approach outside investigational studies in early tumor stages (T1, T2).
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PMID:[Perioperative chemotherapy of squamous cell cancer of the esophagus]. 198 89

29 patients with esophageal and gastric tumors, and 109 patients with rectal carcinoma were preoperatively investigated by endosonography. Tumor infiltration and lymph node spreading were assessed by endosonography and compared to the postoperative histological findings. Depth of tumor infiltration was assessed correctly in 88% of all patients investigated. Lymph node spreading of gastric and esophageal cancer was detected in 84%. In contrast lymph node metastases of rectal carcinoma were rarely seen. The high accuracy of endosonography in detection of lymph node metastases of esophageal cancer makes it possible to select the appropriate treatment, such as surgery, radiotherapy or palliative procedures. Endorectal sonography is a powerful tool to select those patients, who can only be treated by local excision.
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PMID:[Endosonography in preoperative staging of gastrointestinal tumors]. 203 2

A review of 323 patients with carcinoma of the esophagus disclosed 50 cases (15.5%) with glandular and/or mucus-secreting components, in addition to the ordinary component of squamous cell carcinoma. These tumors could be grouped into three type according to representative histologic features of glandular and mucus-secreting portions: glandular type (28 cases), cribiform type (14 cases), and mucoepidermoid type (8 cases). The histologic features of the three types were reminiscent of those of adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma of salivary glands, respectively. Moreover, areas showing glandular or mucus-secreting differentiation were in greater part located in the submucosa and the lamina propria mucosae, thereby suggesting that such differentiation had arisen in the esophageal glands or their ducts. From these findings, in addition to intraepithelial and mucosal carcinomas, carcinoma restricted to the submucosal layer without lymph node metastases should be also defined as "early" esophageal cancer and definition of it according to the existing Guide Lines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus is thought to be adequate at present.
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PMID:[A consideration of the definition of early esophageal cancer on the basis of clinicopathologic viewpoint]. 205 78

Recent efforts to improve survival in patients with esophageal carcinoma have combined both systemic and local therapy. From October 1985 to October 1987, 43 patients with local-regional esophageal cancer (adenocarcinoma in 21, squamous cell in 22) were treated with cisplatin, vinblastine, and 5-fluorouracil chemotherapy concurrent with 4,500 cGy radiation therapy for 21 days before transhiatal esophagectomy 3 weeks later. Two patients died of chemotherapy/radiation therapy toxicity. Forty-one completed preoperative chemotherapy/radiation therapy. At operation, 2 patients had incurable metastatic disease; 39 underwent transhiatal esophagectomy. Eleven patients had no residual tumor in the resected specimen for a 27% (11 of 41) pathological complete response rate. Preoperative chemotherapy/radiation therapy resulted in no increased perioperative morbidity as compared with our historical controls. One patient died postoperatively of an unrecognized brain metastasis (2% operative morbidity). At a median follow-up of 27 months, 20 patients (47%) are alive and clinically disease-free and 21 have died, 19 from progression of their carcinoma. The median survival time for all 43 patients is 29 months (Kaplan-Meier estimate), and cumulative survival is 72% at 12 months, 60% at 24 months, and 46% at 36 months. All 11 patients with a complete response are alive at a median follow-up of 36 months, and all are disease-free. The 2-year survival of 60% of this group as compared with 32% in our earlier patients treated with transhiatal esophagectomy alone suggests that intensive combined modality therapy improves survival in these patients. A randomized prospective trial is now in progress.
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PMID:Chemotherapy and radiation therapy before transhiatal esophagectomy for esophageal carcinoma. 231 Feb 41

Survival after surgical resection of esophageal carcinoma is highly related to stage. The latest staging classifications (UICC/AJCC, 1987/1988) use the TNM system. Accumulating data show endoscopic ultrasonography (EUS) to be consistently more accurate than CT in pre-operative staging of depth of tumor invasion. Detailed images of the esophageal wall obtained by EUS allow accurate staging even in early cancer where CT is ineffective. EUS is also more accurate than CT in staging regional lymph nodes, but is less accurate than CT in staging distant metastases due to tumor stenosis in some patients and limited depth of field. EUS has also been shown to be accurate in diagnosing post-operative recurrence of cancer in the area of the surgical anastomosis. EUS represents a major advance in the clinical staging of esophageal cancer.
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PMID:Esophageal carcinoma: pre-operative staging and evaluation of anastomotic recurrence. 218 79

Neoadjuvant, or pre-operative, chemotherapy for esophageal cancer has become an area of increasing interest because of the failure of conventional therapy (surgery or radiation) to improve disease-free or overall survival. Several autopsy series have demonstrated that, in many symptomatic Western patients, esophageal cancer is a systemic disease. Neoadjuvant chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A number of single-arm, phase II multi-modality trials have been completed. Toxicities of chemotherapy, while substantial, have been tolerable. With careful attention to detail, operative morbidity and mortality has not been increased. Large-scale randomized trials, needed to evaluate the impact of this technique on disease-free and overall survival, have been designed and will shortly be activated.
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PMID:Neoadjuvant chemotherapy and surgery of cancer of the esophagus. 223 85

Gastric metastases from esophageal cancer are seldom diagnosed antemortem. Two patients who had endoscopically detected gastric metastases from esophageal cancer are reported. One patient had a metastasis developing 6 months after radiation therapy; the other developed metastasis after surgical resection of the primary tumor.
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PMID:Gastric metastases from esophageal cancer. 225 16


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