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Query: UMLS:C0027627 (
metastases
)
103,950
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 10 year old child developed severe cardiomyopathy after combined, multicycle chemotherapy for
Ewing's sarcoma
and was treated by heart transplantation with good results. Long term azathioprine and cyclosporin caused only mild impairment of immune function and there were no recurrent infections, local recurrences of the tumour, or distant
metastases
.
...
PMID:Long term survival after heart transplantation for doxorubicin induced cardiomyopathy. 192 98
344 previously untreated patients, under 19 years of age, with soft tissue sarcoma (STS) entered the first German STS Study, CWS-81. 218 of them with chemosensitive STS (Group A: rhabdomyosarcoma [RMS], synovial sarcoma, extraosseous
Ewing's sarcoma
, undifferentiated sarcoma and malignant peripheral neuroectodermal tumor) were evaluable for this analysis after a minimum potential follow-up of 6 years. A staging system based on the extent of disease, defined post-surgically, was used. The chemotherapy for stages I-III (VACA cycle) consisted of vincristine, dactinomycin, cyclophosphamide and doxorubicin. Patients with
metastatic disease
as well as stage III patients who failed to respond to VACA, were given ifosfamide instead of cyclophosphamide. The definitive local tumor control procedure for patients in stages II-III depended upon the tumor status at second-look surgery after 16 weeks of chemotherapy (no irradiation, 40Gy or 50Gy). The DFS rate after 5 years for group A was 57 +/- 4% and for patients with non-metastatic tumors (Stages I-III), 69 +/- 4%. There was no difference in prognosis between stages I and II (DFS rate 88 +/- 5% and 88 +/- 6% respectively). The DFS rate for stage III was 54 +/- 5% and for stage IV, 11 +/- 5%. Lack of local tumor control was the main cause of therapy failure: 10% of patients with localized disease never achieved CR, 18% relapsed locally. The most important prognostic factors were tumor size (p = .0002) and the degree of tumor regression after primary chemotherapy (p = .02).(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Treatment of soft tissue sarcomas in childhood and adolescence: results of the CWS-81 multicenter therapy study]. 194 28
Twenty-two patients received a short-term intensive regimen for
Ewing's sarcoma
between November 1977 and December 1981. The regimen consisted of vincristine (1.5 mg/m2) on day 1, and doxorubicin HCl (75 mg/m2) plus cyclophosphamide (1,000 mg/m2) on day 2. Six cycles were given at 28-day intervals. Local irradiation was started shortly after cycle 2. Eight patients with lesions of expendable bones also underwent surgery as part of the treatment to the primary site, 4 at the end of chemotherapy and 4 at diagnosis. The 5-year event-free survival rate was 45% for all patients and 48% for those with localized disease at diagnosis. Two patients died of treatment-related toxicity. The most common form of failure was distant
metastases
, indicating that finding a better systemic treatment remains the problem in eradicating
Ewing's sarcoma
.
...
PMID:Late follow-up of a short-term intensive regimen for Ewing's sarcoma. 195 Nov 81
The pathologic material from 56 patients diagnosed initially as
Ewing's sarcoma
of the distal extremity and treated on National Cancer Institute protocols between 1968 and 1984 was reviewed and correlated with clinical outcome. Histologically, the tumors were categorized, based on recent pathologic criteria, into three diagnostic groups: (1) typical
Ewing's sarcoma
, (2) atypical
Ewing's sarcoma
, and (3) other (predominantly peripheral neuroepithelioma [PN]). Thirty-two patients (57%) had typical Ewing's, 13 (23%) were atypical, and 11 (20%) were in the "other" diagnostic category (seven [13%] PN, two primitive rhabdomyosarcoma, one primitive sarcoma of bone, and one synovial cell sarcoma). No cases of metastatic neuroblastoma, osteosarcoma, or lymphoma were found. Forty-five patients had localized disease at diagnosis; 11 had
metastases
. Patients with typical
Ewing's sarcoma
were less likely to have
metastatic disease
at the time of diagnosis. Only two of 32 patients with typical
Ewing's sarcoma
had
metastases
compared with nine of 24 patients in the two other groups. The pattern of relapse was also different in these other groups compared with typical Ewing's patients; five patients developed lymph node
metastases
and two patients developed brain metastases. Although the presence of
metastatic disease
at diagnosis was a strong negative prognostic factor, our histologic grouping was independently prognostic of clinical outcome in patients with localized disease. Patients with typical osseous
Ewing's sarcoma
had an improved overall survival (P2 = 0.03) and patients with other tumors (neither typical nor atypical
Ewing's sarcoma
) had a poorer disease-free survival (P2 = 0.02). Since no generally accepted histopathologic prognostic criteria exist for
Ewing's sarcoma
, the potential value of our proposed classification should be evaluated in a larger retrospective and a prospective study.
...
PMID:Prognostic value of histopathology in Ewing's sarcoma. Long-term follow-up of distal extremity primary tumors. 198 13
Significant strides in the treatment of
Ewing's sarcoma
, the second most common bone tumor of childhood, have resulted in cure for approximately 50% of patients. Successful therapy requires systemic chemotherapy for the eradication of microscopic or overt
metastatic disease
and surgery or irradiation therapy for control of the primary lesion. The article debates the controversy over the extent to which surgical resection should play a role in the local management of this disease.
...
PMID:Ewing's sarcoma. Radiotherapy versus surgery for local control. 200 82
Autologous bone marrow transplantation (ABMT) allows delivery of intensive, marrow-ablative chemotherapy or chemoradiotherapy to children with high-risk solid tumors. Results from several studies of neuroblastoma suggest that outcome is improved by ABMT; however, relapses can occur months to years after complete clinical remission. Other high-risk tumors including peripheral neuroepithelioma,
Ewing's sarcoma
, rhabdomyosarcoma, Wilms' tumor, and brain tumors also appear to be responsive to intensive marrow-ablative therapy, although few studies have been reported. For tumors that can
metastasize
to marrow, a sensitive method is necessary for detecting tumor cell contamination. Immunocytologic analysis with monoclonal antibodies can identify one neuroblastoma cell per 10(5) normal marrow cells; this method also is applicable to other tumors with appropriate antibodies. Ex vivo removal (purging) of tumor cells decreases the probability of infusing tumorigenic cells with the ABMT. There is considerable experience in tumor detection and purging for neuroblastoma, but little has been done for other childhood solid tumors. Future investigations of ABMT will aim to further increase disease-free survival by intensifying induction and marrow-ablative regimens and by developing therapies to be given after ABMT that are directed at minimal residual disease. As pilot investigations mature, the efficacy of ABMT and conventional chemotherapy will be compared in multi-institution randomized studies.
...
PMID:Treatment of high-risk solid tumors of childhood with intensive therapy and autologous bone marrow transplantation. 200 84
The authors report on one case of pharyngolaryngeal extraosseous
Ewing's sarcoma
. This is a very rare tumor which preferentially has a paravertebral or retroperitoneal location. The difficult histological diagnosis is greatly facilitated by the use of tumoral markers. The treatment implemented consisted of a "conventional" Cisplatin 5 FU chemotherapy, which allowed an almost complete clinical recession after 3 courses, then of external radiation therapy. The evolution of these tumors still remains unpredictable. Regional
metastases
to the lymph nodes are rare, and they are usually remote and mainly pulmonary. Lastly, the merits of computed tomography for the follow-up of these intramural lesions of the larynx must be emphasized.
...
PMID:[Extraskeletal pharyngolaryngeal Ewing's sarcoma. Apropos of a case]. 201 81
249 thoracotomies for lung-
metastases
were performed in 202 patients at the 2nd Dept. of Surgery of the Vienna University Clinic till 1989. Age ranged from 2 to 78 years, 14 patients were younger than 18 years. The primary tumour was a carcinoma in 143 cases, a sarcoma in 45 cases and a melanoma in 14 patients. The primary tumour in the young patients was osteosarcoma in 8 cases,
Ewing sarcoma
in 2 cases and Wilms tumour in 2 patients. With a minimal follow up period of 2.5 years the 5-years-survival after metastasectomy was 42% for patients with carcinoma and 29% for the sarcoma patients. None of the patients with melanoma survived 5 years. A significant difference was found between the carcinoma and sarcoma groups with respect to survival rate. A prognostic factor was the disease-free interval in carcinoma patients. Actuarial post-thoracotomy survival in patients with osteogenic sarcoma was 34% at 5 years and 18% in the soft-tissue sarcoma group. Size of lesion, vitality of the
metastases
and the disease free interval correlated with survival in the osteogenic group, whilst the number of lesions was of importance in the soft-tissue group. On account of the lesser functional morbidity and the enablement to assess both lungs for treatment, the median sternotomy is recommended for cases with bilateral lung metastases. The results justify an aggressive surgical approach for the treatment of lung metastases.
...
PMID:[Resection of lung metastases. Results and prognostic factors]. 203 96
A total of 59 eligible patients with localized Ewing's sarcoma of the pelvic and sacral bones were entered into a multimodal Intergroup
Ewing's Sarcoma
Study (IESS-II) (1978 to 1982) and compared with a historical control series of 68 patients entered into an earlier multimodal Intergroup
Ewing's Sarcoma
Study (IESS-I) (1973 to 1978). High-dose intermittent multiagent chemotherapy (vincristine, cyclophosphamide, Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH], and dactinomycin) was given to all patients for 6 weeks before and for 70 weeks following local therapy. All patients who had a tumor biopsy or incomplete resection performed received a dose of 55 Gy to the tumor bed. With a median follow-up time of 5.5 years, two of 59 patients (3%) had a local recurrence, five patients (8%) had a local recurrence and
metastases
, and 17 patients (29%) developed
metastases
only. There was significant statistical evidence of an advantage in relapse-free survival (RFS) and survival (S) for patients on IESS-II versus IESS-I, P = .006 and P = .002, respectively. At 5 years, the comparison between IESS-II versus IESS-I was 55% versus 23% for RFS and 63% versus 35% for S.
...
PMID:Multimodal therapy for the management of localized Ewing's sarcoma of pelvic and sacral bones: a report from the second intergroup study. 204 57
The case of a 7-year-old boy with a spinal epidural extraosseous
Ewing's sarcoma
(EES) is presented. He is in complete remission without neurologic deficit 40 months after diagnosis. Another 15 cases were found in the literature and are discussed together with this patient. Twelve of them were male patients. The mean age of the patients was 17.5 years (range, 4 to 47). Symptoms included back pain and/or radicular pain (100%), paresis of one or both legs (83%), sensory disturbances, and bladder and bowel dysfunction. The mean diagnostic delay was 5.8 months. Each patient underwent laminectomy; complete resection of the tumor was impossible in more than 50% of the cases. Most patients received radiation therapy and/or chemotherapy. Four patients suffered from local recurrence, eight from
metastases
. Ten (63%) patients died, 1 to 48 months (mean, 16) after diagnosis. The differential diagnosis is discussed, including disk herniation and several benign and malignant tumors.
...
PMID:Primary spinal epidural extraosseous Ewing's sarcoma. 206 87
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