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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stomal recurrence and distant metastases are two of the most serious complications occurring in the patient treated for carcinoma of the larynx. Their appearances are ominous prognostic signs for survival of the host and both are refractory to any form of effective management. To date, the stomal recurrence has defied a satisfactory pathogenetic explanation but neoplastic cell inculation of the laryngectomy wound and extension from paratracheal lymph nodes appear to be partial explanations. Uncontrolled local disease plays a significant, if not the major role in the genesis of distant metastases.
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PMID:Laryngeal carcinoma: stomal recurrences and distant metastases. 120 97

A microspectrophotometric study of DNA content in nuclei of cells of the normal larynx mucosa, papiloma, epithelial layer of fibromas, areas of atypical hyperplasia of the epithelium of papillomas, intraepithelial cancer, squamous-cell carcinoma of the larynx, matastases in the regional lymph nodes, was carried out on the basis of bioptic and operation materials. A total of 82 histological sections and 50 cytological preparations (impressions) obtained from the same specimens of the tissue were investigated. The microspectrophotometric investigation revealed the growth of DNA "accumulation indices" from stratified squamous epithelium (2.5) through atypical proliferation (3.9) to squamous-cell carcinoma of the larynx (8.2) and its metastases (12.4). The DNA content in intrapithelial cancer was higher than that in invasive squamous-cell carcinoma. Determination of the type of distribution of nuclei of cells of a tumour in cytological and histological preparations (in growth zones) according to ploidity and of characteristic features of the tissue with the help of the generalized "accumulation index" of DNA may be helpful as objective tests in morphological diagnosis of precancer and cancer processes in the larynx and in taking decisions concerning their prognosis.
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PMID:[A comparative microspectrophotometric study of the concentration of DNA in the cells of laryngeal tumors in histologic and cytologic preparations]. 122 86

We evaluate the importance of cancer spread to the lymphatic system in the posterior triangle. The posterior triangle tissues of 51 radical neck specimens were serially sectioned and studied for metastic involvement. The findings were correlated with the findings in the anterior triangle and the primary tumor. Of the 51 neck operations performed, 25 were elective and 26 were therapeutic for carcinoma of the larynx, pharynx, and oral cavity. Metastasis in the anterior triangles was detected in 88.4% of the therapeutic group and in 24.0% of the elective group. However, no metastasis in the posterior triangel was found in either group, regardless of the site of the tumor. We suggest that the posterior triangle can be totally preserved in radical neck surgery, which may make preservation of the spinal accessory nerve a more likely practice.
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PMID:The posterior triangle in radical neck surgery. 124 24

Cutaneous metastases from carcinoma of the larynx are very rare. We observed a 64-year-old Japanese patient with squamous cell carcinoma of the larynx who developed a subcutaneous nodule on the abdomen. It was found to be a metastatic tumour from the laryngeal cancer, histopathologically as well as histochemically.
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PMID:Skin metastasis in laryngeal carcinoma. 145 23

In a retrospective study of 556 patients (505 men, 51 women) with laryngeal cancer the incidence and prognosis of lung malignancies was studied in patients who were examined yearly by chest radiography. In 69 patients (12.4%) a lung malignancy was diagnosed, with 28 having a histologically confirmed second primary malignancy. All of these 69 patients were men. The incidence of radiologically detected lung malignancies, both second primary and metastatic cancer, is higher and more prolonged following supraglottic carcinoma than following glottic carcinoma. In 47 patients (68%) without symptoms, the lung malignancy was detected by routine annual chest radiography. The survival rate in patients with lung cancer detected by the yearly radiography was significantly higher than in patients diagnosed after symptoms (median survival 10 and 4 months, respectively). However, taking into account the lead time between early radiologic diagnosis and the time a tumor would have been diagnosed following symptoms, the observed survival benefit of yearly radiography was much lower, or even nil.
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PMID:Yearly chest radiography in the early detection of lung cancer following laryngeal cancer. 148 33

The recently completed VA Cooperative Study (CSP #268) of induction chemotherapy (cisplatin/5-FU) and definitive radiation (6600 to 7600 cGy) for organ preservation in advanced (stage III or IV) laryngeal cancer demonstrated that, although larynx preservation could be achieved in 64% of randomized preservation could be achieved in 64% of randomized patients, overall survival rates were not improved over conventional treatment (surgery/postoperative radiation). Of 166 patients randomized to induction chemotherapy, 46 had N2 or N3 disease and were analyzed to determine the effectiveness of the organ preservation treatment strategy on control of neck disease and survival. The clinical response of neck metastases to induction chemotherapy was significantly associated with subsequent salvage neck dissection (P = .008). The overall death rate was increased (P = .014) and survival time decreased in patients with less than a complete response in the neck after chemotherapy (P = .15). This was related primarily to failure to control the disease in the neck. The overall survival of patients achieving a complete response in the neck was improved over the randomized group of N2 or N3 patients treated with primary surgery. The findings suggest that response of neck nodes should be assessed independently of primary tumor response in trials of organ preservation strategies using induction chemotherapy, and that failure to achieve a clinical complete response in the neck warrants planned early salvage neck dissection in order to achieve improved overall survival.
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PMID:Effectiveness of salvage neck dissection for advanced regional metastases when induction chemotherapy and radiation are used for organ preservation. 149 57

Between 1979 and 1988, 432 cases of previously untreated laryngeal cancers were histologically diagnosed at the Institute of Pathological Anatomy of the University of Trieste. Of these cases, 192 were supraglottic and 182 glottic cancers. The overall crude incidence was 31.06 0/0000 in males and 2.29 0/0000 in females, with a male/female ratio of 10.2:1 for supraglottic cancers vs. 20.4:1 for glottic cancers. Our incidence values for laryngeal cancer, and supraglottic lesions in particular, are similar to those recorded in France, Spain and other areas of Italy, i.e. in nations where wine production and consumption is very high. The 3-year adjusted survival rate was 45.7% for supraglottic and 83% for glottic cancer patients. Subjects with supraglottic cancer often had a poor prognosis because of the high frequency of cervical lymph node involvement, recurrences and visceral metastases; cancers of the aryepiglottic folds presented the worst clinical evolution.
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PMID:Supraglottic versus glottic laryngeal cancer: epidemiological and pathological aspects. 158 91

The clinical characteristics of laryngeal cancer, its site and extent, determine the incidence of regional metastases. However, data have also shown that lymph node involvement is influenced by the degree of malignancy of the tumor. In the course of histoautoradiographic processing of 79 laryngeal tumors and a 5-8-year follow-up study of the patients, a correlation between proliferative activity and incidence of metastasis was found. Well differentiated tumors with low proliferative activity rarely metastasized whereas in cases of slightly differentiated tumors of strong proliferative activity the occurrence of manifested or occult metastases should always be taken into consideration. The state of the lymph node determines decisively the prognosis and treatment of laryngeal cancer. In some cases, preventive interventions may improve the therapeutical results in seriously endangered patients.
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PMID:Relationship between "dynamic histology" and metastases of laryngeal tumors. 160 12

The status of the cervical lymph nodes is the single most important prognostic factor in head and neck cancer, and the management of metastatic disease plays an important role in the treatment of carcinoma of the larynx. Clinical assessment of the neck is not very accurate, and the role of newer imaging techniques such as CT, MRI and Ultrasound guided Fine Needle Aspiration Cytology is being assessed, in order to improve upon the results of clinical palpation alone. The site of the primary tumour within the larynx is an important factor in affecting the frequency and the pattern of lymph node metastases to the neck. Indications for the use of surgery and radiotherapy for the elective and therapeutic management of lymph node metastases of carcinoma of the larynx are discussed with reference to the various sites of the primary tumour.
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PMID:Metastases of carcinoma of the larynx. 160 17

Between January 1980 and December 1988, 141 patients were treated with radical radiotherapy for carcinoma of the larynx. One hundred and ten (78%) tumours arose on the vocal cords, twenty nine (21%) from the supraglottis and two (1%) from the subglottis. All 63 stage T1 cases, and all except three of 62 T2 cases seen in the time period, were treated by radiotherapy. In addition 14 selected T3 and 5 T4 cases were irradiated. Only 7% had clinical evidence of regional lymph node metastases at presentation. Median follow up is 47.5 months and 2+ year actuarial local control rates are T1-87%, T2-63%, T3-79% and T4-53%. The rates for vocal cord primaries are T1-86%, T2-58%, and T3-75%. Median time to local failure was 8 months with none occurring beyond 21 months. Two of 130 N0 cases (1.5%) relapsed in cervical lymph nodes with a policy of selective prophylactic irradiation of the regional lymphatic areas. Thirty three/thirty seven patients with locoregional failure underwent salvage surgery with 27/32 (84%) evaluable patients achieving ultimate locoregional control with median follow up of 18.5 months from salvage. Four patients (3%) developed distant metastases and 21 (15%) developed a second primary malignancy (including 13 lung cancers) with an actuarial rate of second primary tumours of 23% at five years. Three year actuarial survival for the whole group is 77% but 66% of deaths were due to causes other than larynx cancer. Tumour specific mortality by stage is T1-1.6%, T2-12%, T3,4-21%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Radical radiotherapy for carcinoma of the larynx--Westmead Hospital experience. 176 87


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