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)

Early endocrine therapy after radical retropubic prostatectomy was compared to radical prostatectomy alone (nonearly endocrine therapy) for the treatment of carcinoma of the prostate with lymph node metastases. Our retrospective analysis demonstrated that the 2 cohorts were similar with respect to patient age, Gleason sum score, seminal vesicle invasion, lymph node involvement, tumor volume and pathological stage of the primary tumor. The cause-specific survival of the entire group was 84% at 60 months and 78% at 98 months. The cause-specific curves for the early and nonearly endocrine therapy group were not significantly different (p less than 0.194), although the estimated 9-year survival rates were 91 and 71%, respectively. Survival free of disease was significantly prolonged in the early endocrine therapy group (p less than 0.030), with a 9-year estimated rate free of disease of 67% versus 32% in the nonearly endocrine therapy group. Followup prostate specific antigen serum levels were analyzed and the value as a progression marker is discussed. These data suggest that a radical operation plus early endocrine therapy is effective palliation in selected patients with low volume lymph node metastases, producing clinical survival free of disease in most patients.
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PMID:Prognosis of patients with stage D1 prostate carcinoma following radical prostatectomy with and without early endocrine therapy. 238 31

Since 1976, 126 patients with clinically localised carcinoma of the prostate have been managed by radical retropubic prostatectomy. All patients with tumour spread beyond the capsule or metastasis in lymph nodes received radiotherapy. Tumour category pT3 was divided into invasion of the capsule or infiltration of the seminal vesicle. The disease-free 10-year survival rate in patients with minimal invasion of the capsule was 72% and in patients with infiltration of the seminal vesicles it was 26%. Unilateral lymph node metastases were classified as microscopic disease or macroscopic infiltration. The disease-free 10-year survival rate in patients with metastasis in 1 lymph node (micro- and macro-metastasis) was 65% in contrast to 0% in patients with bilateral disease.
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PMID:Does microinvasion of the capsule and/or micrometastases in regional lymph nodes influence disease-free survival after radical prostatectomy? 239 Jul 5

Over an 18-year period, 453 men with carcinoma of the prostate gland were treated with curative intent using radiation therapy alone at one large community hospital in Hawaii. A retrospective analysis of the survival of these men was undertaken in order to compare this experience with that of other investigators. Clinical stage was found to be a less reliable prognostic factor than the histologic grade of the tumor. Patients with poorly differentiated tumors had the worst prognosis with a 5-year survival probability of 48.4%. Patients who were otherwise eligible for prostatectomy (stage B1) had the best prognosis, 88.1% at 5 years. Inability to clearly demarcate stages A2, B2 and C was reflected in similarity of survival probability for all of these patients, 69.3% to 70.5% at 5 years. Finally, a selected group of patients with metastatic disease confined to the pelvis who were treated with curative intent is presented herewith and compared to a much larger group of patients with metastatic disease who were treated palliatively. Survival was equally dismal in both groups. X-ray treatment alone can be applied with curative intent to all patients who have no evidence of metastasis, with substantial hope for local tumor control and significant survival.
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PMID:Radiation therapy for carcinoma of the prostate gland: experience at a community hospital. 239 87

MR imaging (MRI) possesses good sensitivity in diagnosis of carcinoma of the prostate. It is often not possible to distinguish clearly between carcinoma of the prostate and prostate hypertrophy. MRI can assess the local extension of a prostate carcinoma with a high degree of accuracy (85%); this applies in particular to periprostatic infiltration. MRI possesses only moderate sensitivity in diagnosis of regional lymph node metastases in the minor pelvis.
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PMID:[Value of NMR tomography in the diagnosis and staging of prostatic neoplasms]. 242 61

In seven patients with undifferentiated carcinoma of the prostate, the immunohistochemical stain for prostate-specific antigen was negative. The stain for prostatic acid phosphatase done on the same tissue samples was diffusely positive in three, focally positive in three, and negative in one. Only the three with diffusely positive immunostaining had elevated serum acid phosphatase levels, although five had evidence of metastatic disease. All seven neoplasms were histologically similar, being composed of large cells with large nuclei, a moderate amount of cytoplasm, and indistinct cell borders. All tumors grew as broad sheets within the prostatic stroma as well as in the prostatic urethra; in six cases. Thus, prostatic carcinoma with this histologic pattern frequently loses prostate-specific antigen immunoreactivity. Awareness of this occurrence should prevent a misdiagnosis of urothelial carcinoma in such cases. The prostatic origin of these neoplasms can usually be verified by prostatic acid phosphatase immunostaining, which proves to be more sensitive in this particular setting.
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PMID:Carcinoma of the prostate with atypical immunohistological features. Clinical and histologic correlates. 243 Apr 76

Associations between epidermal growth factor (EGF) and carcinoma of the prostate (CAP) have not been systematically investigated. We used indirect immunohistochemical techniques to demonstrate cytoplasmic EGF in paraffin-embedded sections of the following primary prostatic tissues: benign prostatic hyperplasia (BPH) (N = 10), BPH adjacent to CAP (N = 42), clinically localized CAP (N = 45), untreated metastatic CAP (N = 10), and metastatic CAP after varying periods of androgen deprivation (N = 10). In six of the latter 10 cases biopsies of the primary tumor obtained before androgen deprivation therapy were also available for study. Three of the BPH specimens (6%) and 44 of the CAP specimens (68%) stained. Forty per cent of the localized tumors stained but all untreated and treated metastatic tumors stained (p less than 0.01). There were direct but statistically insignificant correlations between the demonstration of EGF and both the Gleason score of localized and untreated metastatic tumors and the pathologic stage of localized tumors. The proportion of malignant cells stained in EGF positive tumors was similar regardless of Gleason score, pathologic stage or the presence or absence of metastases. However, the proportion of cells stained was greater in five of six specimens obtained during hormonal deprivation compared to specimens of the same tumor obtained before treatment. These data suggest that some prostatic cancers interact with EGF and that the interaction may be influenced by the androgenic milieu.
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PMID:Epidermal growth factor and prostatic carcinoma: an immunohistochemical study. 245 Oct 41

Between 1977 and 1984, adjuvant radiation therapy was administered after radical prostatectomy to 71 patients at high risk for recurrence of carcinoma of the prostate. In 35 patients, tumor remained at the surgical margin (stage C2 disease) and/or the disease had invaded the seminal vesicles (stage C3). Thirty-six patients had microscopic metastases in the pelvic lymph nodes (stage D1a). Radiation therapy was administered only after full recovery from surgery, which included full recovery of continence. The average period between surgery and initiation of radiation therapy was 3 months. Serious or long-term complications attributable to irradiation occurred in 7% of the patients. Tumor recurred locally in only 2 patients. Five-year actuarial survival, disease-related survival, and disease-free survival for patients with stage C2 and C3 disease were 86%, 96%, and 80%, respectively. These survival values for patients with stage D1a disease were 74%, 90%, and 69%, respectively. Our results suggest a greater therapeutic benefit from radical prostatectomy and adjuvant radiation therapy than from radical prostatectomy alone for stages C2 and C3 disease or from radical prostatectomy alone or radiation therapy alone for stage D1a disease; however, the length of follow-up, number of patients treated, and problems in comparing our results with those from historical controls do not allow us to draw firm conclusions about the benefits of this combined therapy. Controlled, randomized studies clearly are required. The serum levels of prostate-specific antigen, but not prostatic acid phosphatase, were invariably elevated in patients at the time of clinical detection of disease recurrence and predicted recurrence up to 4 years before the event.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Radiation therapy as adjuvant treatment after radical prostatectomy. 245 21

Prostatic carcinoma accounts for about 1% of all cancers that metastasize to the skin. The regions most frequently involved are the genital region, the head and the trunk. Clinically the lesions present as nodules; less often diffuse infiltrates, red macules and papules or tumors of an angiomatous appearance occur. Histopathological examination of skin biopsy specimens can reveal gland-like, epithelial or anaplastic differentiation of tumor cells. Prostatic origin can be proven by the immunohistological demonstration of acid prostatic phosphatase or prostatic specific antigen in paraffin-embedded specimens taken for routine histological examination.
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PMID:[Skin metastases in prostatic cancer. Immunohistologic indications of the primary tumor]. 246 19

Fourteen patients with incidentally diagnosed carcinoma of the prostate were reviewed. The frequency of the incidental prostatic carcinoma in our clinic was approximately 7.3% of 191 patients operated for benign prostatic hypertrophy. Five patients with focal and well differentiated carcinoma (stage A1) were managed expectantly with no treatment. Two patients with focal and moderately differentiated carcinoma (stage A2) and three patients with stage A1 cancer were treated by means of chlormadinone acetate. Total retropubic prostatectomy and pelvic lymph-node dissection was performed in four patients with diffuse prostatic carcinoma (stage A2). No serious complication occurred without minimal stress incontinence in one patient. Three patients had diffuse residual carcinoma in the total prostatectomy specimens. In one of them capsular penetration of carcinoma cells was discovered. Follow up was performed for 1.5-7 years (mean 43 months) by repeated transrectal needle biopsy, bone scan and serum phosphatase. Metastasis and recurrence have not developed in any patient. Two patients died without evidence of cancer. The remaining patients are alive without evidence of disease. Radical operation is recommended for patients with stage A2 prostatic carcinoma after transurethral resection of prostate.
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PMID:[Treatment of prostatic incidental carcinoma]. 247 36

A series of 287 patients referred by their family doctors with symptoms of bladder outflow obstruction were asked to attend the hospital for "pre-clinic" screening for carcinoma of prostate (CaP). Blood samples were collected from 211 patients and analysed for serum prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). Thirty-six patients had a serum PSA greater than 10 micrograms/l and 7 had PAP levels greater than 5 iu/l. In no instance was the PAP elevated without an associated increase in PSA concentration. Patients with raised markers underwent further investigations which included prostatic biopsy and/or resection; 17 patients were proved to have carcinoma of the prostate, 9 of whom had distant metastases. The specificity of PSA for detecting prostate cancer in this study was 90% with a sensitivity of 89.5%, in contrast to values for PAP of 100% and 36.8%. The routine use of PAP as a marker for prostatic cancer should be abandoned. The use of PSA as a screening test in a group of patients with prostatism appears justified, but with a positive predictive value of only 47%, its use in a mass unselected screening programme is not recommended.
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PMID:Prostate specific antigen--a screening test for prostatic cancer? 248 12


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