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)

The tremendous progress that has been made in the chemotherapy of malignant diseases since the early 1950's has enabled the cure of a significant number of cancers such as chloriocarcinoma, Burkitt's lymphoma, Hodgkin's disease, non-Hodgkin's lymphoma, the acute leukaemias, testicular carcinoma, and many childhood cancers such as rhabdomyosarcoma, Wilm's tumor, Ewing's sarcoma, ovarian cancer, and retinoblastoma. As a result, the mortality from cancers has dropped by 15% for persons under the age of 45 years and even more for those under 30 years of age. Many other metastatic cancers can now be successfully controlled with chemotherapy and, ultimately, more will be added to the growing list of curable cancers. The chemotherapeutic agents responsible for the cures of some cancers include asparaginase, actinomycin D, Adriamycin, bleomycin, cisplatin, cyclophosphamide, cytosine arabinoside, 5-fluorouracil, 6-mercaptopurine, methotrexate, nitrogen mustard, prednisone, procarbazine, and vincristine. The discovery of new effective drugs such as AMSA and anthracenedione promises to improve the success rates obtained with present therapy. Chemotherapy is indicated for every patient who has metastatic cancer, since virtually every patient can receive some palliation from such therapy, while for some patients chemotherapy holds the promise of prolongation of life or even cure.
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PMID:The curability of advanced cancers with chemotherapy. 627 28

In two groups of patients with disseminated testicular carcinoma the effect of combination chemotherapy on the pituitary-gonadal axis was evaluated, after unilateral orchiectomy: The two groups comprised 15 patients without hCG-producing metastases (group A), and 14 patients with hCG-producing metastases (group B). Seven patients who had received no chemotherapy were studied one year after unilateral orchiectomy as a control group (group C). In group A, serum levels of testosterone and oestradiol increased during chemotherapy, as did the levels of LH and FSH. The serum LH and FSH response to LHRH was increased following chemotherapy, whereas the serum testosterone increase after hCG stimulation remained unchanged. A rise of 316% in SHBG binding capacity was found after chemotherapy. This presumably accounted for the elevated steroid levels in the presence of high gonadotrophin levels, but unaltered Leydig cell response. The elevated serum levels of testosterone and oestradiol and the suppressed serum FSH levels normalized during disappearance of ectopic hCG production in group B patients. Leydig cell refractoriness to hCG and the FSH response to LHRH also reverted to normal. After chemotherapy, FSH, but not LH levels exceeded those of group C patients, presumably as a result of the azoospermia induced by chemotherapy. The hormonal changes associated with chemotherapy are best explained by an increase in serum binding proteins, notably SHBG.
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PMID:Leydig cell function in patients with testicular cancer during and after chemotherapy. 642 50

Twenty-five patients with nonseminomatous germ cell carcinoma of the testis underwent CT and nuclear magnetic resonance (NMR) of the retroperitoneum followed by radical retroperitoneal lymph node dissection for surgical proof of metastatic disease. Computed tomography correctly predicted the presence or absence of adenopathy in 88% and assigned the correct stage in 84%. Nuclear magnetic resonance had comparable figures of 84 and 80%. Computed tomography appeared superior to NMR in detecting other abdominal abnormalities, although these were few in number. Nuclear magnetic resonance is nearly equivalent to CT in staging retroperitoneal lymphadenopathy from testicular cancer and may surpass CT following technical advances and the introduction of oral contrast agents.
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PMID:Comparison of NMR and CT imaging in the evaluation of metastatic retroperitoneal lymphadenopathy from testicular carcinoma. 653 90

Between 1948 and 1982, 22 patients were seen with metastasis to the inguinal nodes from testicular germ cell tumors: 8 had a history of unilateral or bilateral orchiopexy with or without herniorrhaphy, 4 had nonsurgically corrected or uncorrected cryptorchidism, 9 had a history of herniorrhaphy, hydrocelectomy or transscrotal orchiectomy and 1 had no history of scrotal, iliac or inguinal surgery, or of tunica vaginalis or scrotal wall involvement by tumor. The histological type was pure seminoma in 5 patients, embryonal carcinoma in 7 and mixed tumor in 10. Treatment was individualized for tumor type and mode of presentation, and varied during the years according to the modalities available. At the time of this report 8 of 22 patients (36 per cent) are alive without evidence of disease from 2 to 29.5 years, 3 (16 per cent) have died without evidence of disease 10 to 17 years after treatment, 10 (45 per cent) have died of metastases 10 months to 6 years after treatment and 1 has been lost to followup. The over-all incidence of groin metastases from testicular carcinoma is low, even with a history of scrotal or inguinal surgery.
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PMID:Inguinal lymph node metastases from germ cell testicular tumors. 669 90

Data from 93 patients undergoing resection of lung metastases are examined. Survival at 5 years was 32% and operative mortality 2.1%. Histologically, metastases from carcinoma gave better results than metastases from sarcoma (5-year survival 40% and 0 respectively). The best overall results being obtained in the case of metastases from carcinoma of the testis and larynx (5-year survival 66% and 54% respectively). The free interval was shown to be a good therapeutic index when longer than 1 year (44% survival at 5 years when longer than 1 year, 16% when shorter). Resection of lung metastases is recommended when primary tumor is under control, there are no metastases to other organs, the operative risk is reasonable and no other effective therapeutic procedures are available.
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PMID:Surgical management of lung metastases. 674 67

Sixty-three consecutive patients with nonseminomatous testicular carcinoma were prospectively examined for paraaortic metastases before undergoing a staging laparotomy with lymphadenectomies or biopsies. Fifty patients had computed tomographic examinations and paraaortic metastases were correctly predicted in 25 of the 38 patients (sensitivity 66%) with paraaortic tumor. In the 56 patients having the study, lymphography was more accurate as 34 of the 44 patients with metastases (sensitivity 77%) were identified. Using inferior vena cavography in 55 patients, only 24 of 41 patients with metastatic tumor (sensitivity 59%) were diagnoses. All three methods had specificities of 100% in those patients who were free of paraaortic metastases. Overall accuracies were 74% for computed tomography, 82% for lymphography, and 69% for inferior vena cava cavography. Although lymphography was the most accurate method for nonbulky tumor, computed tomography was most useful for defining the extent of bulk disease. Inferior vena cavography did not contribute any new information and was responsible for one false-positive result which was explained by computed tomography. A combination of lymphography followed by computed tomography provided the most accurate assessment of paraaortic metastases.
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PMID:Value of CT and lymphography: distinguishing retroperitoneal metastases from nonseminomatous testicular tumors. 678 19

The supraclavicular lymph nodes are known as a potential site for metastatic disease of the gastrointestinal and genitourinary cancers. The values of supraclavicular node biopsy in patients undergoing staging for testicular cancer were studied prospectively. Of 108 patients with testicular cancer undergoing therapy, 26 had supraclavicular node biopsy as part of their staging procedure. Evidence of metastatic disease to the supraclavicular nodes was found in 36% (10/26) of the patients. Ten of these patients had abnormal examinations of the supraclavicular fossa and nine of them (90%) had histologic evidence of metastatic disease. However, of the 16 patients with normal examination of the supraclavicular fossa, only one patient (6.3%) presented with clinically inapparent metastatic disease. The low yield for detection of clinically inapparent metastatic disease mitigates against indiscriminate supraclavicular node biopsy in the staging of testicular carcinoma.
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PMID:Supraclavicular node biopsy in staging of testicular carcinoma. 682 22

Clinical and histological correlates of survival in patients undergoing complete resection of pulmonary metastases from nonseminomatous testicular carcinoma were determined in 25 Stage C patients aged 17-38 years treated from 1969-1978. All patients had orchiectomy and retroperitoneal lymphadenectomy. Nineteen patients received combination chemotherapy before resection, and all received chemotherapy after resection. Three patients had four additional thoracotomies for pulmonary recurrence. Survival was measured from time of first thoracotomy to time of last followup or death. Actuarial survival for the entire group at one, two, and five years was 80, 63, and 59%, respectively. Median follow-up of the survivors was 3.5 years. Patients in low tumor burden groups such as those with no tumor in retroperitoneal nodes, with unilateral metastases, or with single metastases had better prognosis, as did patients whose primary tumors were moderately well differentiated. Characteristics of pulmonary metastases that favorably influenced the prognosis were the presence of mature teratoma, presence of few mitoses, lack of mononuclear infiltrate, and lack of desmoplastic response. These findings confirm the effectiveness of multimodality therapy which includes the resection of pulmonary metastases for Stage C nonseminomatous carcinoma of the testes. In addition, they suggest that consideration should be given to the stratification of prospective clinical trials on the basis of tumor burden and histologic characteristics of the primary and metastatic lesions.
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PMID:Resection of pulmonary metastases from nonseminomatous testicular tumors. Correlation of clinical and histological features with treatment outcome. 682 70

The significance of localizing accessory spleens in patients with hematologic disorders as well as demonstrating splenic regeneration following splenectomy is well recognized. An experimental contrast material has been developed that, after intravenous injection, selectively opacifies the liver and spleen on computed tomograms. The contrast material was primarily developed to detect small avascular liver lesions (metastases). Its value in detecting accessory or recurrent spleen was recognized incidentally when a patient with testicular carcinoma and a previous splenectomy showed opacification of splenic tissue in the left upper abdomen.
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PMID:Post-splenectomy demonstration of splenic tissue by computed tomography with liposoluble contrast material. 697 89

A 30-year-old man underwent orchiectomy in 1962 for a testicular carcinoma composed of choriocarcinomatous and teratocarcinomatous elements. Bilateral pulmonary metastases regressed completely on combination chemotherapy. However, a cerebral metastasis developed in 1963 and caused severe neurologic signs. At craniotomy a large mass of choriocarcinomatous tissue was incompletely removed. Further chemotherapy resulted in a complete remission. The patient remains free of disease more than 16 years later. The treatment of cerebral metastasis is discussed, with emphasis on the possibility of long-term survival and the role of surgery.
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PMID:Prolonged survival after cerebral metastasis of testicular carcinoma. 719 30


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