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)

If liver metastases are diffuse and spread out in the two lobes of the liver, the question remains as to which treatment should be given. Experimental studies showed that when a tumor grows, its vascular pattern becomes mainly arterial. However, if the tumor is still increasing, its center becomes progressively necrotic. After hepatic artery ligation the blood flow of the liver metastases decreases by 90% in the tumor but depriving the arterial circulation of the tumor is not sufficient to achieve a complete cure since the portal blood supply always saves a rim of neoplastic cells around the necrotic area. On the other hand, local infusion of chemotherapy for liver metastases by the arterial route showed a response rate varying between 34 and 70% and the median survival varying between 8 and 17 months. When FUdR chemotherapy was administered using a totally implantable drug infusion pump no improvement in the survival was observed and moreover a high level of toxicity was described including hepatitis and biliary sclerosis. A combined therapy seems a rational approach to treat tumor cells in surviving to the arterial ligation by perfusing the liver with cytotoxic drugs via the portal vein. Taylor's study was very promising but a randomized phase III clinical trial led by the gastrointestinal cancer group of the EORTC with the aim to evaluate the effectiveness of hepatic artery ligation and portal infusion of 5-FU did not show any difference in the survival of the treated patients when compared with patients treated by hepatic artery ligation alone. 77 patients were registered. Data are now available for 55 patients, respectively 30 and 25 patients in the treated group and in the control group. In both groups the median time to progression was 6 months and the median survival time was 12 months. 20% of the patients treated by hepatic artery ligation and portal chemotherapy had a response, one of them with a complete response, 5 with partial response and 14 patients without significant change in the size of their metastases. On the contrary, in the group treated by hepatic artery ligation alone, only one patient had a partial response with 13 patients having no change in the size of their metastases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Hepatic artery ligation or embolization and locoregional chemotherapy of liver metastases from colorectal cancer. 313 73

The efficiency of composite tests (liver scintigraphy, serum alkaline phosphatase, and serum carcinoembryonic antigen) in finding or excluding liver metastases preoperatively was evaluated in 185 surgical patients with high probability for gastrointestinal cancer--142 with colorectal and 43 with gastric disorders. A pathoanatomic verification procedure showed liver metastases in 21 and 7 patients, respectively. For each test two cut-off levels were defined in accordance with the operational purpose of the test: either to diagnose metastases (no false-positive test results) or to exclude metastases (no false-negative test results). Generally, composite tests increased overall efficiency; in the colorectal group 39% of the patients were correctly classified by the combined, triple test; in the gastric group 94% were correctly classified. In conclusion, we think composite tests are useful, and the operational approach described may be helpful in decision-making and test evaluation.
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PMID:Efficiency of composite tests in gastrointestinal cancer. Preoperative prediction of liver metastases by scintigraphy, alkaline phosphatase, and carcinoembryonic antigen. 329 32

The reaction patterns of eight antibodies directed against blood group substances A, B and H, respectively, against Lewis B antigen, difucosylated carbohydrate antigens (DFCA), gastrointestinal cancer antigen CA 19-9 (GICA), carcinoma-associated antigen CA-50 and CEA, were studied in 68 rectal carcinomas using the avidin-biotin-peroxidase method. A pronounced intratumoral antigenic heterogeneity was revealed for most antigens. It thus became evident that an interpretation based upon small preoperative biopsies would be inaccurate. The overall proportion of positive carcinoma cells, however, did not vary much between larger samples taken postoperatively from different regions of the tumours. The intertumoral antigenic variability was also considerable: nearly all tumours had an individual immunohistochemical profile according to the proportions of positive cells. Heterogeneous staining patterns were also present within metastases, and lymph node metastases from the primary tumour in some cases differed completely from each other. The staining pattern did not correlate with Dukes' stage, and degree of differentiation; the expression of any individual antigen, or several antigens in combination.
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PMID:Antigenic heterogeneity and individuality in adenocarcinomas of the rectum and their secondaries. 330 Jul 60

Major intraabdominal operations result in immunodepression. In addition, manipulation of malignant tumors may release tumor cells into the systemic and portal circulation. The additive effects of immunodepression and tumor cell release during surgical treatment for gastrointestinal cancer may increase the metastases of tumor to the liver. We, therefore, studied the inhibitory effect of immunoactivator OK-432 on the growth of the liver metastases in the perioperative period using a model in which rat ascites hepatoma AH-130 cells transplanted into the portal venous system consistently induce hepatic metastases. Forty-four male Donryu rats were assigned to a test group and a control group. The test group of 24 rats was treated with OK-432 (0.5 mg/day administered i.p.) for 7 days before tumor implantation, and the control group of 20 rats was treated with 0.2 ml of saline i.p. for the same number of days as the test group. The number of hepatic metastatic lesions at 14 days after tumor implantation amounted to 71.5 +/- 45.9 (SD) in the test group of 8 rats and 149.3 +/- 61.9 in the control group of 8 rats. The mean values of survival days after tumor implantation in the test group of 9 rats and the control group of 6 rats were 33.4 +/- 8.1 and 21.8 +/- 6.9, respectively. The values of OKT4+ in peripheral blood T-cell subsets in the test group of 7 rats and in the control group of 6 rats were 51.9 +/- 7.0 and 41.8 +/- 7.2%, respectively. These data showed significant differences between the two groups. Perioperative immunoactivation with OK-432 pretreatment reduced the incidence of liver metastases developed in rats given injections of tumor cells. We believe that the perioperative period is critical for the implantation and growth of metastases and that correction of perioperative immunodepression may favorably affect the development of metastatic disease and survival. This model may have relevance to the adjuvant treatment of human gastrointestinal cancer.
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PMID:Prevention of growth of metastases in rat liver by perioperative immunoactivation. 348 44

Blood and tissue concentrations of doxorubicin (DOX) were assayed after an intraoperative IV test dose of either free DOX 10 mg or its DNA complex 10 mg to patients with gastrointestinal cancer. After administration of the free drug, blood DOX levels decreased in an at least biphasic way, while DOX-DNA gave higher blood concentrations, which decreased slowly with no clear inflexion point on the concentration-time curve within the first hour. Tissue concentrations of DOX did not differ significantly after the two forms of the drug, liver being the tissue with the highest levels, followed by lymph node metastases, tumor tissue, muscle, and normal intestinal mucosa. If skeletal muscle can be used as a substitute for myocardium, lower cardiotoxicity of DOX-DNA than of DOX is not likely to be due to a difference in tissue uptake and retention between the two forms of DOX.
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PMID:Serum and tissue concentrations of doxorubicin after IV administration of doxorubicin or doxorubicin-DNA complex to patients with gastrointestinal cancer. 371 95

In 185 consecutive, surgical patients with suspected or proven gastrointestinal cancer a preoperative liver scintigraphy was performed; liver metastases were bioptically verified in 28 patients. A seven-class descriptive system was used for blind classification of the scintigraphies according to conferential consensus. Two years later (with the knowledge of the verified incidence of metastatic liver disease) the scintigraphies were reclassified. Considering the verified state of the patients, the latter classification was substantially improved. Probability for metastatic disease increased with more abnormal class label. At best, reliability for a twice interpreted scintigraphy as a binary test to denote the true state of the liver was 92 percent. The best cut-off level for diagnostic purposes yields a probability of 1.00 for an abnormal scintigraphy to denote liver metastases, accepting that 54 percent of patients with liver metastases were not found. For screening purposes, at best, a probability of 0.98 for a normal scintigraphy to denote no liver metastases was noted; thus, 83 percent of patients with normal liver state were missed. In conclusion, we find the liver scintigraphy classification system useful to find or exclude metastases in the test population and we think the procedure applied could be useful as a vehicle to report test results for any imaging modality.
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PMID:Reliability for an imaging test: evaluation of scintigraphy to reveal liver state in gastrointestinal cancer. 374 37

Tumor localization by a 131I-labeled monoclonal antibody to CEA has been evaluated in a series of 50 patients with clinically suspected primary or recurrent gastrointestinal cancer. Eighty-five percent of the primary tumors were correctly detected, as were 43% of associated nodal metastases. Localization was compared with computerized tomography in the detection of recurrent disease. Each technique correctly identified 61% of the sites but missed 39%. In addition, labeled antibody localization produced a significant number of false-positive images. Radioactivity accumulated by tumors, both primary and secondary, was significantly higher than that in surrounding normal tissue (P less than .01). However, less than 0.8% of the injected radioactivity and 0.01% of the injected antibody were detectable in the tumors. Radiolabeled antibody was rapidly cleared from the circulation, and this may reflect a recipient reaction to the foreign protein.
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PMID:Evaluation of immunolocalization in gastrointestinal cancer. 382 10

Cancer of the gastrointestinal tract represents a major international health problem. At the present time surgical resection for limited stages of disease represents the only treatment which can consistently provide long-term disease-free survival. Unfortunately, the majority of patients present with either microscopic metastatic disease in distant sites or advanced tumour growth which exceeds the limits of surgical resection. Relatively little progress has been made in the development of effective forms of non-surgical therapy. Gastric cancer, however, has been demonstrated to have greater sensitivity to forms of chemotherapy and radiation therapy than was previously appreciated. During the past decade, more effective forms of palliative therapy have been developed for patients with advanced disease, and approximately 15% of the cases with locally unresectable gastric cancer can now achieve long-term disease-free survival with combined forms of treatment. Unfortunately, similar progress has not been made in the management of pancreatic cancer or advanced colon cancer. The recent experience of the Gastrointestinal Tumor Study Group with the use of combined radiotherapy and chemotherapy for rectal cancer has demonstrated that improved disease-free survival can be achieved for patients with Dukes B and C disease. Overall, the current limited efficacy and considerable toxicity of conventional therapies strongly support the development of new approaches to the management of gastrointestinal cancer; this includes the exploitation of the recent progress that has been made in our understanding of cell proliferation and cell cycle control, and the importance of oncogenes and growth factors for regulation of these processes. Ultimately, our understanding of the molecular genetics of gastrointestinal cancer might allow for development of more effective means for both prevention and treatment at the molecular level.
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PMID:Therapy of gastrointestinal cancer. 391 66

Surgeons' ability to predict liver metastases preoperatively was studied in 185 operable, nonicteric patients strongly suspected to have gastrointestinal cancer. The prediction was based on a clinical assessment comprising medical history, physical examination and low-cost laboratory tests. A pathoanatomic verification procedure was used. The observed predictive value of a positive test was 0.67 and there was a false-negative ratio of 0.79. At the clinical assessment, presence of metastases was believed to be more common in gastric than in colorectal disease (6/43 vs. 3/142), but the actual incidence of metastases was similar in the two groups. Serum alkaline phosphatase (AP) was a priori believed to be of value in the clinical assessment. But the clinical assessment with inclusion of AP was inferior to AP alone as a predictor of metastases, due to undervaluation of the importance of elevated AP in cases of colorectal disease. The difficulties in standardization of the clinical assessment are underlined.
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PMID:The value of clinical assessment for preoperative prediction of liver metastases in suspected gastrointestinal cancer. A prospective, consecutive study. 395 16

The paper discusses the results of a radioimmunologic assay of carcinoembryonic antigen (CEA) levels in 100 cases of gastrointestinal cancer. CEA--PRIST kits (Phadebas, Sweden) and NGR-603 automatic gamma-unit (Tesla, Czechoslovakia) were employed. The test proved to be highly instrumental in the preoperative evaluation of prognosis and early detection of recurrence and metastasis. CEA concentrations within 30-50 ng/ml are highly suggestive of recurrence or metastases, whereas 50-100 ng/ml should serve an indicator of organ dissemination. The test is useful in assessing the effectiveness of treatment in the course of follow-up.
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PMID:[Clinical and prognostic significance of determining the carcinoembryonic antigen in patients with gastrointestinal cancer]. 396 45


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