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)

In a series of 1341 patients with histologically proven malignant melanoma seen at Duke University Medical Center from 1968 to 1978, 107 patients developed central nervous system (CNS) metastases. These patients were evaluated on the basis of which factors were associated with the development of CNS metastases. Male patients, patients with invasive primary lesions as measured by Clark's system, and patients with primary lesions of the head/neck or oral mucosa had higher incidences of CNS metastasis. Age and race were not significant factors. Clinically, single CNS metastases were seen in 48.8% of the patients; multiple cerebral lesions were seen in 37.2% of the patients. In 22% of the patients there was CNS metastasis alone, in 41% a second organ was involved, and in 20% three organs were involved.
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PMID:Central nervous system metastases in malignant melanoma. 720 69

Cerebrospinal fluid (CSF) and plasma levels of carcinoembryonic antigen (CEA) have been measured in 39 patients with disseminated breast cancer, 22 of whom had metastases involving the central nervous system (CNS). CSF CEA was also measured in 13 patients without cancer who had non-malignant disorders. Thirteen of the 22 patients with CNS metastases had elevated CSF CEA, together with 4 of 17 patients with disseminated breast cancer without neurological involvement. These 4 patients were shown to have extensive dorso-lumbar spine deposits. CSF CEA was not detected in any of the 13 patients without cancer. Estimation of CEA in the cerebrospinal fluid may be a useful adjunct in the diagnosis of disseminated breast cancer involving the CNS, provided that spinal metastases are absent.
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PMID:Carcinoembryonic antigen estimation in cerebrospinal fluid in patients with metastatic breast cancer. 730 10

Eighteen of 78 patients (23%) with metastatic colorectal cancer developed clinically significant metastases to the central nervous system (CNR). The patients developing CNS metastases had a decreased likelihood of associated liver metastases compared to the patients without CNS metastases (22% versus 80%). Pulmonary metastases were present in 55% of patients with CNS lesions and in 25% of those without CNS lesions. Overall survival from diagnosis of the primary tumor was comparable (median, 28 months) for patients with or without CNS lesions. The incidence of CNS metastases was comparable irrespective of Duke stage at presentation. For early lesions (Duke B or C), CNS metastases were associated with a shorter survival (31 versus 42 months). For advanced disease (Duke D lesions) at presentation, the overall survival of the group with CNS metastases was longer (24 versus nine months). Therefore, the longer survivorship of patients with advanced disease may contribute to a greater likelihood of CNS metastases.
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PMID:Metastasis to the central nervous system from colorectal cancer. 746 89

Several metastatic models have been developed using clonal selection of human malignant cells metastasizing into a specific organ in NIH-I Swiss immunodeficient mice. The organs of choice were the central nervous system (CNS), targeted by metastases of malignant melanoma, and the liver, with metastases of colon adenocarcinoma. Additional models of adrenal metastases by malignant melanoma, and CNS involvement by implanted human lung squamous carcinoma or lymphoblastoid cells, are also available. Organ metastases, as well as the effects of treatment, were confirmed by autopsies and histological examination of the tissues or by a surgical inspection of the liver. The treatment end points were established as the increases in survival times of treated mice relative to placebo-treated controls. Camptothecins injected i.m. or delivered via gastrointestinal tract inhibit the growth of CNS metastases and increase the survival of treated animals. 9-Amino-20(S)-camptothecin was effective in the CNS model and in the model of liver metastases. The drug increased 3.3- and 5.7-fold the survival rates relative to untreated controls with metastases of colon adenocarcinoma to the liver, and all camptothecins were significantly more effective than 5-fluorouracil, currently a drug of choice in treatment of this disease. The xenograft models of metastases are available for studies of drug passage through the blood-brain barrier optimization of drug delivery to the liver, and for the development of new camptothecin-based treatment strategies.
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PMID:Growth inhibition of human cancer metastases by camptothecins in newly developed xenograft models. 758 47

Models for hematogenous spread of human cancer to the central nervous system (CNS) were established by injecting human tumor cells into the internal carotid artery of nude rats. With 4 out of 10 cell lines, belonging to four different tumor types, metastases developed in all injected animals. Tumor growth manifested clinically as neurological symptoms which appeared after a median latency ranging from 19-87 days for the different tumors. The H-146 and DMS-273 small cell lung cancers and the LOX melanoma almost exclusively gave meningeal tumors, whereas with FEMX-I melanoma cells bone metastases in the skull dominated. For these tumor types a correlation was found between the capacity for experimental metastasis formation and the s.c. tumorigenicity. In agreement with clinical experience, none of the 2 sarcoma and 2 glioblastoma lines gave CNS metastases. With a modified microsurgical technique, allowing for repeated ipsilateral intracarotid injections, we analyzed the drug concentrations obtained in tumor and surrounding brain tissue after i.v. treatment with doxorubicin. The concentration in the LOX tumor reached therapeutic levels and was approximately 100 x higher than in normal brain tissue, both with and without intraarterial pretreatment with arabinose. In the same model, the tissue concentrations of 9.2.27-abrin immunotoxin 10 min after intracarotid injection were examined. Although the levels were low, a tumor to brain concentration ratio of up to 9 was achieved. The data demonstrate that clinically relevant tumor models can be established with the techniques described, and these models may successfully be used to evaluate the pharmacokinetics and effect of intravenous or intraarterial therapy.
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PMID:Nude rat models for human tumor metastasis to CNS. Procedures for intracarotid delivery of cancer cells and drugs. 769 16

From December 1991 to October 1992, 77 lesions in 25 consecutive patients were treated with Gamma Knife radiosurgery. Thirteen patients (52%) had multiple metastases up to sixteen lesions and twelve patients had a single metastasis. The volume of the largest tumour treated was 12.5 cm3. Karnofsky performance status (KPS) of the patients was 20-90% (mean 70). Marginal tumour dose given was 18 to 35 Gy (mean 26.1 Gy) in 30 to 90% isodose line according to the tumour volume and site. All but two patients were followed by MRI or CT scan repeatedly for a minimum of 6 month or to death. All but one of the tumours were locally controlled. Seventeen patients died during follow up and in four death was due to remote CNS metastases. The median survival for this minimally selected group of patients was 8.5 months, and the median survival for the patients with a single metastasis was 10.5 months. In patients with multiple metastases the median survival reached only 2.5 months but in 11 patients out of 13 patients neurological symptoms and signs improved or stabilized shortly after radiosurgery.
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PMID:Gamma knife radiosurgery of a series of only minimally selected metastatic brain tumours. 771 42

Response rates of over 50% can be achieved in patients with metastatic transitional cell carcinoma of the bladder treated with cisplatin-based chemotherapy. With prolonged survival, intraparenchymal brain metastases may occur in as many as 12% of patients who received methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) chemotherapy. Meningeal carcinomatosis from urothelial cancer is rare, however. A 71-year-old man, with metastatic, transitional cell carcinoma of the bladder, attained an excellent partial response to M-VAC chemotherapy. He subsequently presented with an acute confusional state 6 months after diagnosis. Head computed tomographic studies were nondiagnostic. Gadolinium-enhanced magnetic resonance images (MRI), however, demonstrated multifocal 1-cm nodules in the brain parenchyma and enhancement of the meninges. Meningeal carcinomatosis was confirmed by lumbar puncture. Records of 40 patients with advanced transitional cell carcinoma of the bladder treated with chemotherapy between 1977 and 1992 at a cancer center were reviewed retrospectively for the occurrence of documented meningeal carcinomatosis, intraparenchymal brain metastases, or both. Among 13 responders, only 1 other patient, a 64-year-old man, was identified who had minimal metastatic disease and attained a complete response to methotrexate and cisplatin. The patient relapsed 2 years after response, with cerebellar metastases and meningeal carcinomatosis. Central nervous system (CNS) metastases in patients with transitional cell carcinoma of the bladder are unusual. Although parenchymal brain metastases may be more common after prolonged remissions induced by combination chemotherapy, meningeal carcinomatosis remains uncommon. MRI may be a useful adjunct in the diagnosis of CNS metastases. A high index of clinical suspicion for the occurrence of CNS metastases from transitional cell carcinoma is encouraged.
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PMID:Meningeal carcinomatosis from transitional cell carcinoma of the bladder. 831 86

Intramedullary metastatic disease accounts for 5% of CNS metastases. This report describes a 47-year-old female with the simultaneous presentation of primary breast carcinoma and a solitary brain metastasis, both treated surgically. She represented with an increasing hemiparesis due to a spinal cord metastasis 4 years later. The cord lesion was removed microsurgically using a CO2 laser. Postoperatively she made a good recovery and lived independently for 2 years. The rationale for aggressive surgical treatment is discussed.
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PMID:Successful removal of intramedullary spinal cord metastasis: case report. 838 21

Positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) was performed in 19 patients with brain metastases from non-central nervous system (CNS) neoplasms and one patient with a primary CNS lymphoma. Various histopathologic types were represented by the primary neoplasms in the patients with metastases. Only 21 of the 31 lesions (68%) were detected with FDG PET as discrete, metabolically active foci (relative to surrounding structures). Six of the nondetected lesions may have been nondiscernible owing to their small size and/or isointensity relative to closely apposed normal gray matter. However, four lesions of at least 1.2 cm in diameter showed frankly decreased FDG accumulation relative to normal brain. These findings suggest that studies of FDG accumulation by a variety of non-CNS neoplasms and their CNS metastases are in order and that extrapolation of the successes of FDG PET in imaging of primary glial tumors to imaging of brain metastases should proceed with caution.
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PMID:Brain metastases from non-central nervous system tumors: evaluation with PET. 841 53

An incidence of cerebral metastases secondary to epithelial ovarian cancer as high as 11.6% has been reported in small series and related to the prolonged survival of ovarian cancer patients treated with platinum compounds (Hardy, J. R., and Harvey, V. J. Gynecol. Oncol. 33, 296-300, 1989). A review of the histories of 413 ovarian cancer patients, treated from 1981 to 1989 with platinum-based combination chemotherapy according to the protocols of the Gruppo Oncologico Nord Ovest (GONO) (North West Oncology Group), showed that only 9 patients (2.2%) developed clinical evidence of cerebral metastases. Six of 9 patients had FIGO Stage IIIc disease and 1 each with FIGO Stages Ic, IIc, and IV. All these patients had received cisplatin or carboplatin-based combination chemotherapy. Clinical response to initial cytotoxic therapy was as follows: complete response, 3 patients; partial response, 4 patients; stable disease, 1 patient; progressive disease, 1 patient. Cerebral metastases occurred at a median of 19 months (range 3-36) from diagnosis and median survival of patients with central nervous system (CNS) metastasis was 26 months (range 10-81) from diagnosis of primary disease and 8 months (range 1-45) from diagnosis of CNS involvement. The incidence of CNS metastases in our series is similar to that reported in the past and significantly lower than figures reported by the above mentioned paper. On the basis of our data we do not agree with Hardy and Harvey about the relationship possibly existing between prolonged survival and incidence of CNS metastases and, particularly, about the need for prophylactic cranial irradiation.
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PMID:Cerebral metastases secondary to ovarian cancer: still an unusual event. 848 58


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