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

Extraluminal cancer spreadings such as peritoneal dissemination, liver metastases, lymph node metastases and infiltration to surrounding organs were examined in 236 patients with gastric cancer by ultrasound (US). Peritoneal dissemination was found in 36 of 236 cases. Ascites, nodules in the cul-de-sac and thickened wall of the transverse colon could be detected by US in 24 of 36 cases (sensitivity of 67%). Liver metastases were detected in 18 out of 23 cases (78%). Infiltration to the surrounding organs, mainly to the pancreas, was impossible to demonstrate by US. Sensitivity was 44% (17/39). Lymph node metastases in the region around the celiac axis were indicated in 30 of 40 cases (75%) by US. Para-aortic nodal metastases were also detected in 27 of 34 cases (79%). Ultrasonic images of para-aortic lymph node metastases were classified into four figures: plate type, sandwich type, unilateral multiple type, unilateral solitary type. These types were not necessarily the same in indication of laparotomy, selection of combined or adjuvant therapy, significance of nodal dissection and also prognosis. Solitary involved para-aortic node near the left renal vein should be removed in a case free from peritoneal dissemination or liver metastases. Ultrasound could be very useful in screening patients with gastric cancer for peritoneal dissemination, liver metastases and lymph node metastases.
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PMID:[Pre-operative staging in advanced gastric cancer by ultrasound; with special reference to para-aortic lymph node metastases]. 354 75

Lymph node metastases are important determinants in the prognosis of primary colorectal cancer. Although it has been established that enlarged, palpable lymph nodes contain metastases in less than half of the cases, no definitive data concerning the incidence of metastases in lymph nodes measuring 5 mm or less are available. We treated the surgical specimens of 52 consecutive patients who had colon cancer with a lymph node clearance technique at the Roswell Park Memorial Institute, Buffalo. We found 2699 lymph nodes in the 52 specimens, with a mean of 52 lymph nodes per specimen (range, five to 151). Sixty-four lymph nodes were found with metastases in 21 (40%) of the 52 patients. Fifty-nine of 64 of the lymph nodes were reexamined and remeasured. Thirty-nine lymph node metastases measured less than 5 mm, 13 were between 5 and 10 mm, and eight were larger than 10 mm. We concluded that lymph node metastases in colon cancer occur most frequently in lymph nodes measuring less than 5 mm (small lymph nodes). The use of lymph node clearing techniques in surgical specimens improves detection of small lymph node metastases and thereby diminishes understaging.
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PMID:Metastases in small lymph nodes from colon cancer. 367 88

Reviewing the axillar lymph node status in 196 consecutive breast cancer patients and comparing clinical assessment to pathological findings, the author found an overall erroneous appraisal of 39% with 45% false negative and 29% false positive cases. In more than 15% of the cases there were skip metastases. In the T1 group, stratification to the greatest diameter of the tumor gave a significant difference (P less than 0.01) between axillar LNI in tumours smaller or equal to 1 cm and those with a diameter between 1 and 2 cm. Lymph node metastases in the interpectoral space is extremely rare (less than 0.5%) and always macroscopic. Axillar lymph nodes were always invaded in T4 tumours. The author warns against clinical studies based upon clinical assessment of the axillar lymph node status. He advocates a complete axillar lymph node dissection in all cases. He suggests that the T1 classification should be restricted to tumours with a diameter smaller or equal to 1 cm.
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PMID:Clinical evaluation of axillar lymph nodes compared to surgical and pathological findings. 370 22

From 1960 to 1982, a total number of 216 patients with Stage I melanoma underwent local excision as the single treatment. Life-table analysis was performed on 211 evaluable patients to investigate the prognostic value of several factors on survival as well as disease-free survival. The influence of sex, age, localization of the tumor, and margin of the excision on prognosis was not statistically significant. The Clark level and Breslow thickness were important factors to predict the prognosis. Local recurrence occurred in only one patient; in most cases tumor growth close to the original site of excision indicates early manifestation of hematogenic spread. Lymph node metastases developed in 31 patients; ten of them remained free of disease after node dissection. Six patients died from hematogenic metastases without nodal involvement. Tumors with thickness less than 1.5 mm have excellent prognosis regardless of the location of the melanoma or the margin of the excision. With increasing thickness of the tumor, prognosis is proportionally worse. By performing wide excisions the final outcome can not be improved.
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PMID:Prognoses and surgical treatment of patients with stage I melanomas of the skin: a retrospective analysis of 211 patients. 371 94

When using routine methods of lymphadenectomy the excisable parietal groups of lymph nodes are left intact. This is considered to be an unjustified ground for refusal of a curative operation for gastric cancer Metastases to lymph nodes of these groups are frequently found in gastric cancer. The authors recommend to use extensive lymphadenectomy when the removed preparation includes the lymph nodes of parietal groups. It was shown that the degree of the operative risk did not increase in this case. Five year survival was achieved in certain patients having metastases to lymph nodes of parietal groups.
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PMID:[Extensive lymphadenectomy in gastrectomy and gastric resection in cancer]. 400 19

A study of 153 patients with squamous cell carcinoma of the vulva is reviewed. Regional node metastases were present in 20%, and lymphatic spread proved the single most significant prognostic factor in this disease. Recurrent carcinoma developed in 47% of cases with nodal metastases. Lymph node metastases were directly related to stage of disease, tumor differentiation, lesion size, and depth of invasion. Sixty percent of nodal disease was not suspected by clinical examination. No patient developing recurrent disease after identification of positive nodes survived the disease. Surgical staging based only upon size of lesion and presence of nodal metastases appears to offer a clearer prognostic profile than conventional clinical staging. The pattern and frequency of nodal spread suggest that in selected instances modifications of the standard surgical treatment of vulvar cancer may be appropriate.
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PMID:Lymphatic spread in carcinoma of the vulva. 401 31

In this retrospective study 127 patients with a squamous cell carcinoma of the nasal vestibule were evaluated. Though treated with curative intent, 23 patients eventually died with or because of tumour. Lymph node metastases were of the utmost importance and were detected in 31 patients, in two-thirds of whom the treatment was unsuccessful. Since elective treatment of possible lymph node metastases is a possibility to improve prognosis we have established a high-risk group in which metastases are to be expected and elective treatment of the neck should be considered. These patients are those with a large lesion on presentation and those with a poorly differentiated tumour.
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PMID:Carcinoma of the nasal vestibule: prognostic factors in relation to lymph node metastasis. 405 21

The study reported in this paper was concerned with the problems and results of surgical treatment of invasive vulval carcinoma. Surgery was performed on 228 patients, 101 of them (44.2%) with Stage III and Stage IV carcinoma. In 156 women radical vulvectomy was combined with pelvic and inguinal lymphadenectomy. Lymph node metastases were found postoperatively in 110 patients (48%). Thirty-six patients (32.7%) had lymph node metastases in the small pelvis. The operation coefficient was 82%; postoperative morbidity was 21.4%, postoperative mortality 0.4%. Among the 228 patients operated on the 5-year survival rate was 59.2% (135 patients), and the three-year survival rate 71% (163 patients).
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PMID:[Operative treatment of vulvar cancer]. 405 43

Lymph node metastases occurring within 150 days of local non-curative irradiation and excision of a transplantable mammary adenocarcinoma (LMCI) have been scored and their growth measured in isogeneic rats. Single doses (5-40 Gy) of 60Co gamma-rays were given to the primary at 8-10 mm diameter and these were excised either immediately or up to 30 days later. From the results it is concluded that approximately half of all rats have occult dissemination at the time of irradiation. Only these form metastases after the early excision of 10-40 Gy treated tumours but the number of positive sites per animal is significantly reduced. Delayed excision of the irradiated primary permits the further seeding of metastases and, with its regrowth, the incidence of positive rats and the mean number of metastases per animal is restored to that observed after control surgery. This process was dependent on the radiation-induced delay in growth of the primary tumour. However, all metastases, irrespective of site, radiation dose, and time of primary tumour excision showed a growth rate characteristic of the untreated LMCI tumour. No evidence was obtained for an enhancement in the dissemination of metastatic cells from the irradiated but regrowing primary tumour. However, an alteration in the pathways of lymphatic dissemination leading to an increased number of metastases seeding the mediastinum and abdominal lymph nodes may have occurred.
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PMID:Metastasis and the excision of irradiated LMCI tumours in the rat. 407 Jun 81

As part of a detailed study of prognostic factors in breast cancer, we have analyzed the ten year survival rates of 524 patients with primary invasive carcinomas 2.0 cm or less in diameter (T1). This report describes the subset of 142 patients (27%) who had metastases only in axillary lymph nodes (T1N1M0). All the patients were treated initially by at least a modified radical mastectomy. Factors associated with a significantly poorer prognosis were: axillary lymph node metastases suspected on clinical examination; perimenopausal menstrual status at diagnosis; tumor larger than 1.0 cm; prominent lymphoid reaction; infiltrating duct or lobular rather than medullary, colloid and tubular carcinoma; and blood vessel invasion. When compared with those patients with negative nodes (T1N0M0), the patients with one or more lymph node metastases had a significantly poorer prognosis. Generally, survival rates tended to diminish as the number of involved lymph nodes increased. In this respect, comparison of patients with one-three and four or more nodal metastases provided a significant discrimination of prognostic groups in the entire series. However, for patients with disease limited to Level I, the same discrimination was obtained comparing those with one-two and three or more positive nodes. In the subset with a single lymph node metastasis, the size of the metastasis (micro or less than or equal to 2 mm vs macro or greater than 2 mm) was not significantly related to prognosis. Lymph node metastases were significantly less frequent among tumors smaller than 1 cm and special tumor types (medullary, colloid, lobular and tubular). However, no factor proved to be a reliable predictor of the presence of axillary metastases for the single largest group consisting of patients with infiltrating duct carcinoma 1-2 cm in diameter.
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PMID:Prognosis in stage II (T1N1M0) breast cancer. 627 Oct 83


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