Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Charcteristics of urethral transitional cell carcinoma in patients who have undergone cystectomy for bladder cancer have been reviewed. The retained urethra was the site of urothelial malignancy in 7 per cent of 348 patients who underwent cystectomy alone. Urethras removed during prophylactic cystourethrectomy in 110 patients showed unsuspected carcinoma in situ and marked atypic in 12.5 per cent. Patients with urethral cancer were at greater risk for meatal and upper tract tumors, a reflection of multicentric tumor neogenesis, and at greater risk for perineal tumors and inguinal metastases, a reflection of direct invasion. Cytology is advocated for examining the retained urethra. However, urethrectomy to include a fossa navicularis and glandular meatus at the time of cystectomy seems justified as a definitive means of guarding against the often asymptomatic and potentially lethal urethral occurrences of transitional cell carcinoma. Furthermore, incontinuity removal of the bladder and urethra more nearly satisfies the requirements for cancer surgery by avoiding transection of a tumor containing viscus.
 ...
PMID:Transitional cell carcinoma of the urethra in men having cystectomy for bladder cancer. 124 14

Radical ilioinguinal lymphadenectomy remains the mainstay of treatment for certain genitourinary carcinomas either with the propensity for or with clinical evidence of metastases to the inguinal-pelvic region. The most frequent indication for this procedure in urologic practice is carcinoma of the penis, followed by carcinoma of the urethra, scrotum, and testis with scrotal invasion. This article reviews the anatomy of the inguinal and iliac region and presents a detailed discussion of the surgical technique and its most recent modifications.
 ...
PMID:Management of regional lymphatic drainage in carcinoma of the penis. 157 21

Primary carcinoma of the urethra is a rare lesion, and there are no standard therapeutical modalities suggested in the literature. We report the case of a 65-year-old woman with transitional cell carcinoma of the distal urethra and metastasis to the inguinal lymph nodes (T2 N1 MO G2). Locally, the lesion was treated by Nd:YAG laser coagulation in four sessions. Ileoinguinal and pelvic lymph-node dissection was performed as a diagnostic and therapeutic procedure. Twenty-eight months after the initial treatment, no evidence of tumor recurrence has been found, although extensive biopsy specimens have been taken. Clinical staging showed no evidence of metastases.
 ...
PMID:[Treatment of distal urethral cancer by laser coagulation]. 281 40

Cancer of the urinary bladder, renal pelvis and ureter is usually transitional cell carcinoma. One third of cases of urethral cancer are also transitional cell carcinoma. In planning the treatment for these urothelial cancers, the anatomic stage (Ta-T4), the histologic grade (1-3), tumor multiplicity and tumor size are generally taken into account. Superficial and low-grade tumors can usually be treated by transurethral resection. However, such patients run the risk of subsequent tumor recurrence in the bladder. This risk may be reduced by intravesical administration of anti-neoplastic agents and BCG. Diffuse carcinoma in situ (CIS) should be treated intravesically before deciding on surgical extirpation of the bladder. Patients with tumors showing deep muscle invasion are usually managed by surgery. The role of adjuvant chemotherapy and/or radiation therapy is currently under investigation. Patients with unresectable cancer and/or metastases are candidates for systemic chemotherapy. This form of therapy is now resulting in an increased number of complete and partial remissions. However, there is still no evidence that systemic chemotherapy prolongs the duration of survival, especially in patients showing partial remission.
 ...
PMID:[Current status of the treatment of urothelial tumors]. 334 82

The results of treatments for localized carcinoma of the urethra were assessed in 21 consecutive women treated at our institutions over a twenty year period. Only one of the tumors was confined to the distal urethra. Eighty-six percent invaded the periurethral tissues and 24% were known to be associated with regional lymph node metastases. Fifty-seven percent were adenocarcinomas. Five patients refused active therapeutic intervention and expired within one to 30 months following diagnosis. Sixteen patients were treated with extirpative surgery, radiation therapy, or combinations of the two. Four are free of disease at one, four, eleven, and 15 years after treatment. Nine developed pelvic recurrences, two developed pelvic recurrences and distant metastases and one developed distant metastases only from six to 72 months (mean, 19 months) after initial treatment. Eight of these 12 patients died at two to 13 months (mean, 8 months) after secondary treatment, two are alive with residual pelvic tumor, and two are clinically free of disease at 7 and 48 months. Only six patients were known to have distant metastases at the time of death and five of these six had adenocarcinomas. Advanced localized urethral cancer in women is difficult to eradicate and usually fatal.
 ...
PMID:Localized urethral cancer in women. 362 Nov 27

Radical ilioinguinal lymphadenectomy remains the mainstay of treatment for certain genitourinary carcinomas either with the propensity for or with clinical evidence of metastases to the inguinal-pelvic region. The most frequent indication for this procedure in urologic practice is carcinoma of the penis, followed by carcinoma of the urethra, scrotum, and testis with scrotal invasion. This article reviews the anatomy of the inguinal and iliac region and presents a detailed discussion of the surgical technique.
 ...
PMID:Radical ilioinguinal lymphadenectomy. 638 82

Urethral bladder substitution is traditionally suggested to good prognosis cystectomized patients. In our series this diversion was chosen for all but the salvage cystectomized men. Between the 1st of February 1991 and the 30th of April 1996, one hundred consecutive men underwent lower urinary tract reconstruction after radical cystoprostatectomy for bladder cancer. An orthotopic ileal neobladder was constructed (in 84 cases according to Kock's technique and in 16 to Studer's technique). Total early complication rate was 29% (29/100), including one perioperative death due to sepsis (mortality rate 1%). 13 patients required surgery (6 retroperitoneal hematomas, 2 wound dehiscences, 1 urinary fistula, 1 lymphocele, 1 rectal-neobladder fistula, 1 rectal-cutaneous fistula, 1 necrosis of the terminal ureter). The late complication rate was 19% (19/100); in 8 cases reparative surgery was required (1 mechanical ileus, 2 bladder neck stenoses, 3 stenoses of the ureteral anastomosis, 2 laparoceles). Four patients were lost at the follow-up; out of the 96 remaining patients only 85 were evaluable for continence: continence during the day was achieved in a period between there to six months in 78 patients (91.7%); night continence was achieved with planned awakenings in 60 patients (70.5%). Eight patients recovered potency, another 7 had successful intercourses after PGE1 intracavernous injection. Renal function based on creatinine value was mildly impaired in 5/78 evaluable patients (6.4%) (peak creatinine 2.8 mg%). In 29 patients tumour progression was observed (29%): 9 pelvic and 20 metastatic. Among the latter 2 urethral recurrences were observed (2%). Twenty-four patients died for metastatic cancer, one for primitive lung cancer, one patient for postoperative septic shock. Adjuvant chemotherapy was administered in 11 patients without complication with an indwelling catheter in the neobladder to avoid drug reabsorption. Four patients showed complete response (2 are alive after a mean of 12 months), 6 were non responders and 1 had a partial response. In our series the ileal neobladder is a feasible method of urinary diversion when urethral cancer involvement is ruled out. Early and late complications are proportionally decreasing with experience and overall continence is satisfactory. The fate of the neobladder depends on both the technique and patient's compliance. Only educated patients can cope successfully with neobladder diversion without major complications. All the patients operated for non salvage cystectomy deserve to be diverted with a continent urethral bladder substitution.
 ...
PMID:[100 orthotopic neobladders in men after cystectomy: a 5-year experience]. 902 35

Urethral cancer is an uncommon tumor (<0.1% of all genitourinary neoplasms). Most of them are squamous carcinoma, adenocarcinomas are about 5% of all urethral cancer. Surgery is the only curative treatment. Surgical technics depend of tumoral location and extension. Conservative surgery is elective if survival is not compromised. Extensive surgery is needed in large lesions. Chemotherapy (CT) and radiotherapy (RT) must be used in patients in which surgery is not possible. Due to the low incidence of this neoplasm is not well established the best therapeutic approach. We present the case of a female (35 years old) with a diagnosis of urethral adenocarcinoma. The initial stage was IV due to non-regional lymph nodes metastases. Surgery was impossible and the patient received chemotherapy and radiotherapy. The patient achieved complete response with CT but a progression was observed in course of RT. The patient died due to systemic progression.
 ...
PMID:[Advanced urethral carcinoma. Which is the best management of a infrequent disease?]. 1504 83

Herein, we report two cases of female urethral cancer. Case 1 presented with acute urinary retention and case 2 presented with a painful perineal mass. Magnetic resonance imaging (MRI) revealed a urethral tumor in both cases. Histopathological examination of transperineal biopsy specimens from both patients suggested clear cell adenocarcinoma in case 1 and squamous cell carcinoma in case 2. Both cases underwent total urethrectomy with partial resection of the vaginal wall and cystostomy urinary diversion. With reference to case 1, obturator lymph node metastases were observed during surgery, and treatment comprised combined radiotherapy to 60 Gy and chemotherapy with 5-fluorouracil and cisplatin following surgery. However, metastases appeared in the lung 6 months after initial treatment and she died 20 months after surgery. For case 2, tumor marker failure was observed 5 months after surgery. The same combined treatment was performed and a complete response was obtained. At 19 months after surgery, the patient showed no evidence of recurrence.
 ...
PMID:[Two cases of primary female urethral cancer]. 1792 63

We performed transurethral resection of the prostate (TUR-P) for a 66-year-old man with benign prostatic hyperplasia. Pathological examination diagnosed poorly differentiated urothelial carcinoma of the urethra with broad prostatic permeation. Random bladder biopsies showed no malignancy, but a second TUR-P revealed urothelial carcinoma in the prostate and bladder neck. Computed tomography (CT) showed lymph node metastases from para-aortic to right/left external iliac and left obturator nodes, so clinical stage T3N2M0 carcinoma of the prostatic urethra was diagnosed. Given the presence of lymph node metastases, neoadjuvant chemotherapy using cisplatin 70 mg/m(2), ifosfamide 1.2 g/m(2) and docetaxel 70 mg/m(2) (PIT) was considered. After chemotherapy, CT showed complete response (CR) of all lymph nodes. Local control in the bladder was considered to be good, so total prostatectomy and retroperitoneal lymph node dissection was selected instead of total cystoprostatectomy. Pathological findings of surgical specimens showed no residual carcinoma in the prostatic urethra or lymph nodes, although prostatic adenocarcinoma was recognized. No recurrences or metastases have been encountered as of 3 years and 5 months since surgery.
 ...
PMID:Advanced carcinoma of the prostatic urethra in a patient with marked response to chemotherapy, leading to preservation of the bladder. 2008 14


1 2 Next >>