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

To achieve the visualization of regional lymph nodes by lymphoscintigraphy, 21 patients with head-and-neck cancer were studied with the aid of 99mTc-labeled rhenium sulfur colloid (99mTc Re). Four injection sites were selected; the injections were given into the subcutaneous tissue of the parietal area of 11 patients, into the submucosa of the retromolar area of 6 patients, into the subcutaneous tissue of the postauricular area of 2 patients, and into the thyroid glands of 2 patients. Lymphoscintigraphy was done three hours after the injection. The cervical regions were visible in 85.7% of the patients on the affected side and in 90.5% on the healthy side. The visualization comprised the following regions: submental, submandibular, deep cervical, accessory, and supraclavicular regions. In total, 102 nodes were visualized on the affected side (average 4.8 per patient) and 110 nodes in the healthy side (average 5.5). Histologically, 15 of 21 patients had lymph nodes metastases and 6 did not. Of these 21 patients, 66.7% (14/21) had confirmed lymph node metastases in the visualized regions. This technique appears to be a relatively easy and efficient method of imaging the regional lymph nodes in head-and-neck cancer both before treatment and after neck surgery.
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PMID:Lymphoscintigraphy of head-and-neck cancer. 144 66

While it is estimated to be one of the most prevalent cancers in the world, cancer of the head and neck is an uncommon malignant tumor in the United States and accounts for only 5% of all malignancies. Head and neck cancer is a term that encompasses heterogeneous groups of patients. The most common histologic type is the squamous cell carcinoma. Cancer of the oral cavity is the most common site among the head and neck tumors. The majority of patients (70-80%) present with locally advanced (Stage III and IV) cancer. The standard treatments of surgery and/or radiotherapy have a high cure rate for patients with early disease (Stages I or II), but not for patients with locally advanced tumors. Local recurrence and persistent disease occur in more than 60% of patients present with advanced cancer, and approximately 10%-20% of all patients develop distant metastases. Chemotherapy is usually used for palliation in patients with recurrent and metastatic head and neck cancer at which time these patients have failed the definitive therapy of surgery and/or radiotherapy and the chances for salvage is almost nil. With the identification of more active cytotoxic agent(s) and combinations, chemotherapy is being investigated as part of multi-modality treatment in patients with previously untreated and locally advanced head and neck cancer.
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PMID:Clinical trials with fluorinated pyrimidines in patients with head and neck cancer. 266 85

A series of 97 consecutive patients with well-differentiated thyroid carcinoma treated between 1941 and 1970 presented with distant metastatic disease or extensive nonresectable local neck disease or had residual carcinoma after thyroid resection. Men 40 years of age or younger and women 50 years of age or younger were considered at low risk for dying of disease; older patients were considered at high risk for dying of disease. Of 17 patients with distant metastatic carcinoma, 40% of younger patients in the low-risk group and 92% of older patients in the high-risk group died. Of 80 patients with unresectable or residual local neck cancer, only 13% of younger patients but 71% of older patients died. Survival related better to risk group classification as defined by age and sex than to any details of disease presentation or management. Treatment was far more successful in patients in the low-risk group.
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PMID:Surgically incurable well-differentiated thyroid carcinoma. Prognostic factors and results of therapy. 335 83

One hundred eighty-two previously untreated head and neck cancer patients were stratified by pretreatment-quantitated natural killer (NK) cell activity (less than 60 lytic units [LU] vs greater than or equal to 60 LU) and followed up longitudinally for the development of distant metastases (DMs). Patients with NK activity of less than 60 LU (n = 99) developed DMs at a higher rate than the remaining group. Further stratification of patients on the bases of both regional nodal disease and treatment demonstrated that the risk of DMs predominantly involved one group, ie, patients with histopathologically documented nodal metastases, NK activity of less than 60 LU, and prior treatment with combined surgery and radiation therapy (12[46%] of 26 patients). If one of these three factors was absent, the risk of DMs was not greater than 12%, regardless of the factor. Head and neck cancer patients should be stratified by pretreatment natural immune status to determine the impact of therapy on disease progression.
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PMID:Multimodality therapy and distant metastases. The impact of natural killer cell activity. 366 48

Fifteen patients with differentiated thyroid cancer were examined following 131I thyroid ablation, of these seven were examined after radio-iodine therapy to disseminated neck cancer. They had no further radio-iodine uptake and were evaluated using a 201Tl scan. In thirteen patients there was a good correlation between the results and the clinical diagnosis, showing no uptake in seven subjects with negative clinical findings, and positive delineation of tumour tissue in the neck region in six patients. The remaining two patients with lymph node metastases after previous radio-iodine irradiation showed marked clinical regression of the metastases with absent uptake of both 131I and 201Tl, probably due to radiation-induced changes. The comparison of thallium scans with plasma thyroglobulin levels showed certain differences (high plasma thyroglobulin without any proof of remaining thyroid tissue in one patient and normal/low plasma thyroglobulin in the presence of a tumour in two patients) but both measurements could give additional information. It is believed that while in the differential diagnosis of a thyroid nodule no important information could be expected of scanning (compared with the high value of aspiration biopsy), the evaluation of patients without 131I uptake by 201Tl scans could provide important information for further therapy.
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PMID:The rational use of 201Tl scintigraphy in the evaluation of differentiated thyroid cancer. 674 96

Head and neck cancer is estimated to be one of the most prevalent cancers in the world. This tumour type accounts for 5% of all new cancer cases in the US and Europe each year. Patients with locally recurrent or metastatic squamous cell carcinoma of the head and neck have a poor prognosis, with a median duration of survival between 4 and 6 months. During the past few years, screening for potentially active new compounds, new associations and new modalities of chemotherapy administration have had some degree of success. Clinical investigations have also focused on the addition of chemotherapy to locoregional treatment for patients with locally advanced disease. Induction chemotherapy or concomitant chemo- and radiation therapy can result in high response rates, and reduced incidence of distant metastases. However, there is no clear demonstration of any benefit from the addition of chemotherapy to locoregional therapy on overall survival in patients with resectable disease. In patients with resectable laryngeal or hypopharyngeal cancer, chemotherapy combined with radiotherapy can be considered as a standard treatment option for larynx preservation, keeping total laryngectomy reserved for salvage therapy. In patients with unresectable head and neck cancer, simultaneous chemoradiotherapy has been shown to improve locoregional control and survival, at the cost of greater toxicity. Outside clinical trials, this approach can also be considered as a standard therapy for unresectable disease.
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PMID:Head and neck cancer: guidelines for chemotherapy. 874 Dec 33

Head and neck cancer is very suitable for investigation with PET (positron emission tomography), usually owing to the locoregional spread at the time of diagnosis. Thus, the data collected enable any lesions present to be visualised. Evaluation of tumour metabolism with PET may simplify the diagnosis of metastases, and be of predictive value, enabling response to radiotherapy and cytostatic therapy to be predicted. It serves as a complement to CT (computed tomography) and MRI (magnetic resonance imaging) in the diagnosis of recurrence, and is thus useful in planning surgical intervention. Methods capable of distinguishing hypoxic or rapidly dividing cells can be useful in the choice of effective treatment methods such as hyperfractionated radiotherapy, drugs which enhance radiosensitivity, the degree of radical surgery, and the use of gene therapy.
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PMID:[PET-findings in head-and neck cancers]. 983 63

Thymidine phosphorylase (Th.P) is an angiogenic factor shown to induce endothelial cell migration and proliferation. On the other hand, loss of wild type p53 function leads to down-regulation of thrombospondin-1, an inhibitor of angiogenesis. In this immunohistochemical study we investigated the intratumoural angiogenesis and thymidine phosphorylase (Th.P) expression in paraffin-embedded bioptical material from 104 locally advanced squamous cell head and neck cancers. The nuclear accumulation of mutant p53 protein and the cytoplasmic expression of bcl-2 protein was also assessed. High vascular grade was observed in 56% and high Th.P tumour cell reactivity in 48% of cases. High microvessel score was associated with an increased percentage of cancer cells expressing thymidine phosphorylase (P = 0.001). Increased p53 nuclear accumulation also correlated with high vascular grade (P = 0.001). High histological grade and absence of bcl-2 overexpression were associated with lymph node involvement (P = 0.002 and P = 0.02 respectively). No correlation of clinically detected lymphadenopathy with angiogenesis and p53 was observed. We conclude that intense neo-angiogenesis in locally advanced squamous cell head neck cancer is a frequent event, which is associated with nuclear p53 accumulation and thymidine phosphorylase overexpression.
Clin Exp Metastasis 1998 Oct
PMID:Neo-angiogenesis in locally advanced squamous cell head and neck cancer correlates with thymidine phosphorylase expression and p53 nuclear oncoprotein accumulation. 993 13

We have previously reported that immune anti-tumor effector cells, both cytotoxic T lymphocytes (CTLs) and IL-2-activated natural killer (A-NK) cells, are effective at eliminating human head-and-neck cancer (HNC) targets in vitro and in vivo in xenograft models. In this study, these 2 types of human effector cell were compared for the ability to prevent the development of lymph node metastases in a metastasis model of human squamous-cell carcinoma of the head and neck (SCCHN) established in nude mice. A tumor cell line, OSC-19, was injected into the floor of the mouth in nude mice, and the tumor grew progressively and metastasized to cervical lymph nodes by day 21. As effector cells, a human HLA-A2-restricted CTL line recognizing a shared antigen on OSC-19 and human non-MHC-restricted A-NK cells were used. Both types of effector cell mediated high levels of lysis against OSC-19 targets in 4-hr (51)Cr-release assays. Administration of human CTLs or A-NK cells and IL-2 to the site of tumor growth in mice with 7-day OSC-19 tumors resulted in significant reduction of the number of lymph node metastases relative to untreated or sham-operated controls or to mice treated with IL-2 without the effector cells. Our results suggest that in a xenograft model of human SCCHN implanted in the oral cavity of nude mice, the development of lymph node metastases can be successfully controlled by adoptive transfer of human SCCHN-specific CTLs or SCCHN-reactive A-NK cells plus IL-2.
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PMID:Immunotherapy with effector cells and IL-2 of lymph node metastases of human squamous-cell carcinoma of the head and neck established in nude mice. 1040 67

Carcinoma cell lines are frequently refractory to transforming growth factor-beta (TGF beta)-mediated cell cycle arrest. Whether and how TGF beta signaling is disrupted in the majority of human tumors, however, remains unclear. To investigate whether TGF beta signaling might be disrupted by inactivation of the key signaling molecule, the TGF beta type I (T beta R-I) receptor, and whether or not T beta R-I inactivation is associated with late stage disease, we conducted a comprehensive structural analysis of the T beta R-I gene in fine-needle aspirates of 23 head-&-neck cancer metastases. We encountered 4 different mutations of T beta R-I, 3 of which have not been previously identified. In 1 case, we found a somatic intragenic 4-bp deletion predicting for a truncation of the receptor protein. This is the first example of a true loss-of-function mutation of T beta R-I in a human epithelial neoplasm. In 2 other cases, we identified missense mutations located between the juxtamembrane- and serine-threonine kinase domains. One of these resulted in an alanine-to-threonine substitution (A230T), which disrupts receptor signaling activity by causing rapid protein degradation within the endoplasmatic reticulum. This represents a novel mechanism of inactivation of a TGF beta signaling intermediate. Finally, we identified a serine-to-tyrosine substitution at codon 387 (S387Y) in a metastasis but not in the corresponding primary tumor. We had previously shown this S387Y mutant to be predominantly associated with breast cancer metastases and to have a diminished ability to mediate TGF beta-dependent signaling. In aggregate, these findings provide further support for the hypothesis that inactivation of the TGF beta signaling pathway occurs in a significant subset of human cancers.
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PMID:Novel inactivating mutations of transforming growth factor-beta type I receptor gene in head-and-neck cancer metastases. 1147 74


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