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

1,271 patients with breast cancer treated at the Institut Gustave Roussy between 1967 and 1972 and with a minimum follow-up of 10 years, have been studied in order to analyse the risk factors for bilateralization. Patients with metastases at presentation (160) who have an incidence of bilateralization at two years of 20% have been excluded since the contralateral tumor is regarded as part of the metastatic process. For 1,111 patients, non-metastatic at presentation, the following factors have been studied: age, T-stage, N-stage, tumor grade, tumor growth rate (doubling tumor size in less than six months) and the presence of inflammatory signs. Of these factors, only advanced T stage, fixed axillary lymphadenopathy and the presence of inflammatory sign were associated with a significantly increased risk of bilateralization. For patients presenting with T1 tumors the incidence of bilateralization is 19% at 10 years but this is probably because relatively more of these patients lived long enough to develop a second cancer. A more detailed histopathological study was performed on 682 patients whose tumors were operable at presentation and for whom the following histological characteristics are known: type, grading (Scarff and Bloom), number of axillary nodes involved by tumor and anatomical size of the tumor. None of these characteristics was found to increase the risk of bilateralization. Comparing the two breast tumors (and excluding those with a diffuse infiltration in either breast) in 74 patients in whom the exact tumor site was known, in only 7, was the second tumor a "mirror-image" of the first. Overall, MO patients with bilateral tumors have a decreased survival compared with those with unilateral tumors. For those patients operable at presentation, the 10 year survival is 51% and 63%. The conclusions of this study are that there are two populations of patients with bilateral breast cancer: Those in whom the controlateral tumor is part of a generalized metastatic process and occurs particularly in those with a poor prognosis (metastases at presentation, inflammatory carcinomas, fixed lymphadenopathy). Those in whom there is a relatively long interval (5-10 years) between the development of the two tumors who have not any metastases. This population particularly comprises patients with T1 tumors thus for whom continuing clinical and mammographic follow-up is justified.
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PMID:[Bilateralization of breast cancer]. 373 Jun 33

From 1974 to 1983, 4 patients with multiple primary bronchogenic carcinoma were treated. It comprised 0.64% (4/622) of all lung cancers admitted to our hospital during the same period. Out of these 4 patients, 2 were synchronous and 2 were metachronous. 3 were bilateral, the other was unilateral. 3 were preoperatively misdiagnosed as pulmonary metastases and the fourth case was confirmed only postoperatively. The common pathologic combination was squamous carcinoma and squamous carcinoma. Two patients with synchronous cancers survived for 15 and 42 months after the operation. Two with metachronous cancers are living up to now (for more than four years) after the second cancer had been removed. The diagnosis and treatment of this cancer are discussed. The authors believe that the survival rate may be increased by early diagnosis and prompt operation.
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PMID:[Diagnosis and treatment of multiple primary bronchogenic carcinoma]. 374 54

The numbers of second cancers among 182,040 women treated for cervical cancer that were reported to 15 cancer registries in 8 countries were compared to the numbers expected had the same risk prevailed as in the general population. A small 9% excess of second cancers (5,146 observed vs. 4,736 expected) occurred 1 or more years after treatment. Large radiation doses experienced by 82,616 women did not dramatically alter their risk of developing a second cancer; at most, about 162 of 3,324 second cancers (approximately equal to 5%) could be attributed to radiation. The relative risk (RR = 1.1) for developing cancer in organs close to the cervix that had received high radiation exposures--most notably, the bladder, rectum, uterine corpus, ovary, small intestine, bone, and connective tissue--and for developing multiple myeloma increased with time since treatment. No similar increase was seen for 99,424 women not treated with radiation. Only a slight excess of acute and non-lymphocytic leukemia was found among irradiated women (RR = 1.3), and substantially fewer cases were observed than expected on the basis of current radiation risk estimates. The small risk of leukemia may be associated with low doses of radiation absorbed by the bone marrow outside the pelvis, inasmuch as the marrow in the pelvis may have been destroyed or rendered inactive by very large radiotherapy exposures. There was little evidence of a radiation effect for cancers of the stomach, colon, liver, and gallbladder, for melanoma and other skin cancers, or for chronic lymphocytic leukemia despite substantial exposures. An excess of thyroid cancer possibly was related to the low dose received by this organ. Ovarian damage caused by radiation may have been responsible for a low breast cancer risk (RR = 0.7), which was evident even among postmenopausal women. A substantial excess of lung cancer (RR = 3.7) largely may be due to misclassification of metastases and the confounding influence of cigarette smoking. Women who were under 30 or over 50 years of age when irradiated were at greatest absolute risk for developing a second cancer. The RR, however, was higher among those under age 30 years at exposure (RR = 3.9) than among older women. The expression period for radiation-induced solid tumors appeared to continue to the end of life.
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PMID:Second cancers following radiation treatment for cervical cancer. An international collaboration among cancer registries. 385 84

Among 4,184 patients with cancer of the esophagus, 55 second primary cancers were observed, whereas 64 were expected [relative risk (RR) = 0.86]. The absence of an excess risk of alcohol- and tobacco-related cancers was not anticipated. A significant 19% deficit of second cancers was found among 30,843 patients with stomach cancer. Cancer of the rectum, kidney, and lung all occurred significantly below expectation. An excess risk of ovarian cancer (RR = 1.9) was seen in women. Reasons for these findings are not entirely clear. Cancer of the small intestine is rare, and despite a relatively short survival expectation, a moderate excess of second cancers was seen among 868 patients (36 vs. 26.8). Only cancers of the liver and gallbladder were significantly elevated, and the possibility of misclassified metastases is discussed. Colon cancer is one of the most common cancers in Denmark, and 29,490 patients with this disease were at slightly lower risk for development of second cancer (RR = 0.96; 95% confidence interval = 0.9-1.0) than the general Danish population, excluding secondary colon cancers. Esophageal, stomach, and liver cancers occurred less frequently than expected. That cancers of the uterine corpus and ovary were significantly increased supports the notion that common risk factors, such as diet and endogenous hormones, influence the development of these cancers. A significant 23% deficit of second cancers was also found among 26,597 patients with cancer of the rectum, excluding secondary rectal cancer. Significant deficits were seen for cancers of the stomach (RR = 0.5), lung (RR = 0.8), and brain (RR = 0.5), and for multiple myeloma (RR = 0.4). The likelihood of underreporting of second cancers, especially of the digestive system, is discussed. However, cancer of sites previously reported to be associated with rectal cancer, e.g., the colon, breast, and uterus, did not occur below expectation. Cancers of the liver and biliary tract occurred in 4,453 patients; their average survival was only 1 year. Except for a slight excess of cancer of the ovary (5 vs. 1.6), the risk of second cancer development for all sites was consistent with unity (RR = 0.90). The risk of second cancers among 7,752 persons with cancer of the pancreas was not greater than expected (88 vs. 85.2). Males were at significant risk of kidney cancer (RR = 3.2), whereas females showed elevated rates of cancers of the uterine corpus (RR = 3.2) and ovary (RR = 3.1). No site occurred significantly below expectation.
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PMID:Second cancer following cancer of the digestive system in Denmark, 1943-80. 408 3

To lay the groundwork for subsequent chapters in this monograph of multiple primary cancers in Connecticut and Denmark, we present a description of the historical significance of previous studies, focusing on key surveys that have enhanced our understanding of the origins of multiple cancers. Case reports, hospital series, and cancer registry studies have progressively sharpened our perspective on the patterns and causes of multiple cancers. These findings in turn have generated hypotheses about host and environmental determinants of various combinations of cancer and have provided clues to the actual mechanisms of carcinogenesis. The registries of Connecticut and Denmark which began in the 1930s and 1940s, respectively, afford investigators a unique opportunity to analyze the cancer experience of well-defined populations, followed for long periods. The major contribution of this monograph is the evaluation of second cancer risks among long-term survivors of cancer, including relatively rare tumors about which little information currently exists. For patients with a particular cancer, the number of observed second cancers are tabulated over time and compared with those expected if the patients experienced the same rates prevailing in the corresponding general population. We have discussed problems in distinguishing statistical artifacts from biologically plausible associations in light of the potential biases inherent in follow-up surveys of cancer patients; for example, heightened medical surveillance and mistaken metastases could result in false indications of elevated risk. Several differences in the reporting, follow-up, and coding practices between the Connecticut and Denmark registries are described and probably account for many differences in the reported findings.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Introduction to the study of multiple primary cancers. 408 4

A 10% increased risk of developing a second cancer was observed among approximately 36,000 persons reported to the Danish Cancer Registry with a cancer of the respiratory system during 1943-80. This estimate is markedly influenced by a striking tendency by physicians not to report or the Cancer Registry not to accept a report of a second lung cancer following a primary lung cancer (14 observed vs. 99 expected). A significant 30% excess of all second cancer was seen after laryngeal cancer (368 vs. 282), whereas the 22% excess following cancer of the nasal cavities and paranasal sinuses did not quite reach the level of statistical significance (95% CI = 0.9-1.6). For cancers of the lung and larynx, second cancers arose mainly in the buccal cavity, bladder, kidney (after lung cancer only) and lung (after laryngeal cancer only). These second cancers may be due to common carcinogenic factors, most likely tobacco. Elevated risks of second cancers of the breast, cervix uteri, and other female genital organs were found consistently. Radiotherapy may have contributed to the increased risk of breast cancer, but the excess risk of cancer of the female genital organs other than the cervix was unexpected. Although not significant, the risk of esophageal cancer following cancer of the larynx was below expectation (1 vs. 4.1), which was surprising because alcohol consumption and smoking are thought to be common risk factors for these 2 sites. Significant excesses of pancreatic cancer were observed following cancers of the lung, larynx, and nasal cavities, which might be due to more careful medical surveillance of these patients or to common risk factors such as cigarette smoking. Finally, the risk of a patient developing liver cancer after lung cancer was significantly elevated (22 vs. 11.6). This increase is unlikely to be due to misdiagnosed metastases from the lung, inasmuch as the risk was generally elevated throughout the observation period.
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PMID:Second cancer following cancer of the respiratory system in Denmark, 1943-80. 408 5

Pulmonary dissemination of breast cancer is frequent in those patients who have died of the disease and in those survivors who have not been cured after removal of the breast and X-ray treatment in the advanced states of the disease. When the metastases are identified, they are almost always multiple and bilateral. The appearance of a solitary, late pulmonary coin lesion (metachrone) in someone with breast cancer certainly suggests a pulmonary metastasis, but in fact, it is more likely to be a second cancer than a metastasis, that is, a primary bronchopulmonary cancer. The presence of a solitary pulmonary coin lesion in someone who has or who has had breast cancer, presents therefore certain particular problems. After having controlled by xerotomography or CAT that there is no pulmonary diffusion in either lung, that there is no invasion of other tissues or organs, and after having controlled locally around the breast cancer, then it is imperative to remove the lesion without delay since it is certainly malignant and most probably a second cancer, that is a primary broncho-pulmonary cancer, an adenocarcinoma, detected at an asymptomatic stage. the prognosis of a broncho-pulmonary adenocarcinoma, depends on the precocity of its removal.
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PMID:[Surgical treatment of pulmonary round foci detected in one male and eight female patients with breast cancer. Solitary metastasis, a second primary bronchopulmonary cancer or benign round foci? (author's transl)]. 624 93

Observed and disease-free survivals were evaluated in a consecutive series of 46 resections of pulmonary metastases, with major chance of being a unique phenomenon. Survival curves were computed both since the treatment of primary tumors and since resection of lung metastases. From the treatment of primary tumors, median disease-free interval was 33 months, and rose to 66 months after resection of lung metastases. From the treatment of secondary lung cancers the observed survivals at 1, 3 and 5 years were respectively 60%, 41% and 26%. Survival was clearly affected by development and resectability of post-thoracotomic recurrence (100% without recurrence, 50% with resectable recurrence and 4% with unresectable recurrence). Recurrence rate was related to the first disease-free interval and to the anatomical extent (particularly for nodal status) of secondary lung cancer. This fact suggests that the failure of secondary lung cancer resection may arise either from the primary cancer (poor selection) or from the secondary cancer (delay in treatment).
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PMID:Secondary lung cancer resection with curative intent: causes of success and failure and prognostic factors. 714 60

During the past decade, one of the major changes in the field of oncology has been in the surgical approach to primary and secondary cancer of the liver. As a result of data and experience gained in liver transplantation programs and with the application of vascular surgical principles, resectability rates have been increased. The present rate of 32% has been achieved with an overall 30-day operative mortality rate of 9%. More sophisticated intraoperative and postoperative supports have been essential in achieving these results. The median operating time is now 4 3/4 hours in length. Complications are minimal. The median postoperative hospital stay is now 13 days. During the past decade, 436 patients with liver tumors were treated by the authors. It has become apparent in this experience and in that reported by others that an increasing number of patients with primary liver cancer or metastatic cancer in the liver can be cured by surgery with minimal operative risk. Adjuvant chemotherapy may increase the salvage rate. Current therapeutic results are best evaluated after staging of the liver disease: Stage I (no involvement of margins of resection, hepatic vascular structures or bile ducts; all gross disease removed): 85% three-year survival estimate, using the Kaplan-Meier method, for individuals with primary liver cancer; 71% for those with metastatic colorectal cancer. Stages II and III (regional or extrahepatic spread): 22% three-year survival for individuals with primary liver cancer but no survivors at two years with metastatic colorectal cancer. These data permit better selection of patients who are most likely to benefit from surgery.
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PMID:The seventies evolution in liver surgery for cancer. 722 10

One hundred and four patients with bilateral breast cancers, detected clinically, were studied. Patients with synchronous lesions experienced the worst survival. Lymph node metastases in the second mastectomy had obvious adverse effect on survival. The development of scirrhous carcinoma in the second breast did not alter survival. A maximum of 21 patients might have been adversely affected by the development of a second cancer because of lymph node metastases in the second breast only. Survivorship data suggest the adequacy of treatment of contralateral breast cancers when they become detectable by clinical means alone.
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PMID:Factors influencing survival in bilateral breast cancer. 725 54


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