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)

Radiation therapy is the elective treatment of inoperable non small cell lung cancer, but is potentially curative only for a few of them: failures result from distant metastases and/or from progressive local disease. During the last years, following the progress in chemotherapy, combining radiation and drugs is becoming a more common approach. Nevertheless, one of the main concerns remains the potential interference between both modalities leading to an increased toxicity, which may outweigh all potential benefit. Several organs can be a target for acute or late toxicity: lung (pneumonitis and fibrosis), esophagus (acute esophagitis, stenosis), heart (pericarditis, impaired ventricular functions, heart failure, coronary stenosis), spinal cord (transient myelopathy, radiation myelitis), skin (moist desquamation, fibrosis, telangiectasia). The current published trials combining drug and radiation appear to be a rather safe approach especially when avoiding concomitant treatment. However, several points remain unsolved: the optimal combination scheme, the real risk of late damage observation including the second cancer occurrence risk. This risk is uneasy to evaluate due to the long latency period. The way of describing the late damage is crucial, seeking for a more precise system of evaluating, recording and reporting late effects, taking into account objective damage as well as the patient's symptoms. Therefore, combining drug and radiation should preferentially be performed within prospective studies, with precise evaluation procedures.
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PMID:[Non small-cell bronchial cancers: toxicity of the association radiotherapy-chemotherapy. Review of the literature]. 794 85

Synchronous primary lung cancers (SPLCs) occur in up to 0.5% of patients with lung cancer. They are first diagnosed intraoperatively or upon pathologic examination of resected tissue in up to 40% of patients with SPLCs. Complete surgical resection is possible in over 90% of patients, with an operative mortality of 2.1%. Despite a high frequency of early stage disease (two thirds of patients have either stage I or II tumors), surgical therapy yields an overall 5-year survival of only 20%, far lower than expected. These findings suggest that the biology of SPLCs is different from that of ordinary lung cancers, or that the diagnosis of SPLCs is being made too often, and that in some patients the second cancer focus actually represents metastatic disease. The use of newer techniques of identifying the molecular and biologic characteristics of these cancers, including analysis of DNA ploidy patterns, may more accurately define SPLC patients. Optimal interventional and preventive therapies remain to be determined.
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PMID:Synchronous primary lung cancers. 846 33

From 1960 to 1986, 397 cases of non-metastatic male breast cancer (MBC) treated in 14 French regional cancer centres were reviewed. The median age was 64 years (range 25-93). TNM classification (UICC, 1978) showed seven T0, 79 T1, 162 T2, 31 T3, 74 T4 and 44 unclassified tumours (Tx). Clinical positive lymph nodes were found in 31% of the patients. 24 patients received radiotherapy only, and 373 underwent surgery, 247 of these with postoperative irradiation. Adjuvant chemotherapy and hormonal therapy were used in 71 and 68 patients, respectively. There were 382 infiltrating carcinomas and 15 pure ductal carcinoma in situ. Lymph node involvement was found in 56% of infiltrating carcinoma. The oestrogen (ER) and progesterone (PgR) receptors were positive in 79% and 77%, respectively, of examined cases. Isolated local and regional recurrence were observed in 8.8% and 4.5% of cases, respectively and 40% of patients developed metastases. The crude survival rates by Kaplan-Meier method were 65% and 38% at 5 and 10 years, respectively, and the disease-specific survival rates (without death due to intercurrent disease or second cancer) was 74% at 5 years and 51% at 10 years. The disease-specific survival rate for pN- and pN+ groups were 77% and 39% at 10 years. The prognostic factors were clinical size (T) and histological axillary status (pN-/pN+). The relative risk of death for pN- was 1.0, 2.0 and 3.2 in the T0-T1, T2 and T3-T4 groups, respectively. For pN+, these relative risks increased 1.9, 3.9 and 6.0 in the same groups. The optimal treatment include modified radical mastectomy and irradiation for cases with risk factors of local relapse (nodal invasion, large tumour with cutaneous or muscular involvement). Locoregional failure had unfavourable prognosis. First-line adjuvant treatment seems to be tamoxifen, due to the very high rate of positive hormonal receptors and the old age of the patients, which contraindicate chemotherapy in many cases. The prognosis of patients with breast cancer is the same in male and female patients when disease-specific survival rate, tumour size and axillary involvement are compared.
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PMID:Male breast cancer: results of the treatments and prognostic factors in 397 cases. 856 48

The results of surgical treatment of 65 patients with pT1 squamous cell carcinoma of the esophagus and the histologic workup of the specimens were analyzed. The treatment of choice was transthoracic enbloc esophagectomy (n = 45); in 16 patients with very distal carcinoma and restrained lung function transhiatal esophagectomy was performed. Two patients with concomitant early gastric carcinoma or lymphoma had total esophagogastrectomy, and in 2 other patients cervical esophagectomy was performed. The postoperative 30-day mortality was 6.1%. 74% of the cases had an infiltration of the submucosa, whereas in 26% the carcinoma was limited to the mucosa. No patients with mucosal carcinoma had lymph node metastases, whereas 23% of the patients with submucosal infiltration showed lymph node involvement. Tumors of other organs, especially stomach and hypopharynx, were found in 15.4% of the patients. The 5-year survival rate of the total group of 65 patients was 61.3%. As 3 patients with mucosal carcinoma died during long-term follow-up due to recurrence or second cancer, no significant prognostic difference was found between patients with mucosal or submucosal infiltration. The survival curves of patients with pN0 and those with pN1 tumors were not significantly different.
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PMID:[Early squamous epithelial carcinoma of the esophagus--multicentricity, metastatic pattern and prognosis]. 864 21

From 1986 to 1992, 55 cases of PPWC were treated with a conservative intent at the Regional Cancer Center (Rennes, France) and Saint-Yves Center (Vannes, France): 16 oropharyngeal posterior wall carcinoma (OP) and 39 hypopharyngeal posterior wall (HP); the mean age of the population was 60.3 years (31-81 years). A previous and simultaneous head and neck cancer was noted in 15 and 13% of cases respectively. Half of the cases (55%) were T1 T2 tumors and 82% were N0 N1. Except for three patients treated by curietherapy (5%), all patients were treated by radiotherapy (RT) alone (75%) or associated with curietherapy (7%) or partial pharyngectomy (13%). 15% received neoadjuvant chemotherapy, mainly for T3 tumors. With a followup of 4-88 months (mean: 23 months) 38% of patients are still alive; 8% of loco-regionally controlled patients died of second cancer or intercurrent disease. The tumor control was 67%. The nodes control was 90%. During the course of the disease, 19% of patients had metastases. The complete response at the end of treatment was 78%. Among these patients, 54% remained definitively free of disease. There is no difference between OP and HP. The analysis of survival curves showed the following points: significant difference between T1 T2, and T2 T3 (P < 0.05), N0 N1 and N2 N3 (P < 0.03), well differentiated histology or not (P < 0.02), RT alone or associated with curietherapy or surgery (P < 0.03) even for limited tumors T1 T2 N0 N1 (P < 0.03). There was no significant difference between group treated or not by chemotherapy even for T3 tumors. These findings do not differ if we consider either OP or HP. We conclude that OP and HP have the same prognostic factors and must be considered as the same clinical entity. For limited tumors T1 T2 N0 N1, patients managed by radiotherapy associated with complementary local treatment (conservative surgery or curietherapy) do better than patients treated by RT alone (plateau 80% at 18 months+vs plateau 25% at 12 months +). For these limited tumors, our recommendation is to treat patients by external RT (50 Gy) and curietherapy boost (20 Gy) rather than by conservative surgery and external RT (70 Gy). These two treatments have the same efficacity but the first one is expected to diminish late complications of RT. Neo adjuvant chemotherapy does not seen to improve survival even for advanced tumors. Generally speaking these results remain poor for locally advanced desease and for undifferentiated tumors. These patients need a new therapeutic approach (concomittant radio-chemotherapy, hyper or hypofonctionnated RT).
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PMID:[Radiotherapy and curietherapy of squamous cell carcinoma of the posterior pharyngeal wall (excluding the nasopharynx)]. 867 82

A 66-year-old man, admitted to the hospital for prostatic carcinoma, presented with a nodular lesion located on the presternal region and a small nodule (0.5 cm in diameter) simulating a scalp sebaceous cyst located on the scalp. Moreover, an irregular darkbrown lesion was observed on the left side of the abdomen, and a brownish macula was also present on the presternal region. Histologic examination of the two nodular lesions revealed cutaneous metastases from prostatic carcinoma. The pigmented lesion, localized on the abdomen, proved to be a superficial spreading melanoma with a maximal depth of 1.36 mm. Histologic examination of the brownish lesion on the presternal region revealed nevus cell nests within the epidermis and in the dermis. We discuss the propensity of developing a secondary cancer in a patient with a primary malignancy.
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PMID:Skin metastases from prostate cancer associated with malignant melanoma. 916 71

Among 2087 patients who underwent primary resection of colorectal cancer in our department within the past 20 years, 68 (3.2%) were found to have a secondary or additional cancer in their large bowel after the first resection. Statistically significant risk factors in the secondary cancer group were a high incidence of coexisting adenoma and high frequency of colorectal cancer in second-degree relatives. Those in whom secondary cancer occurred were divided into two groups: the adenoma component (AC) group; and the non-adenoma component (DN) group. Secondary cancer in the DN group revealed lower grade of cell differentiation and more frequent depressed macroscopic findings than in the AC group. As a result, the prognosis of the DN group was worse than that of the AC group (p < 0.05). Based on these results, the recommended follow-up should include colonoscopy in the first years after primary cancer resection and according to the findings of the first colonoscopy the frequency of colonofiberscopic follow-up must be decided.
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PMID:[Frequency and characteristics of secondary cancer in the colon and rectum after primary resection]. 969 72

The expression of human leukocyte antigen (HLA) class I molecules on the cell surface is necessary for the presentation of peptide antigens to cytotoxic CD8+ T lymphocytes of the immune system. Down-regulation of HLA class I gene expression has been implicated in tumorigenesis, including squamous cell carcinoma of the head and neck (SCCHN). Loss of MHC class I antigens may be one mechanism by which tumor cells escape immune detection. We performed prospective immunostaining of 26 primary SCCHN tumors and samples of normal mucosa harvested several centimeters away from the primary tumor, using a large panel of antibodies directed against allele-specific as well as monomorphic determinants of HLA class I molecules. Loss of expression of HLA class I proteins in the tumor was found in 50% (13 of 26) of primary tumors and was highly correlated with HLA loss in the corresponding normal mucosa (P < 0.0001). Further analysis demonstrated that the loss of HLA class I expression in the tumor was significantly associated with regional lymph node metastases (nodal stage; P = 0.0388), and that the number of HLA class I alleles lost in the normal mucosa was associated with subsequent development of a new primary aerodigestive tract cancer (P = 0.042). A patient with two metachronous cancers available for analysis had no evidence of HLA loss in the first tumor, demonstrated allelic loss in the second cancer, and subsequently died of disease. These results suggest that the loss of expression of HLA class I alleles may have prognostic implications.
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PMID:Human leukocyte antigen class I allelic and haplotype loss in squamous cell carcinoma of the head and neck: clinical and immunogenetic consequences. 1091 26

Metastatic osteosarcoma most commonly affects the lungs and other bones. Hepatic metastasis at the time of diagnosis is extremely rare. A 14-year-old boy with synovial sarcoma of the left popliteal fossa was treated with surgical resection, radiotherapy for microscopic residual disease, and 1 year of chemotherapy (vincristine, cyclophosphamide, dactinomycin, and doxorubicin). Approximately 10 years after the initial diagnosis, a secondary osteosarcoma developed in the left proximal tibia. Computed tomography at presentation showed bilateral pulmonary metastases and large ossified nodules in the liver that demonstrated abnormal avidity on 99mTc MDP bone scan indicating hepatic metastasis. Despite chemotherapy (cisplatin, ifosfamide, high-dose methotrexate, and dacarbazine), the patient died of progressive disease 4 months after the diagnosis of the second cancer. Hepatic metastasis was found at the time of diagnosis of a secondary osteosarcoma and manifested as ossified nodules. The risk of radiation-induced osteosarcoma should always be considered in decisions about treatment for soft-tissue sarcoma.
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PMID:Metastatic osteosarcoma to the liver after treatment for synovial sarcoma: a case report. 1125 30

Patients with advanced laryngeal carcinoma present a high mortality rate due to locoregional recurrence, distant metastases and second cancer. We present a report about the most important prognostic factors in mortality in patients included in III and IV stages. The most important are the presence of metastatic lymph nodes (p = 0.001), extracapsular spread (p = 0.002) and N stage (p = 0.005).
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PMID:[Mortality in advanced stage laryngeal cancer]. 1169 64


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