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)

The complete autopsies of 145 patients dying of colorectal cancer are reviewed. Isolated local or distant metastases are infrequent, compared to disseminated disease. Solitary local recurrences are most common after resection of rectal tumors. Right colon tumors spread to local and distant sites in 90% of autopsies, and to distant sites alone in 10%. Rectal tumors spread locally only in 25% of cases, to distant site alone in 25%, and to both in 50%. Regardless of the origin of the primary tumor, the liver is the most common site of metastasis, followed by the regional lymph nodes and the lungs. Two-thirds of the patients with right colon lesions died of liver metastases, and three-quarters of those with rectal tumors succumbed to disseminated disease. The current curative and palliative treatment of recurrent colorectal cancer in clinical medicine by surgery, radiotherapy, and chemotherapy is reviewed. It is suggested that an understanding of the anatomic patterns of cancer recurrence will increase in importance as advances in the modalities of treatment are made,
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PMID:The clinical correlation of an autopsy study of recurrent colorectal cancer. 44 5

Single determination of CA 15.3 and bone scintigraphy were performed on the same day as follow-up procedures in 864 patients with breast cancer. The sensitivity and specificity of bone scintigraphy for skeletal metastases were 99% and 88.8%, respectively. The overall sensitivity and specificity of CA 15.3 (cut-off for pathological values greater than 30 U/mL) for cancer recurrence or distant metastases were 69.2% and 92.1%, respectively. The sensitivity of CA 15.3 for bone metastases was lower (69.4%) than that of bone scintigraphy. This was mainly due to the relatively high proportion of false-negative CA 15.3 levels in patients with 1-2 bone metastases (sensitivity = 33.3%). According to this result, the circulating levels of CA 15.3 showed a good correlation with tumor extension and, in patients with bone metastases, with the number of skeletal lesions. As regards the contribution of CA 15.3 to the diagnosis of bone metastases, the demonstration of elevated CA 15.3 values in patients with positive bone scintigraphy could support the diagnosis of skeletal metastases. In fact, the positive predictive value of CA 15.3 in patients with positive bone scintigraphy was significantly higher than with only bone scintigraphy (53.8%) or CA 15.3 (50.4%). Finally, very high values of CA 15.3 in patients with known bone metastases could indicate the presence of visceral metastases (mean CA 15.3 in patients with bone metastases = 125.8 U/mL; mean CA 15.3 in patients with bone and visceral metastases = 420.5 U/mL).
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PMID:Single determination of CA 15.3 and bone scintigraphy in the diagnosis of skeletal metastases of breast cancer. 145 Feb 26

The combined treatment of 36 patients for a pulmonary cancer recurrence included the performance of preoperative radiotherapy, reoperation and postoperative polychemotherapy. After reoperation, 3 (8.3%) patients died. In 17 of the 28 patients, the treatment was ineffective, all of them died. The mean lifetime was 20.8 mos. Eleven patients are alive for from 2 to 50 mos with no tumor recurrences, or metastases revealed.
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PMID:[Combined treatment of recurrent lung cancer]. 150 57

We describe the surgical management and followup of 11 patients with local recurrence of renal cell carcinoma in the renal fossa, 10 of whom demonstrated no evidence of distant metastatic disease at the time of recurrence. Average interval to recurrence was 31 months from nephrectomy, with the majority of patients presenting with symptoms of weight loss, fatigue and lumbar discomfort. A total of 13 resections of recurrent carcinoma was performed with 3 immediate postoperative complications, including a retroperitoneal abscess, jejunal necrosis requiring resection and a duodenal obstruction requiring duodenojejunostomy. There were 2 postoperative deaths, 2 patients died of disseminated disease at 8 and 22 months, and 3 died of causes unrelated to cancer recurrence at 4 months, 6 months and 10 years. Four patients were without disease at a followup of 35, 46, 48 and 211 months. We include in this review a report on 1 patient who maintains a disease-free survival of 17 years after resection of a recurrent spindle cell carcinoma. We conclude that an aggressive surgical approach to recurrent renal cell carcinoma within the renal fossa can produce long-term disease-free survival and is justified when compared to the results reported for chemotherapy.
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PMID:Experience with fossa recurrence of renal cell carcinoma. 159 72

In 20 women with breast carcinoma, 17 of whom had locally advanced cancer and 3 of whom had confirmed metastases, the expression of P-glycoprotein was evaluated before the start of a chemotherapy regimen that included multidrug resistance-related drugs. With the use of the C494 monoclonal antibody in an avidin-biotin-immunoperoxidase technique, P-glycoprotein was detected in 17 of 20 tumor samples. Results were expressed in a semiquantitative manner, taking into account the number of positive tumor cells (N index) and the specific staining intensity (I index). The 17 patients with nonmetastatic cancer were followed from the first cycle of chemotherapy to cancer recurrence; subsequent to six cycles of chemotherapy, all of these patients except one were rendered clinically disease-free through surgery and/or radiation. The end point was defined as either local/regional recurrence or metastasis. Strong P-glycoprotein-positive staining in a majority of tumor cells (the N+/I+ phenotype) was significantly correlated with no initial response to chemotherapy (P less than .02) and with a shorter progression-free survival (P less than .02). Thus, the pretreatment evaluation of P-glycoprotein expression may be of prognostic value in patients with locally advanced breast cancer.
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PMID:Clinical relevance of immunohistochemical detection of multidrug resistance P-glycoprotein in breast carcinoma. 167 Nov 4

A long-term survivor of advanced gastric cancer with multiple metastases to the liver treated by chemotherapy is described. Chemotherapy comprising a combination of uracil and tegafur with mitomycin C achieved a complete response in the patient which lasted for approximately four years. Four years after initiation of the chemotherapy, a unique form of cancer recurrence occurred on the skin, showing infiltrative erythema. Cancer metastases developed further despite more treatment, and the patient died of generalized metastasis four years six months after the initiation of chemotherapy. It is significant that, at autopsy, no cancer cells were revealed in the primary lesion or in the liver which had been present before the initial chemotherapy.
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PMID:A long-term survivor of metastatic gastric cancer treated by chemotherapy: case report. 194 59

During 25 years, 708 patients with primary malignant tumours of the thoracic oesophagus (n = 376) or cardia (n = 332) were referred to our department. Two hundred and forty-nine patients had squamous cell carcinoma and 425 adenocarcinoma. The other 34 tumours, which were primarily classified as undifferentiated carcinoma, malignant carcinoid or non-epithelial, were re-evaluated by means of a second microscopic histologic examination and immunohistologic investigation. This showed primary malignant non-epithelial tumours in seven patients (0.99%): two malignant melanomas, one leiomyosarcoma, one malignant fibrous histiocytoma in the oesophagus (1.06%), two malignant lymphomas, and one malignant melanoma in the cardia (0.90%). All but two of the patients with non-epithelial malignant tumours were 67 years of age or older, and oesophagogastrectomy was performed in all. All tumours were 5 cm or more in diameter (median, 8 cm). Distant metastases were found in three cases. Five died of postoperative complications, one of cancer recurrence 7 months after the operation, and one of an unrelated cause without cancer recurrence 16 months postoperatively. Except for two of the melanomas, the diagnosis was not established until histologic examination of the surgical specimen was performed and, for the third melanoma and the malignant fibrous histiocytoma, not until the present re-evaluation. The characteristics of these seven tumours are discussed, and the importance of obtaining a correct diagnosis from endoscopic biopsy specimens is emphasized.
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PMID:Primary malignant non-epithelial tumours of the thoracic oesophagus and cardia in a 25-year surgical material. 221 93

A 57-year-old female patient with recurrent sigmoid colon cancer was successfully treated with 5-FU and UFT for 8 years. The patient, with cancer recurrence in the para-aortic lymph nodes, which were palpated in the abdomen, was given oral 5-FU at a daily dose of 200 mg. During the second week of administration, the mass showed a remarkable decrease in size, and complete disappearance was achieved within one month. However, 5 years and 2 months after discontinuation of 5-FU administration, recurrence in the supra-clavicular lymph nodes and para-aortic lymph nodes was recognized. After administration of UFT at a daily dose of 600 mg, complete disappearance of para-aortic lymph node recurrence was observed. At present, the patient is under observation as an outpatient at our hospital. This case suggests the effectiveness of 5-FU and UFT for lymph node metastases of sigmoid colon cancer.
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PMID:[A case of recurrent sigmoid colon cancer successfully treated with 5-FU and UFT]. 312 10

In 150 patients who got cancer recurrence after curative resection for cancer of the thoracic esophagus, the sites where recurrent lesions were clinically detected for the first time were examined. The distribution of recurrent lesions in patients who did not undergo neck dissection at the operation (group A) differed from the distribution in those who underwent neck dissection (group B). Cervical and/or upper mediastinal recurrence occurred in 49% of cases in group A and in 11% of group B. On the contrary, middle or lower mediastinal recurrence was more often in group B. The distribution of recurrent lesions varied depending on the state of lymph node metastasis detected at surgery. Cervical and upper mediastinal recurrence was much more frequent than hematogenic recurrence in cases without lymph node involvement in group A, while hematogenic recurrence was more frequent in cases with both mediastinal and abdominal lymph node metastasis. In the upper mediastinum, recurrence along the recurrent laryngeal nerves was most frequent and it was supposed to have developed from residual lymphatic metastases. In the middle and lower mediastinum, recurrent lesions were located around the left main bronchus and descending aorta, and cancer infiltration of the neighboring organs was frequent. Recurrence at the abdominal paraaortic nodes was observed mainly in cases with perigastric lymph node involvement.
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PMID:[Distribution of recurrent lesions after radical resection of cancer of the thoracic esophagus]. 322 6

A study was made of the results of measuring the carcinoembryonic and carbohydrate antigens using a kit of reagents in 75 patients with rectal cancer recurrences and metastases. The concentration of these antigens in healthy persons was for CEA 6.4 +/- 0.71 micrograms/l, the carbohydrate antigen--19.6 +/- 2.51 units/ml. In this group of patients rectal cancer local recurrence was found in 52, metastases to the liver in 19 and metastatic involvement of the liver and lungs in 4. An elevated level of the CEA was detected in 92.8% of the patients with cancer recurrence (the mean concentration was 99.9 +/- 9.29 micrograms/l), and in 100% of the patients with metastases (the mean concentration was 193.4 +/- 30.42 micrograms/l). The content of the carbohydrate antigen in cancer recurrences was raised in 21.3% of the cases only, in metastases to the liver in 31.6% and in 2 patients with metastatic liver and lung involvement. Thus, measuring the CEA content turned out to be the most specific and sensitive test for the diagnosis of rectal cancer recurrences and metastases. The use of the carbohydrate antigen for this purpose was found ineffective.
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PMID:[Determination of carcinoembryonic and carbohydrate antigens in the diagnosis of recurrences and metastases of rectal cancer]. 346 48


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