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

1,092 patients were operated for carcinoma of the uterine cervix according to a standardized radical abdominal hysterectomy with obligatory pelvic lymphadenectomy. The operative specimen showed metastases of the lymph nodes in 45,6% of the cases. In 15% of the cases embolization of tumor cells was found. In 8.7% of the specimes micro-metastases were seen and in 21.9% gross metastases were found. Postoperatively 1.5% of the cases developed bleeding. Ileus occured in 0.7% of the cases. A vesicovaginal fistula occurred in 0.3% of the patients. 1.4% of the patients developed a uretero-vaginal fistula. The operative mortality up to the 30th post-operative day was 1%.
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PMID:[Complications in 1,092 radical abdominal hysterectomies with pelvic lymphadenectomies (author's transl)]. 735 69

A mass associated with the gastrointestinal tract was detected by sonography in 33 patients. Etiologies included primary or metastatic tumor; intussusception; inflammation secondary to bowel infarction, pancreatitis, or irradiation; and a dilated, fluid-filled gut related to retained gastric contents, obstruction, ileus, or an ileal bypass. Mesenteric or omental changes were identified with inflammation and frequently with metastatic disease. The diagnosis was confirmed by repeat sonography, abdominal radiography, barium examination of the small bowel, computed tomography, surgery, or autopsy. Ultrasound patterns are characteristic in tumor, intussusception, and inflammation; specific features allowing differentiation between tumor and inflammation are described. Colonic haustra, valvulae conniventes, or bowel contours and peristalsis on real-time sonography are helpful in identifying fluid-filled bowel loops.
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PMID:Ultrasound patterns of disorders affecting the gastrointestinal tract. 736 Sep 50

To evaluate surgical staging procedures in women with endometrial carcinoma, we examined the techniques used to assess the peritoneal cavity in 295 clinical stage I patients treated between 1985 and 1993. These patients were felt to be at increased risk for extrauterine disease because of significant myometrial invasion, high-grade (2 or 3), or variant histology (papillary serous, clear cell, or mixed). Patients had a mean of two intraperitoneal samples taken: 224 patients (76%) had at least an omental biopsy and peritoneal cytology. Additional peritoneal biopsy sites included pericolic gutters (50), pelvic peritoneum (45), bowel serosa/mesentery (24), diaphragm (22), appendix (11), and adhesions (7). At the time of staging laparotomy, 22 patients (7.5%) had gross evidence of peritoneal spread, which was readily confirmed by directed biopsy. In the 273 women without gross peritoneal disease, 3 (1%) had occult metastases detected by routine biopsy, 3 (1%) had microscopic metastases in palpably abnormal biopsies, and 22 had positive cytology as the only evidence of peritoneal disease. Only three operative complications were potentially attributable to peritoneal assessment: cystotomy (1), partial small bowel obstruction (1), and ileus (1). Peritoneal failures have been noted in 12 patients over a mean follow-up interval of 39 months. Seven of these patients had obvious peritoneal disease at laparotomy. Two of the remaining 5 had optimal peritoneal sampling and represent false-negative cases. A staging laparotomy that included total abdominal hysterectomy with adnexal resection, cytology, omental biopsy, and biopsy of grossly abnormal sites would have potentially identified all patients with known peritoneal disease. Routine biopsy of other grossly normal peritoneal sites is associated with extremely low yield and is not recommended.
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PMID:Staging laparotomy for endometrial carcinoma: assessment of peritoneal spread. 782 45

A total of 25 patients at least 75 years old underwent continent urinary diversion via a modified Indiana Pouch during a 68-month period, 21 of these with simultaneous radical cystectomy or anterior exenteration. The preoperative medical conditions as well as the early and late operative morbidity and mortality are reviewed with a mean follow up of 27 months. Average age of patients was 78.5 years, and the mean age of survivors is 81 years. There were two early mortalities attributed to ileal gangrene with secondary sepsis and aspiration pneumonia. Postoperative complications (superficial wound infection, middle colic vein bleed, right ureteral leak, ileus) occurred in five patients, two of whom required re-operation. Mean hospital stay was 12.4 days and ranged from 9-20. There were only six late complications [ureteral stricture (3), small bowel obstruction (1), incontinence (1)] necessitating re-hospitalization and surgical intervention. Late infectious complications included recurrent urinary tract infections (3), pyelonephritis (2), and C. Difficile enterocolitis (2) all managed medically. In addition, 10 other patients have died, 9 from metastatic disease and 1 from intercurrent medical problems. Of the 13 remaining patients, 11 are disease free and all are continent with a mean follow-up time of 33 months. We conclude that continent urinary diversion via a modified Indiana pouch with radical cystectomy or anterior exenteration can be performed with minimal morbidity or mortality, even in an elderly population.
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PMID:Continent urinary diversion using a Modified Indiana Pouch in elderly patients. 794 43

In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.
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PMID:[The latest results of the advanced hypopharyngeal cancer surgery with immediate reconstruction using the free jejunal autograft]. 797 Jul 59

The data of 27 patients who suffered from malignant tumors of the small bowel between 1970 and 1992 were retrospectively documented and evaluated. In the mainly elderly patients (5th to 8th decade of life) the tumor was most frequently localized in the ileum (41%), followed by the jejunum (30%) and the duodenum (22%). Adenocarcinoma was the most frequent histological diagnosis. Only 28% of the tumors were limited to the intestinal wall. 40% had metastases, local or to other organs. Due to diagnostic problems only 30% of these tumors were found preoperatively. In 22% of the cases an explorative laparotomy and in 33% an emergency operation because of ileus and/or peritonitis led to the correct diagnosis. Still, in 64% of the patients a R0-resection was possible. Nevertheless, the median period of survival was only 24.8 months. But patients who were R0-resected survived 65 months.
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PMID:[Malignant tumors of the small intestine. Diagnostic problems and differentiated surgical therapy]. 805 Mar

Small cell carcinoma of the prostate is a rare disease, since only about 50 cases in the English literature and two cases in Japanese literature have been reported. Here we report a case that is the youngest ever described in the literature. A 24-year-old man was referred to our hospital with right dull lumbago and dysuria. He had the same symptom for one and half year before referral. IVP showed right non-visualizing kidney and left hydronephrosis. Form abdominal CT scans and cystoscopic findings a retrovesical tumor was highly suspicious. Transperineal needle biopsy specimens revealed an undifferentiated malignant tumor. His serum Neuron Specific Enolase (NSE) and LDH were remarkably high and whole body CT scan and upper GI tract examination demonstrated no lesion. He developed ileus and underwent exploratory laparotomy and colostomy was constructed. There was a large mass arising from the prostate which invaded into the peritoneal cavity, and multiple metastases were seen on the omentum and mesenteric lymph nodes. Specimens from the mass arising from the prostate and lymph nodes revealed small cell carcinoma pathologically. A panel of antibodies were used to seek potential tumor markers and to identify substances produced by the tumor cells including enzymes, cytoskeletal components and hormones. And stains were positive for the NSE and chronogranin. An intensive anti-cancer chemotherapy with VP-16 and CDDP was done with minor response (MR) and the serum tumor marker, LDH and NSE, decreased markedly. However, he had expired on the 58th hospital day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Small cell carcinoma of the prostate]. 806 70

Malignant melanoma is the most common metastatic lesion of the intestine, found at autopsy in approximately 60% of patients who die from melanoma. Common symptoms include bleeding, perforation and ileus/subileus. Patients with such symptoms should be operated on immediately, if they are not too reduced because of advanced disease. Long-term survival (five years) has been achieved in 34 of 179 (19%) of stage IVA melanoma patients after a radical operation procedure. Surgical removal of gastrointestinal metastases provides effective palliation in 80-95% of patients, who undergo laparotomy. We describe two patients with gastrointestinal metastases from malignant melanoma. A 33 year-old man had a large melanoma metastasis removed (non-radically) from the small intestine. He recovered rapidly, and experienced good palliative effect for three months, but died from a recurrence of the disease six months after operation. The other patient had a melanoma metastasis in the right lobe of the liver, which was treated by right hemihepatectomy. There has been no recurrence ten months after operation. We recommend surgical removal of abdominal melanoma metastasis if the surgery can be performed without unacceptable risk.
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PMID:[Surgical treatment of gastrointestinal malignant melanoma]. 819 66

A study was conducted on weekly infusion of high-dose 5-FU by way of the hepatic artery for liver metastases from colorectal cancer. In the evaluation of 13 cases, no CR and 6 PR were observed. The response rate was 46.2%, 1-year survival was 73% and 1.5-year survival was 42%. No patients suffered from major side effects. Two patients had ileus, which was controllable by supportive care with intravenous hyperalimentation, and was caused by peritoneal dissemination of cancer. In conclusion, this regimen was relatively safe, effective, and useful for improving the quality of life of patients, compared with other regimens. How to control extrahepatic metastases in addition to this regimen is a subject for forthcoming study.
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PMID:[Weekly hepatic arterial infusion of high-dose 5-FU for liver metastases from colorectal cancer]. 825 47

We report a rare case of advanced renal cell carcinoma in a patient who showed complete resolution of metastases to the lung and bones after nephrectomy, partial jejunectomy and subsequent alpha-interferon therapy. The patient was a 54-year-old man whose right lung and left femur metastases were detected before nephrectomy. In the seventh week after nephrectomy, a partial jejunectomy was carried out because of the obstructive ileus caused by intraluminal multiple metastases of the jejunum. A pathological fracture of the metastasized right humerus occurred subsequently. After four months of intramuscular alpha-interferon administration (3 x 10(6) units/day), however, x-rays revealed the complete disappearance of the metastatic lung shadow and a solid union of the humerus, and there were no tumor cells in the femur specimen resected at the subsequent reconstruction surgery of the left leg. Seven years have passed from onset, and the patient is still alive and disease free.
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PMID:Regression of pulmonary and multiple skeletal metastases from renal cell carcinoma by nephrectomy and alpha-interferon therapy: a case report. 828 92


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