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)

Use of the biofragmentable anastomosis ring (BAR) was attempted in 33 patients at two New York City institutions and employed in 31 instances. Anastomoses performed were end-to-end enterocolic (n = 15), colocolic (n = 15), and side-to-side colocolic (n = 1). Patients ranged in age from 27 to 86 years, with the following diagnoses: primary colon cancer, 15; sessile adenoma, four; colostomy, five; diverticulosis, two; metastatic cancer with obstruction, multiple polyposis, perforated appendiceal mass, malignant carcinoid of appendix, intussuscepting right colon mass, one each. In two instances use of the device was aborted because of concern with the blood supply to the bowel wall in one and tissue edema in another. The average duration of postoperative ileus was 4.7 days. Two patients were subsequently treated for small bowel obstruction thought unrelated to use of the anastomotic device. There were no deaths and no evidence of stricture.
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PMID:Murphy's Button revisited. Clinical experience with the biofragmentable anastomotic ring. 842 5

Metastasis of lung cancer to the digestive tract (excluding the esophagus) was confirmed by surgery or autopsy in 30 of the 1635 lung-cancer patients admitted to this Center during the 17-year period since 1977. The diagnosis was made before death in 7 and after death in 23. Metastasis of large cell carcinoma was the most common (3.7%), followed by adenocarcinoma (2.4%), small cell carcinoma (1.7%), and squamous cell carcinoma (0.7%). Metastasis to the stomach occurred in 0.4%, to the small intestine in 1.1% and to the colon in 0.5%. The overall percentage of metastasis to the digestive tract was 1.8%. Among the 298 cases diagnosed at autopsy, metastasis to the digestive tract occurred in 9.7%; stomach, 2.6%; small intestine, 5.7%; and colon, 3.0%. Eleven of the patients in whom the diagnosis was made at autopsy had abdominal symptoms while they were alive. In 11 cases diagnosed at autopsy, occult blood was positive in 9, but 6 of those 9 patients were asymptomatic. The occult-blood test is considered to be helpful as a supplementary diagnostic method in detecting metastasis of lung cancer to the digestive tract. Among the cases diagnosed while the patients were alive, metastasis was observed in the small intestine in 6 and in the colon in 1. The major manifestations were melena, ileus, intussusception, and perforation; 4 patients required emergency surgery. The prognosis was poor: the mean survival period from the onset of symptoms was 49 days. The direct cause of death was metastasis to the digestive tract in 5 cases. The possibility of metastasis to the digestive tract is high when progressive abdominal symptoms are observed and the stool is persistently positive on occult-blood tests.
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PMID:[Gastrointestinal metastasis from lung cancer]. 893 39

Cryosurgery of hepatic metastases from colorectal carcinoma is a form of local therapy for unresectable disease. After curative resection, failures occur in the liver, and at extrahepatic sites. This pilot study evaluated the toxicity and tolerance to cryotherapy and intraoperative chemotherapy for unresectable hepatic metastases from colorectal cancer. If after exploratory celiotomy for potential curative resection of hepatic metastases the patient was deemed unresectable because of location and/or number of lesions, cryosurgery and intraoperative chemotherapy with systemic 5-fluorouracil 600 mg/m2 and leucovorin 500 mg/m2 was performed. Four patients were treated with cryochemotherapy. All patients developed toxicity. Two patients developed grade II leukopenia on Postoperative Days 2 and 12, and grades II and III diarrhea on Postoperative Days 5 and 7, respectively. Grade III hyperbilirubinemia and thrombocytopenia occurred in one patient on Postoperative Days 3 and 7. Acute respiratory distress syndrome, postoperative ileus, and grade II mucositis occurred in one patient each. All patients had delays and dose reductions on their subsequent chemotherapy treatments secondary to toxicity. Two patients had disease progression, one had stable disease. and one is "disease free." Combining the tumoricidal effects of chemotherapy and cryosurgery is in theory a good concept. However, the toxicity of 5-FU and leucovorin is enhanced by this approach.
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PMID:A pilot study of cryochemotherapy for hepatic metastases from colorectal cancer. 897 87

Urethral bladder substitution is traditionally suggested to good prognosis cystectomized patients. In our series this diversion was chosen for all but the salvage cystectomized men. Between the 1st of February 1991 and the 30th of April 1996, one hundred consecutive men underwent lower urinary tract reconstruction after radical cystoprostatectomy for bladder cancer. An orthotopic ileal neobladder was constructed (in 84 cases according to Kock's technique and in 16 to Studer's technique). Total early complication rate was 29% (29/100), including one perioperative death due to sepsis (mortality rate 1%). 13 patients required surgery (6 retroperitoneal hematomas, 2 wound dehiscences, 1 urinary fistula, 1 lymphocele, 1 rectal-neobladder fistula, 1 rectal-cutaneous fistula, 1 necrosis of the terminal ureter). The late complication rate was 19% (19/100); in 8 cases reparative surgery was required (1 mechanical ileus, 2 bladder neck stenoses, 3 stenoses of the ureteral anastomosis, 2 laparoceles). Four patients were lost at the follow-up; out of the 96 remaining patients only 85 were evaluable for continence: continence during the day was achieved in a period between there to six months in 78 patients (91.7%); night continence was achieved with planned awakenings in 60 patients (70.5%). Eight patients recovered potency, another 7 had successful intercourses after PGE1 intracavernous injection. Renal function based on creatinine value was mildly impaired in 5/78 evaluable patients (6.4%) (peak creatinine 2.8 mg%). In 29 patients tumour progression was observed (29%): 9 pelvic and 20 metastatic. Among the latter 2 urethral recurrences were observed (2%). Twenty-four patients died for metastatic cancer, one for primitive lung cancer, one patient for postoperative septic shock. Adjuvant chemotherapy was administered in 11 patients without complication with an indwelling catheter in the neobladder to avoid drug reabsorption. Four patients showed complete response (2 are alive after a mean of 12 months), 6 were non responders and 1 had a partial response. In our series the ileal neobladder is a feasible method of urinary diversion when urethral cancer involvement is ruled out. Early and late complications are proportionally decreasing with experience and overall continence is satisfactory. The fate of the neobladder depends on both the technique and patient's compliance. Only educated patients can cope successfully with neobladder diversion without major complications. All the patients operated for non salvage cystectomy deserve to be diverted with a continent urethral bladder substitution.
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PMID:[100 orthotopic neobladders in men after cystectomy: a 5-year experience]. 902 35

The quantity of patients with colonic cancer, operated on for an acute ileus (AI), survived more than 5 years, is significantly less than those who were treated in a planned order. The tumor infiltration of intestinal wall and the presence of the lymph node metastases are the most important prognostical factors. The presence of AI in preoperational period, low differentiation of tumor and the patients young age have negative influence on the survival indexes.
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PMID:[Remote follow-up results of the treatment of patients with surgeries for acute ileus]. 978 59

The effects of transcatheter intraarterial infusion of anticancer drugs on the prognosis of cervical cancer were retrospectively studied. Two or three sessions of transcatheter arterial infusion therapy were performed for 68 patients with primary uterine cervical cancer. The number of patients with stage I, II, III, or IV disease were 13, 22, 24, and 9, respectively. Patients with squamous cell carcinoma comprised 3, 17, 17, and 5 of the respective groups, and the patients with stage I and II disease had either adenocarcinoma or adenosquamous carcinoma, or bulky tumor (>4 cm). The drugs infused were cisplatin (60-70 mg/m2), doxorubicin hydrochloride (30-40 mg/m2), mitomycin (15 mg/m2), and 5-fluorouracil (500 mg/body). They were infused via the bilateral internal iliac arteries. Fifty-eight of the 68 patients (85%) received a radical hysterectomy after transcatheter arterial infusion: 12 of 13 with stage I disease, 21 of 22 with stage II disease, 20 of 24 with stage III disease, and five of nine with stage IV disease. Two patients with stage III disease received radical radiotherapy. The other eight patients (one with stage I disease, one with stage II disease, two with stage III disease, and four with stage IV disease) did not receive an operation after transcatheter arterial infusion because they had distant metastases at the time of operation. Thirty-two of 58 patients (56%) received postoperative radiotherapy. The complete histologic response rates (no active cancer cells) after transcatheter arterial infusion were: 2 of 12 patients with stage I disease, 3 of 21 patients with stage II disease, 5 of 20 patients with stage III disease, and one of five patients with stage IV disease. Tumors with squamous cell carcinoma disappeared at a significantly better rate (10/36, 28%) than did tumors with adenocarcinoma or adenosquamous cell carcinoma (1/22, 5%; p < 0.05). The overall 5-year survival rates of the patients with stages I, II, and III disease were 92.3%, 62.2%, and 71%, respectively. The 5-year survival rates of the patients who underwent surgery with stage I, II, and III disease were 100%, 66.3%, and 71.5%, respectively. Leukocytopenia and thrombocytopenia occurred as an acute complication in 75% and 79% of the patients, respectively. As a late complication, ileus occurred in 7%. Transcatheter arterial infusion may improve the prognosis of patients with cervical cancer without increasing the incidence of late complications.
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PMID:Clinical results of transcatheter arterial infusion for uterine cervical cancer. 1002 92

Carcinoid tumors are new growths from neuroendocrine cells. The following clinical variants of carcinoid were observed in 11 patients with histologically verified carcinoid: 1) asymptomatic variant (an occasional finding at endoscopy)--2 cases; 2) carcinoid with symptoms of a mass detected at surgery--2 cases of intestinal ileus, 2 cases of appendix carcinoid simulating acute appendicitis; 3) carcinoid with hepatic metastases and carcinoid syndrome with unknown primary focus--2 cases; 4) carcinoid with metastases to the liver and carcinoid syndrome with location of the primary tumor in the lungs (2 cases) and pancreas (1 case). It is stated that carcinoid tumors are encountered more frequently than diagnosed (0.1-0.5% of all the tumors). Manifestations of carcinoid syndrome allow to diagnose carcinoid only at late stage when a large mass of hormone-active tumor tissue and metastases to the liver are present.
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PMID:[Carcinoid tumors]. 1006 96

We report herein the case of an 81-year-old woman found to have small intestinal carcinoma producing carbohydrate antigen (CA)19-9, in whom recurrence on the abdominal wall was strongly suspected 4 months after resection. She presented to our hospital with acute abdominal pain with severe anemia. Marked serum elevation of CA19-9 to 164.8 U/ml suggested a progression to malignancy. A fluorography using an ileus tube revealed an abnormal mucosal pattern. An exploratory laparotomy showed an incomplete annular constrictive Borrmann type 2 tumor, located approximately 190 cm from Treitz's ligament, without any signs of peritoneal or hepatic metastases. Histological examination confirmed a diagnosis of papillotubular adenocarcinoma without metastases of the regional lymph nodes. CA19-9 antigenicity was detected in the cytoplasm and on the surface of the cancer cells, using the monoclonal CA19-9 antibody, NS19-9. In this report, we demonstrate the CA19-9 productivity and distribution of the cancer tissues in relation to their prognosis.
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PMID:Adenocarcinoma of the ileum producing carbohydrate antigen 19-9: report of a case. 1105 36

We report a patient with a large intra-abdominal metastasis of myxoid liposarcoma. The patient first noticed an asymptomatic mass in her left leg in 1985, when she was 20 years old. The mass was left untouched until she realized its rapid growth and consulted a local doctor in 1994. After needle biopsy, she was histologically diagnosed as having a myxoid liposarcoma. She disagreed with the recommendation for an amputation below the knee, made at another hospital. A marginal resection was performed as an alternative treatment. She subsequently underwent three more marginal resections and four intra-lesional resections for repeated local recurrences. In 1997, an abdominal computed tomography scan revealed the presence of multiple intra-abdominal metastases, and the lesions were judged to be inoperable. Ileus and respiratory distress, caused by compression by the abdominal mass, gradually worsened, and she died in 1999, at the age of 34. The girth of her abdomen was 135 cm at the time of death.
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PMID:A myxoid liposarcoma in the lower leg, with a large intra-abdominal metastasis. 1128 94

Purpose To determine the efficacy and morbidity of carbon dioxide laser vaporization of intestinal metastases of epithelial ovarian cancer. Patients and methods Following maximum surgical cytoreduction, 20 patients were treated with laser vaporization of serosal and mesenteric metastases with a carbon dioxide hand-held laser at a median wattage of 25 watts using a super-pulse mode. The maximum diameter of intestinal metastases ranged from 1 mm to 2 cm and the number ranged from 1 to> 100 implants. These patients were compared with 20 matched controls. Results Median laser time was 7 min and no patient experienced bleeding> 15 ml. Eighteen patients (90%) had no gross residual disease following laser vaporization compared to five (25%) of the controls (P = 0.0001). Nineteen patients (95%) had no gross intestinal residual disease following laser vaporization compared to eight (40%) of the controls (P = 0.01). There was no difference in the incidence of postoperative ileus, wound infection or febrile morbidity between the groups. No patient in either group developed bowel obstruction, perforation, fistula, peritonitis or abscess. Conclusion Carbon dioxide laser vaporization of intestinal metastases of epithelial ovarian cancer represents intensive cytoreduction which results in superior debulking and does not appear to increase postoperative morbidity.
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PMID:Carbon dioxide laser vaporization of intestinal metastases of epithelial ovarian cancer. 1157 26


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