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

Although hepatic resections for colorectal metastases have become established procedures, there is still only a small number of reports of hepatic resections for such metastases in the caudate lobe. From 1993 to 2001, seven patients underwent eight hepatic resections for colorectal metastases in the caudate lobe at our department. The patients were five men and two women, and their ages were from 53 to 73 years. The ratio of synchronous to metachronous liver metastases was 2 : 5. Solitary metastasis was observed in one patient. One patient with a metastasis in the Spiegel lobe and three patients with metastasis in the caudate process underwent partial resection of the site. The other patients underwent resection of the Spiegel lobe (two times), resection of the right-sided caudate lobe, and total caudate lobe resection. The mean (+/-SE) operative time was 315.9 +/- 30.6 min. Mean intraoperative blood loss was 1325.9 +/- 421.1 ml, and mean postoperative hospital stay was 21 +/- 3.7 days. One patient, who underwent sigmoidectomy and hepatectomy as an emergency operation due to ileus, experienced wound infection. No patient died within 12 months after the surgery. Five patients were alive at 24 months, and three at 36 months. The outcome of these patients encourages us to continue performing hepatic resection for colorectal metastases in the caudate lobe, as it is assumed to be a safe and effective procedure.
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PMID:Hepatic resection for colorectal metastases in the caudate lobe of the liver. 1554 36

The key points of this article are anorexia and cachexia are: A major cause of cancer deaths. Several drugs are available to treat anorexia and cachexia. Dyspnea in cancer usually is caused by several factors. Treatment consists of reversing underlying causes, empiric bronchodilators, cortico-steroids--and in the terminally ill patients-opioids, benzodiazepines,and chlorpromazine. Delirium is associated with advanced cancer. Empiric treatment with neuroleptics while evaluating for reversible causes is a reasonable approach to management. Nausea and vomiting are caused by extra-abdominal factors (drugs,electrolyte abnormalities, central nervous system metastases) or intra-abdominal factors (gastroparesis, ileus, gastric outlet obstruction, bowel obstruction). The pattern of nausea and vomiting differs depending upon whether the cause is extra- or intra-abdominal. Reversible causes should be sought and empiric metoclopramide or haloperidol should be initiated. Fatigue may be caused by anemia, depression, endocrine abnormalities,or electrolyte disturbances that should be treated before using empiric methylphenidate. Constipation should be treated with laxatives and stool softeners. Both should start with the first opioid dose.
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PMID:Common symptoms in advanced cancer. 1583 69

A 77-year-old woman underwent an ileocecal resection and a partial resection of the small intestine for cecal cancer. However, ileus caused by a recurrence in the small intestine was detected two years and four months postoperatively, so an ileal resection was performed. Furthermore, metastases to the lungs, lymph nodes, and peritoneum were detected, and CPT-11-based chemotherapy was administered. The patient was initially treated by combination therapy with a small dose of CPT-11 and CDDP. The combination drugs were changed to MMC, 5'-DFUR, etc. while the appearance of adverse reactions was monitored. Three years of continuous treatment served to prevent the proliferation of tumors. At present, TS-1 chemotherapy is ongoing. The results suggest that CPT-11-based chemotherapy can be continued by changing the combination of concomitant drugs while monitoring adverse reactions. It thus may be an effective regimen for advanced and recurrent large bowel cancer.
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PMID:[Long-term survival in a case of large bowel cancer--efficacy of CPT-11-based chemotherapy]. 1604 74

We present our data on the treatment of Wilms' Tumor (WT) with an emphasis on both the positive effect and the adverse effect of preoperative chemotherapy with regard to surgical intervention. From 1980 to 2000 70 children were treated. 57 % received preoperative chemotherapy (ChTx) and 43 % were operated on primarily. 75 % of the tumors responded to ChTx with significant shrinkage of the size. After preoperative ChTx 54 % of the cases were regrouped as stage I, whereas after primary operation 46 % of the patients were grouped as stage I, thus indicating a downstaging with preoperative ChTx. In 8 % of the patients with preoperative chemotherapy intraoperative complications occurred with a rupture of the tumor in 1 case. In contrast, there were intraoperative complications in 25 % of the patients with a primary operation with rupture of the tumor in 3 cases. 1 child (1.5 %) was treated with chemotherapy who did not have a Wilms' tumor but a benign nephroma (CMN). 3 cases had a clear cell sarcoma (CCSK) and in one case histology revealed a rhabdoid tumor (MRTK). In one case of CCSK only histology of the metastases disclosed the correct diagnosis. The rate of postoperative complications such as ileus was the same for both groups. Irrespective of the known adverse effects such as changing tumor histology, which may affect the correct staging, and the remaining risk of an initial inadequate treatment, our data show that the regimen of preoperative chemotherapy as proposed by the SIOP study should not be abandoned. However, the relatively small number of our patients does not allow a significant statement to be made but confirms the results of past SIOP studies.
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PMID:Surgical complications in the treatment of Wilms' tumor. 1641 59

From 2000 till 2005 were retrospectively analyzed 150 cases with cervical cancer stage I B. All patients were operated by radical hysterectomy type I - III with lymph mode dyssection. In 120 patients the lymph modes were negative. 30 patients had GOG Score of > or = 120. The histology of 23 patients was squamous and for 7 patients adenocarcinomas. All tumours were with invasion of outer third of the cervix. With exception of 2 patients all had lymph-vascular space invasion. In all 30 high risky patients with negative lymph nodes was used small field of postoperative radiation (dose 50-60 Gy). The patients were followed median for 40 months, as we had only 2 patients with recurrence (6%). We did not have ileus, fistulas or any other complications. By resection of the bulky lymph nodes we converted the risky patients with macro metastases into patients with micrometastases. In the postoperative period we used small field of pelvic radiation. All this lead to less complications, less recurrences and better quality of life for these patients.
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PMID:[Some new aspects of the treatment for cervical cancer of I B2 stage]. 1663 14

An 81-year-old man was admitted to our department due to acute ileus. He was diagnosed with sigmoid colon cancer with multiple metastatic lesions in the right lobe of the liver. Two weeks after insertion of an ileus tube, he underwent sigmoidectomy and permanent colostomy. The final diagnosis was stage IV sigmoid colon cancer with metastasis to the omentum. One month after the operation, adjuvant chemotherapy with oral administration of tegafur/uracil compound (UFT) and Leucovorin (LV), and drip venous infusion of irinotecan hydrochloride (CPT-11) was initiated (UFT 300 mg/day for 14 days, LV 75 mg/day for 14 days, CPT-11 90 mg/m(2) on the 1 st day, with 1 course consisting of 21 days). The levels of tumor markers, CA19-9 and CEA, and the size of metastases on CT were reduced remarkably after one and 4 courses of this therapy, respectively. Although the administration was temporarily discontinued due to low-grade nausea, we continued the treatment. Adjuvant chemotherapy with an oral administering agent is favorable for older patients with advanced colorectal cancer to reduce side effects and preserve the quality of life.
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PMID:[Advanced rectal cancer in an older patient, in whom metastatic liver lesions were effectively controlled with oral UFT+LV and venous CPT-11 administration--case report]. 1677 Jan 6

A 45-year-old patient presented with a history of recurrent abdominal pain of unknown origin. The CT scan of the abdomen demonstrated a thickened mesenteric root and a segmental ileus of the jejunum. Laparotomy revealed a neuroendocrine tumour of the small bowel. Such tumours are rare causes of recurrent abdominal pain. Especially when the CT scan of the abdomen reveals mesenteric abnormalities (desmoplastic reaction) and/or a segmental ileus, a neuroendocrine tumour of the small bowel should be considered. The therapy of choice is resection of the tumour followed by systemic therapy including somatostain analogues and chemotherapy in the case of a hormone secreting tumour or metastases.
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PMID:[Recurring, severe upper abdominal pain in a 45 year old patient]. 1689 73

A recent major advance in the surgical treatment of colorectal cancer has been the introduction of laparoscopic surgery. Laparoscopic colectomy is associated with decreased postoperative pain, faster ileus resolution, shorter hospital stay, improved cosmesis, and decreased morbidity when compared with open colectomy. However, early reports of high rates of laparoscopic wound metastases gave rise to questions regarding the adequacy of the laparoscopic technique for curative resection of malignancies. These concerns over oncologic outcomes are addressed by several single and multi-institutional randomized trials in the United States and throughout the world that have compared laparoscopic-assisted colectomy with conventional open colectomy. These studies have established both the short- and long-term safety and oncologic efficacy of laparoscopic colectomy for cancer. To ensure successful outcomes, surgeons performing laparoscopic colectomy should be adequately experienced. Limitations include the technical requirements of advanced laparoscopic skills and training, increased operative time, and equipment costs. Despite these limitations, patient recovery benefits may offset the increased operative costs and result in improved outcome overall.
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PMID:Laparoscopic treatment of colorectal neoplasia. 1690 89

Intestinal obstruction and ileus continue to represent a surgical challenge, regarding diagnosis and treatment. The decision when to operate is often difficult and should be based primarily on the clinical impression, although modern diagnostic tests are very helpful. Additionally, it is crucial to choose an operation that the patient can tolerate, as the spectrum of surgical interventions ranges from the taking-down of a single adhesion, that may be done laparoscopically, to sophisticated lysis of the intestine in patients with metastatic cancer in the peritoneal cavity, and simple diversion to extensive resections. These aspects are highly relevant, as good outcome can only be expected when the operation is performed correctly and optimal timing and appropriate choice of procedure are ensured.
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PMID:[Surgical treatment of ileus. Differential diagnosis and therapeutic results]. 1694 34

The cases of 4 patients with primary skin melanoma, who underwent resection of the small intestine due to the intestinal metastases, are presented. Two patients died as a result of metastases after intestinal resection; the other two have been alive for a year and 10 years without any symptoms of the disease. The presence of the melanoma metastases to the intestine can be suspected in patients with anaemia caused by bleeding into the lumen of an intestine, ileus, rapid weight loss or noticeable tumor in the abdomen. The resection of intestine with metastases should be chosen as a safe method, which allows good palliation; it also offers the chance for a longer life.
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PMID:[Metastases of the melanoma to the intestine]. 1742 92


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