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)

314 patients with liver metastases were admitted to the Department of Surgery. University of Angers, from 1963 to 1983. The primary sites include tumors of the colon and rectum (129 patients), pancreas (74 patients), stomach (51 patients), extrahepatic bile ducts (38 patients), esophagus (7 patients), small intestine (4 patients), ovaries (4 patients), kidney (3 patients) and 4 malignant melanomas. Surgical management of liver metastases was hepatectomy (23 cases) or wedge resection (4 cases) when metastases were solitary or multiple but unilateral, selective (2 patients), total (4 patients), temporary (4 patients), desarterialization or regional intraarterial chimiotherapy (12 patients) were performed for non resectable metastases. Most of the resections (22 cases) were done for apparently solitary metastases from colorectal cancer, while a palliative treatment was utilized for some hypervascular deposits from renal, ovarian and endocrine primary tumors. The operative mortality rate was 4 per cent (2 of 49 patients): one right, and one left hepatectomies. Nine patients survived more than 2 years after liver resection, two lived more than 4 years; the longest survival (62 months) occurred after plurisegmentectomies for carcinoid metastases. The results of palliative surgery were deceptive, 14 patients died within one year, 2 patients survived 2 years, and 1 patient had a 68 months survival after liver desarterialization for carcinoid metastases. We conclude that an agressive surgical approach in the treatment of solitary or multiple resectable liver metastases is based upon several tenets. The primary tumor, when the site is the colon or the rectum preferendly must be well differentiated, Dukes B class, especially with no evidence of extrahepatic metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical possibilities in the treatment of hepatic metastases]. 240 48

The concept of en bloc removal of tissue surrounding the esophagus was applied to intrathoracic esophageal cancers, and the first 80 cases were operated on by this technique between 1969 and 1981. Analysis of prognostic factors showed that only penetration through the esophageal wall and lymph node spread influenced survival. Since 1981, a new staging system based on wall penetration (W) and lymph nodes (N), as well as systemic metastases (M), and similar to the modified Dukes' system for colon cancer has been used to select patients before and during surgery for en bloc resection if favorable pathology (W1, N0, or N1) could be anticipated. When curative resection was not attainable, based on preoperative and operative staging, a standard esophagectomy was considered for relief of symptoms when necessary. From July 1981 to June 1984, 68 esophageal cancers were referred to us, and 31 were resected by the en bloc method, 21 by standard esophagectomy, and 16 were not resected. The success of preoperative staging was confirmed, as only nine of the 31 en bloc cases demonstrated both W2 and N2 pathology. The proportion of W2N2 cases subjected to en bloc esophagectomy was less (p less than 0.01) than that in the preceding series. This selection of cases showed a favorable deviation in the survival curve following en bloc esophagectomy since 1981 compared to the earlier interval. Patients treated by en bloc esophagectomy had a significantly greater survival than they did following standard esophagectomy at all time intervals after 6 months. There was no difference in hospital mortality or complications between the two operations. Further evidence for the value of the new staging system was shown by the significant difference in survival curves between those with favorable versus unfavorable staging and treated by en bloc esophagectomy. Among all cases resected between 1981 and 1984, 18-month survival in W1 stage was 67% compared to 35% for W2 disease. Survival with N0 disease was 58% versus 43% for N1 stage and 21% for N2 stage. The favorable survival rates after en bloc resection in those with limited (less than W2N2) disease support the concept of selecting patients for curative surgery based on preoperative and operative staging. Preoperative radiation therapy caused a significant decline in patient survival at 6 and 12 months and has been abandoned.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Selection of operation for esophageal cancer based on staging. 242 25

This study was undertaken to determine the optimal surgical treatment of colorectal cancers with adherence to adjacent organs in the absence of distant metastases. A retrospective review of colorectal cancer at Virginia Mason Hospital from 1975 to 1979 divided patients with Dukes' stage B2 and C2 colorectal cancers into three treatment groups: standard colectomy, en bloc resection, and colectomy with separation of adherent organs, with 5 year survival rates of 55 percent, 61 percent, and 23 percent, respectively. No operative mortality occurred with en bloc resection. Survival after en bloc resection was influenced by Dukes' stage and the histologic documentation of cancer within the adherent organ. Unacceptably high local recurrence rates and poor 5 year survival rates were observed in cases where adherent organs were separated from the colorectal cancer. We conclude that colorectal cancer adherent to other organs should be treated by en bloc resection. The survival rate after en bloc resection will be comparable to the rate after standard colectomy for nonadherent colorectal cancers.
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PMID:En bloc resection of colon cancer adherent to other organs. 244 Mar 34

In 32 patients with colorectal carcinomas, the immunoreactivity of carcinoembryonic antigen (CEA) was measured on section preparations of the tumours by means of a computer controlled microdensitometric method. By measuring numerous single points, the intensity of the immunohistochemical staining reaction of CEA was evaluated. This method is superior to the commonly used semiquantitative method (+, ++, ) for the assessment of various degrees of staining intensity whenever the antigen to be measured is not homogeneously dispersed in the tissue. The results show that highly differentiated colorectal carcinomas of stage A according to Dukes classification have a lower CEA immunoreactivity than highly differentiated carcinomas of stage B. A correlation between CEA immunoreactivity and degree of malignancy could only be found in patients in stage B. Stage C carcinomas of all degrees of differentiation appeared with a very low CEA immunoreactivity. CEA follow-up controls in our study were of little value for detecting local recurrences; metastases, however, almost always caused an increase in serum CEA titers. Prognostically, a preoperatively increased serum CEA level seems to be as unfavourable as a low CEA immunoreactivity in the tumour.
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PMID:Measuring of immunoreactivity of carcinoembryonic antigen (CEA) in colorectal cancer by microdensitometry. 247 Nov 80

A comparison of the prognostic values of the Dukes and Jass systems were performed with 722 patients with rectal cancer enrolled in the National Surgical Adjuvant Breast and Bowel Projects, protocol R-01. The Jass system revealed four prognostic groups when all patients or only Dukes' B and C cases were examined; however, the magnitude of differences between groups I and II and III and IV were small. Dukes' classification, as defined in this study, revealed five prognostic groups. A statistically strong association between the Jass and Dukes systems was observed. Although histologic grade permitted further prognostic discrimination of all Dukes stages except A, only the Jass system allowed for the subdivision of C cases with up to four nodes positive for metastases. Those in that group had survival rates comparable to B cases (no nodal involvement) when scores of I and II were found. The distributions of the patients in the extremes of the Jass and Dukes systems (C2 as defined) were almost similar. The findings indicate that the Jass system is a valid prognostic method for patients with rectal carcinoma. In this material, however, it basically allowed for only two major prognostic groups whereas five were noted by the Dukes method. These results, as well as the more objective nature of Dukes' classification, warrant its continued use for prognosis and therapeutic decisions for patients with rectal cancer.
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PMID:Relative prognostic value of the Dukes and the Jass systems in rectal cancer. Findings from the National Surgical Adjuvant Breast and Bowel Projects (Protocol R-01) 237 29

From 1976 through 1985, 68 patients were treated with radiation therapy at Ospedali Galliera, Genoa, Italy, for recurrence of radically-operated rectal adenocarcinomas, most of them in Dukes (Astler, Coller) B2, C1, and C2 stages. The average disease-free interval between surgery and recurrence was 12 months (range 2-144) in the whole group, versus only 6 months in stage C2 patients. Pain relief was obtained in 45 patients (66%), and reduction in recurrence size in 22 (32%), with the following global results: disease progression in 16 patients, no progression/regression in 26, partial regression in 19, complete response in 3, and not evaluable in 4. Twenty-one patients had many contemporaneous distant metastases (2 cases) or within a short period of time after the locoregional recurrence (19 cases). These results lead us to believe that radiation therapy should not be employed in so many cases of radical surgery for rectal adenocarcinoma as it is today, but only in case of locoregional recurrences, as an alternative to postoperative radiotherapy, combined, if needed, with adjuvant chemotherapy.
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PMID:[Radiotherapy of recurrences of adenocarcinoma of the rectum after radical surgery: Galliera Hospitals (1976-1985)]. 259 27

The prognostic value of nucleolar organizer regions and ploidy status in patients with Dukes' C colorectal cancer was determined. In addition, nucleolar organizer regions and ploidy status were compared with the established prognostic indices age, sex, tumour location and degree of histological differentiation. Fifty-one patients (27 men, 24 women) aged 35-81 years (median 64.8 years) were studied. Five years after presentation, 16 patients were alive and well. Survivors had significantly lower nucleolar organizer region counts (median value and range) in primary tumours 12 (8-15) and lymph node metastases 11 (8-15) than non-survivors 17 (14-25) and 18 (13-25) respectively (P less than 0.05). Fewer survivors had aneuploid tumours than non-survivors: four survivors compared with 17 non-survivors. In a regression analysis model, nucleolar organizer regions were the most important individual variable for predicting survival (chi2 = 15, P less than 0.01) while ploidy values (chi2 = 6, P less than 0.2) were equivalent to histological differentiation.
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PMID:Prognostic value of nucleolar organizer regions and ploidy values in advanced colorectal cancer. 259 72

Thirty patients with Dukes stage D colon carcinoma who had undergone operative removal of the primary tumor and had growing hepatic metastases each received four intradermal injections of 0.5-4 mg of alum-precipitated goat anti-idiotypic antibodies (anti-Id). The anti-Id had been produced against murine monoclonal antibody (mAb) CO17-1A, which defines a human colon carcinoma associated antigen. All patients elaborated anti-anti-Id that shared idiotopes with mAb CO17-1A, bound to tumor cells and isolated tumor antigen, and competed with the mAb for binding to tumor cells. The clinical response was monitored by ultrasonography, CT, radionuclide scanning, and serum marker assays. Six patients had partial tumor responses; five of these had received additional booster anti-Id injections along with chemotherapy. Seven patients had stabilized tumor; six had received additional anti-Id, with chemotherapy also in four. Conclusions about the clinical role of such immunization await further study, but in demonstrating a specific response to anti-Id, our results support the use of this approach in human immunotherapy against tumors or pathogens.
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PMID:Modulation of cancer patients' immune responses by administration of anti-idiotypic antibodies. 261 Aug 26

Of 359 patients with colorectal cancer admitted over a period of about 11 years, 17 (4.7%) were 40 years of age or younger (group 1) and 342 (group 2) were older. In group 1 at the time of diagnosis, there were 9 men and 8 women; the average age was 34.2 years. Abdominal pain and diarrhea were the most common presenting symptoms. The average delay between onset of symptoms and treatment was 8.2 months (7.2 in group 2). Tumor stage at the time of diagnosis or at laparotomy was not more advanced than in group 2, the incidence of Dukes C lesions being 17.6% and 24.8%, and distant metastasis 17.6% and 18.7%, respectively. Analysis of tumor according to the stage (Astler and Coller classification), pelvic fat involvement, lymph node metastases and grading revealed no statistically significant differences between the 2 groups. The age factor had no impact on survival. It is concluded that in the present series, colorectal cancer in young patients differs in no respect from the disease in older patients.
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PMID:Colorectal cancer in patients 40 years of age and younger. 262 89

The discovery of synchronous hepatic metastases from colorectal cancer poses a tactical problem ticklish to resolve. What are favourable circumstances for curative excision of hepatic metastases? When and how to operate them? To try to respond, we analysed a collective of 36 patients between 10. 1. 1985 and 30. 12. 1986. Of the patients staged Dukes B presenting synchronous hepatic metastases (less than 4, less than 50% of hepatic involvement by the tumour) without systemic involvement, excision at the first attempt is realizable and will be a benefit for the patient. For the others, excision is to be considered in the near future after having analysed (tumour grading and staging, CEA, ploidy of primary tumour). Patients presenting extrahepatic metastases will not benefit from hepatic resection. Surgery, associated or not to regional infusion chemotherapy is discussed.
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PMID:[Synchronous hepatic metastases of colorectal adenocarcinoma: what is the course? Apropos of 36 cases]. 263 69


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