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 use of aggressive chemotherapy undoubtedly has brought about a dramatic increase in the cure rate of osteosarcoma. The authors' investigations have increased the authors' knowledge of chemotherapy for osteosarcoma, the differential efficacy of currently used agents, and the pronounced schedule dependency and relative route independency of their efficiency. The authors were able to confirm the prognostic significance of tumor response after preoperative chemotherapy. Preoperative chemotherapy in itself has facilitated and promoted limb-salvage surgery. Also, more patients can be cured today by use of aggressive thoracic surgery in case of primary or secondary pulmonary metastases. The authors' efforts to steadily increase metastasis-free survival rates by intensifying chemotherapy in this series of studies, however, have been only moderately successful. Still, chemotherapy-related acute toxicity is considerable and increases with aggressiveness of treatment, and the manifestations of late toxicity may continue to increase with follow-up time. Future trials should be targeted toward exploration of the minimum indispensable amount of toxic treatment yielding comparable or even better results than those currently attainable.
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PMID:Local control and survival from the Cooperative Osteosarcoma Study Group studies of the German Society of Pediatric Oncology and the Vienna Bone Tumor Registry. 171 20

The omental lymphoid organ (OLO) is a part of the greater omentum composed of vascularized milky spots situated between fat cells and containing lymphocytes, plasma cells and macrophages. We analysed the disappearance of intraperitoneally injected tumor cells from the peritoneal cavity and their infiltration into and disappearance from the OLO and the parathymic lymph nodes (PTLN) that drain the peritoneal cavity. After intraperitoneal inoculation of irradiated syngeneic tumor cells, they were visible in the OLO within 24 h. After 3 days, no tumor cells were seen anymore, but there were many macrophages that had phagocytosed tumor cells. After intraperitoneal inoculation of nonirradiated syngeneic tumor cells, a solid growing tumor mass developed in the OLO. The PTLN were also invaded by these nonirradiated tumor cells within 24 h as transfer of cell suspensions of these lymph nodes into naive mice leads to the death of the recipient mice due to tumor growth. However, from day 6 onwards, after tumor inoculation, these lymph nodes contained no tumor cells, despite progressive tumor growth intraperitoneally and in the liver and lungs. In allogeneic mice, tumor cells were rejected in the OLO after 7-10 days. Simultaneously, the number of lymphocytes and macrophages increased and a plasma cell reaction developed. The PTLN did not have tumor-inducing potency at any stage after intraperitoneal tumor injection. This study suggests, that the PTLN are more effective in the (local) eradication of tumor cells than the OLO. Still, considering its immunological potential, the OLO might be important as 'inducer' of immunological reactions in the peritoneal cavity.
Invasion Metastasis 1991
PMID:Parathymic lymph nodes during growth and rejection of intraperitoneally inoculated tumor cells. 176 34

The antiestrogen tamoxifen is the most widely used hormonal therapy for breast cancer. The drug exerts its antiproliferative effects primarily through estrogen receptor (ER)-mediated mechanisms, although other cellular actions may augment tumor inhibition. Clinically, tamoxifen has been less well studied in premenopausal than in postmenopausal patients. The drug has complex endocrine effects that are dependent on the treatment duration and dose, menopausal status, and target organ. In postmenopausal women receiving tamoxifen, serum estrogen levels remain low, and the normally elevated gonadotropin levels decrease. In contrast, serum estrogen levels are strikingly elevated in many premenopausal women, and gonadotropin concentrations are either unchanged or slightly increased. Large systematic trials in metastatic breast cancer have established tamoxifen as the recommended hormonal therapy for postmenopausal women with ER-positive tumors. Tamoxifen is also an active agent for premenopausal metastatic disease, and response rates are comparable to those reported for oophorectomy. Clinical experience with tamoxifen in this younger age group, however, is more limited. Few premenopausal women (less than 400) have been included in phase II and phase III trials. Two randomized trials (total of 160 patients) comparing oophorectomy with tamoxifen do not definitively establish therapeutic equivalence, and a survival advantage for either treatment cannot be excluded. Many questions remain concerning the appropriate role for tamoxifen in premenopausal patients. Still, tamoxifen has an attractive toxicity profile, and it offers a favorable therapeutic alternative for premenopausal women with ER-positive metastatic breast cancer who wish to avoid surgical or radiation castration.
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PMID:Tamoxifen in premenopausal patients with metastatic breast cancer: a review. 204 68

Metastasis to distant organs is the principal cause of death from renal cell carcinoma (RCC). No commonly accepted therapy is available for disseminated RCC at present. Immunotherapy is a mode of therapy that either interferes with the immune system or makes use of drugs that have been derived from soluble mediators of the immune system. Several lines of evidence suggest that combinations of genetically engineered cytokines (e.g. interleukin-2 and interferon alpha) may be particularly active in the treatment of advanced RCC. There are two major rationales for considering immunotherapy for RCC: (1) there is currently no other therapy available, and (2) there is hardly any innovative approach besides immunotherapy. Still, immunotherapy is far from being a standard therapy for disseminated RCC.
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PMID:Rationale for immunotherapy of renal cell carcinoma. 210 Apr 10

The wide range of oncogenic proliferative potentials of the fibroblast is demonstrated with a series of eight patients. Diagnoses included infantile digital fibromatosis, "aggressive fibromatosis," aggressive fibromatosis progressing to poorly differentiated sarcoma, infantile myofibromatosis, recurrent desmoid tumor, fibrosarcoma arising in a keloid, dermatofibrosarcoma protuberans, and malignant fibrous histiocytoma of left atrium. Still other types of fibroblastic tumefactions might have been included. Oncogenic factors that may have been operative in the causation of the lesions presented include: genetic factors, sex-linked factors, hormonal factors, numerous growth factors, and certain viruses, especially retroviruses. Certain fibromatoses in children are commonly self-limited and need only be monitored carefully as the process regresses. Aggressive fibromatosis, on the other hand, can prove fatal if the lesion is not completely resected with a wide margin and, occasionally, the process may become frankly malignant, with metastases. The standard triad of excisional surgery, radiotherapy, and chemotherapy has been used to treat frankly malignant fibrous tumors with variable results.
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PMID:The ubiquitous fibroblast. Multiple oncogenic potentials with illustrative cases. 303 75

In most western countries, carcinoma of the prostate is the second most frequent cause of cancer death following carcinoma of the lung. In the pathogenesis of clinical carcinoma of the prostate, several mutational steps can be distinguished which correlate with subclinical and clinical situations. Focal carcinoma is identified in autopsy series at least 500-1,000 times more than is appreciated on clinical grounds alone. Still, focal carcinoma must be considered the precursor of all clinical disease. At least three mutational steps must be involved in the pathogenesis: the development of focal carcinoma from normal cells, the progression to hormone-dependent clinical carcinoma, and the progression to hormone-independent carcinoma. The geographic variation of these events suggests that exogenous factors play an important role in the pathogenesis of prostatic cancer. Focal, noninvasive carcinoma is found in the clinical situation incidentally upon treatment of obstruction in 8-12% of cases with benign prostatic hyperplasia. This lesion is usually not treated aggressively. The incidence of clinical prostatic carcinoma is strictly age-related. Because the tumor largely occurs after age 50, and competing causes of death play an important role, only about 50% of all patients with clinical prostatic carcinoma are likely to die of this disease. Prostatic carcinoma is most frequently diagnosed in the metastatic state (40-50%). The remainder are locally confined with an incidence of lymph node metastases of roughly 35%. Tumors diagnosed in the metastatic state have a distinctly poorer prognosis than tumors diagnosed as potentially curable lesions. Metastatic prostatic carcinoma is usually managed by means of androgen suppression. Hormone-dependent human tumor lines in nude mice suggest that endocrine-dependent cells are not killed by androgen withdrawal, but remain dormant and can be restimulated to grow. In the same sense, management of prostatic carcinoma appears to be palliative. Patients die of prostatic carcinoma because hormone-independent cell populations develop and cannot be influenced by hormonal management. Still-open questions concerning endocrine management are the timing of androgen withdrawal (early versus delayed) and the degree of androgen withdrawal (total versus subtotal). Luteinizing hormone-releasing hormone (LHRH) agonists and antiandrogens allow endocrine management with minimal side effects. Prolongation of life and cure can only be expected from simultaneous effective treatment of hormone-independent tumor cell populations.
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PMID:Current concepts in the management of prostatic cancer. 338 35

In most reviews of arterial embolism or thrombosis the source of emboli or the cause of thrombosis can reasonably be established in over 90% of patients. Still about 10% remain without demonstrable cardiac or intraarterial sources. Although hypercoagulability induced by malignancy has been alluded to as a cause of unexplained intravascular thrombosis reports of arterial thromboembolism with such association are rare. Seven patients with unequivocal thromboembolism are presented. Two distinct clinical patterns are observed, one with in situ thrombosis of small arteries and the other with occlusion of large arteries causing limb ischemia or fatal organ infarction. The various pathogenetic mechanisms of arterial thrombosis or embolism in malignancy include sustained spasm of arteries, precipitation of cryoglobulins or other abnormal proteins in small arteries, direct tumor invasion of arteries, fragmentation and embolization of intracardiac or intraarterial metastases and spontaneous arterial thrombosis due to hypercoagulability. The hypercoagulable state can be recognized by the observation of shortened bleeding and clotting times, partial thromboplastin and prothrombin times, elevation of coagulation factors, platelets and yield stress index and resistance to anticoagulation. Patients presenting with arterial thromboembolic events with out demonstrable source should be investigated for malignancy. Conversely patients with malignancy should be searched for evidence of hypercoagulability in an attempt to prevent arterial thromboembolic complications.
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PMID:Arterial thrombosis and embolism in malignancy. 403 Aug 80

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

Each year in the United States, approximately 100,000 men are found to have prostate cancer. Of these, about half show evidence of bony metastases at the time of presentation. Each year, too, some 30,000 American men die of prostate cancer. Conceptually, the treatment of metastatic prostate cancer has changed little in the 50 years since Charles B. Huggins and Clarence V. Hodges discovered the hormone-dependent nature of prostate cancer cells. Still, as the years have passed, several therapeutic options have become available. For the most advanced cases, treatment centers on relief of urinary obstruction and amelioration of the pain of bony metastases, along with vigilance for the potentially disastrous sequelae of acute neurologic change due to spinal fractures. In Part I of this article, which appeared in the April 15 issue of Hospital Practice, we discussed the assessment and management of localized carcinoma of the prostate. In this part, the focus shifts to disseminated disease (Figure 1). We again present two cases representing distinctly different points on the spectrum of disease and discuss how management would proceed in each case. This strategy affords an opportunity to review the various available treatment options, with their advantages and drawbacks.
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PMID:Managing prostate cancer. Part II: Disseminated disease. 847 66

Differentiated thyroid carcinoma (DTC) is a rare tumor with a generally good prognosis. Still some of these cancers cause the patient's death after many years of illness. Thus, treatment and aftercare have to be risk-adapted according to tumor type and staging. Surgery is the primary treatment for this tumor and its metastases, followed by therapy with radioiodine. According to the guidelines edited by the German Association for Nuclear Medicine (DGN)--work group for therapy--radioiodine therapy is an effective regimen with minimal side-effects. Radioiodine scintigraphy is the most important part of the aftercare program, together with the monitoring of the highly specific tumormarker thyreoglobulin. Other diagnostic modalities may be added when considering therapeutic options or confirming clinical suspicions. This paper aims at giving an update and overview on the applications of radioiodine, other radioisotopes and additional diagnostic and therapeutic options in differentiated thyroid cancer and related aspects of radiation exposure and radiation protection. As new therapeutic procedures and optimised diagnostic modalities become available, there is new hope for patients with locally advanced or metastatic DTC.
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PMID:[Radioiodine therapy and radioiodine after-care in differentiated thyroid gland carcinomas]. 922 38


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