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Query: UMLS:C0027627 (
metastases
)
103,950
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Four patients with malignant fibrous histiocytoma of bone (MFH-B) metastasizing to brain are reported. In two cases, signs of cerebral involvement developed between 4 and 28 months after diagnosis. Both patients had known pulmonary or bony
metastases
. As a consequence of this experience, two further patients were subsequently identified, one with a definite cerebral metastasis and one who had an asymptomatic supratentorial lesion, possibly metastatic. It is suggested that patients with MFH-B and widespread
metastatic disease
at presentation or developing within a short interval should undergo cerebral imaging.
Sarcoma
2000
PMID:Cerebral metastases from malignant fibrous histiocytoma of bone. 1852 Dec 91
Purpose. The present prospective randomized adjuvant trial was carried out to compare the toxicity, feasibility and efficacy of augmented chemotherapy added to hyperfractionated accelerated radiotherapy after wide or marginal resection of grade 2 and grade 3 soft tissue sarcoma (STS).Patients and methods. Fifty-nine patients underwent primary surgery by wide or marginal excision and were subsequently randomized to receive radiotherapy alone or under the addition of six courses of ifosfamide (1500 mg/m(2) , days 1-4), dacarbazine (DTIC) (200 mg/m(2) , days 1-4) and doxorubicin (25 mg/m(2) , days 1-2) administered in 14-day-intervals supported by granulocyte-colony stimulating factor (30 x 10(6) IU/day, s.c.) on days 5-13. According to the randomization protocol, 28 patients received radiotherapy only, whereas 31 patients were treated with additional chemotherapy.Results. The relative ifosfamide-doxorubicin-DTIC (IFADIC) dose intensity achieved was 93%. After a mean observation period of 41+/-19.7 months (range, 8.1-84 months), 16 patients (57%) in the control group versus 24 patients (77%) in the chemotherapy group were free of disease (p>0.05).Within the control group, tumor relapses occurred in 12 patients (43%;six patients with distant
metastases
, two with local relapse, four with both) versus seven patients (23%; five patients with distant
metastases
, one with local recurrence, one with both) from the chemotherapy group. Relapse-free survival (RFS) (p=0.1), time to local failure (TLF) (p=0.09), time to distant failure (TDF) (p=0.17) as well as overall survival (OS) (p=0.4) did not differ significantly between the two treatment groups. Treatment-related toxicity was generally mild in both treatment arms.Conclusion. We conclude that the safety profile of intensified IFADIC added to radiotherapy was manageable and tolerable in the current setting. Inclusion of intensified IFADIC was not translated into a significant benefit concerning OS, RFS, TLF andTDF as compared with radiotherapy only, although a potential benefit of chemotherapy for grade 3 STS patients needs to be validated in prospective randomized trials including larger patient numbers.
Sarcoma
2000
PMID:Intensified Adjuvant IFADIC Chemotherapy for Adult Soft Tissue Sarcoma: A Prospective Randomized Feasibility Trial. 1852 Dec 95
Purpose. Chondrosarcoma (CS) most commonly involves the pelvis. The factors that influence local and systemic control of pelvic CS and the functional outcome should be evaluated.Patients. Fifty-one patients (37 males and 14 females; mean age, 39.4 years) with pelvic CS were included in this retrospective study.Methods. The tumor stage, surgical treatment, surgical margin achieved, complications, incidence of local recurrence (LR), incidence of distant
metastases
, and the oncologic and functional status were evaluated. Oncologic outcome was estimated by the method of Kaplan and Meier, and the functional status was scored according to Musculoskeleral Tumor Society (MSTS) criteria. Analysis of variance was used to determine the factors that influence the oncologic and functional outcome.Results. Surgical stages were IA in three cases, IB in 23, IIB in 23, and III in two. Hemipelvectomy (H) was performed in 13 cases, internal hemipelvectomy (IH) with endoprosthetic replacement in 17, and continuity resection (CR) in 23.Two patients received IH and CR, one due to LR, and one due to instability. Radical or wide margins were achieved in 27 cases, marginal margins in 16, and intralesional margins in eight. Local complication required additional surgery in 10 cases due to local infections and/or hematomas.Two patients died perioperatively. In 48 out of the 49 remaining patients, follow-up was available with a mean duration of 73.4 months (range, 4-229 months).Twenty patients died of the disease, two patients are alive with
metastases
, four patients are disease free after LR, and 22 patients show no evidence of the disease. LR occurred in 10 cases (20.4%), and 17 patients (34.6%) developed distant
metastases
. Functional evaluation of the 28 survivors revealed good and excellent results in 19 cases, fair in three and poor in six.The mean MSTS score of all survivors was 69.2%, after H it was 37.6%, after IH was 61.4%, and after CR was 79.5%.Conclusion. In pelvic chondrosarcoma, survival was determined by the tumor stage and the surgical margin achieved.The incidence of LR was influenced by the surgical margin achieved, whereas the incidence of distant
metastases
was influenced by the tumor stage. The best oncologic results in chondrosarcoma involving the innominate bone could be found in low-grade tumors, and the best functional results after continuity resection and restoration of the pelvic girdle.
Sarcoma
2000
PMID:Chondrosarcoma of the pelvis: oncologic and functional outcome. 1852 Dec 96
Purpose. To illustrate the propensity of meningeal hemangiopericytoma to spread extraneurally, as a distinction to the ordinary meningioma.Patients or subjects. A patient with long history of meningeal hemangiopericytoma was reported.Methods. A case report on meningeal hemangiopericytoma with a literature review was presented.Results. The patient has multiple local recurrence as well as distant
metastases
.This is the first case report of metastatic meningeal hemangiopericytoma causing compression of the pancreatic head.The patient also has biopsy-proven pulmonary
metastases
.The patient received both local and systemic therapy.Discussion. It is important to recognize the distinctive features differentiating meningeal hemangiopericytoma from meningioma. The positive impact of clinico-pathological correlation on patient management is emphasized.
Sarcoma
2000
PMID:Pancreatic head mass from metastatic meningeal hemangiopericytoma. 1852 Dec 97
Purpose. Angiosarcoma is a rare tumor with endothelial cell differentiation that may arise in any anatomic location.The purpose of this report was to identify prognostic factors on outcome in a group of prospectively followed patients with confirmed angiosarcoma.Subjects. Adult patients (>16 years old) with angiosarcoma treated between July 1982 and February 1998 were identified from a prospective database.Methods. Pathologic confirmation of all cases was performed prior to inclusion in this analysis. Various prognostic factors were evaluated for disease-specific survival. Survival was determined by the Kaplan- Meier method. Statistical significance was evaluated by log-rank test for univariate analysis and Cox stepwise regression for multivariate analysis (p<0.05).Results. Fifty patients were identified; at the initial evaluation, this group included 32 patients with a primary tumor, three with local recurrence and 15 with
metastatic disease
. Tumor sites included 16 head and neck and skin of head, eight extremity, seven trunk, six breast, five pelvis, four viscera and four thoracic. Median follow-up among survivors was 71 months (range, 38-191 months).Two- and 5-year disease-specific survival was 50 and 30%, respectively, with a median of 24 months. The factor predictive of tumor-related mortality was presentation status (p=0.001; relative risk, 5). Two-year disease-specific survival for patients presenting with recurrent or
metastatic disease
was 13%, compared with 70% for those with primary disease.
Sarcoma
2000
PMID:Confirmed angiosarcoma: prognostic factors and outcome in 50 prospectively followed patients. 1852 Dec 98
Purpose. To enumerate lessons from studying 4292 patients with rhabdomyosarcoma (RMS) in the Intergroup Rhabdomyosarcoma Study Group (IRSG, 1972-1997).Patients. Untreated patients < 21 years of age at diagnosis received systemic chemotherapy, with or without irradiation (XRT) and/or surgical removal of the tumor.Methods. Pathologic materials and treatment were reviewed to ascertain compliance and to confirm response and relapse status.Results. Survival at 5 years increased from 55 to 71% over the period. Important lessons include the fact that extent of disease at diagnosis affects prognosis. Re-excising an incompletely removed tumor is worthwhile if acceptable form and function can be preserved. The eye, vagina, and bladder can usually be saved. XRT is not necessary for children with localized, completely excised embryonal RMS. Hyperfractionated XRT has thus far not produced superior local control rates compared with conventional, once-daily XRT. Patients with non-metastatic cranial parameningeal sarcoma can usually be cured with localized XRT and systemic chemotherapy, without whole-brain XRT and intrathecal drugs. Adding doxorubicin, cisplatin, etoposide, and ifosfamide has not significantly improved survival of patients with gross residual or
metastatic disease
beyond that achieved with VAC (vincristine, actinomycin D, cyclophosphamide) and XRT. Most patients with alveolar RMS have a tumor-specific translocation. Mature rhabdomyoblasts after treatment of patients with bladder rhabdomyosarcoma are not necessarily malignant, provided that the tumor has shrunk and malignant cells have disappeared.Discussion. Current IRSG-V protocols, summarized herein, incorporate recommendations for risk-based management. Two new agents, topotecan and irinotecan, are under investigation for patients who have an intermediate or high risk of recurrence.
Sarcoma
2001
PMID:The Intergroup Rhabdomyosarcoma Study Group (IRSG): Major Lessons From the IRS-I Through IRS-IV Studies as Background for the Current IRS-V Treatment Protocols. 1852 3
We report a rare case of a primary leiomyosarcoma of the adrenal gland. A 73-year-old woman presented with an inferior vena cava syndrome. MR imaging was suggestive of a large tumour originating from the right adrenal gland. Angiography revealed a tumour vascularised by the right adrenal artery. At explorative laparotomy a tumour of 27 cm in diameter was found which was completely fixed to the liver; the tumour was therefore considered unresectable. As a consequence of the mechanical problems caused by this large tumour, the patient died 3 weeks after the operation. Autopsy revealed no distant
metastases
or other primary tumour site.
Sarcoma
2001
PMID:Primary leiomyosarcoma of the adrenal gland. 1852 10
Using the second best method of meta-analysis it is significantly shown that patients with an interval of less than 7 months between diagnosis of soft tissue sarcoma and lung surgery for
metastases
do not benefit.
Sarcoma
2002
PMID:Which Soft Tissue Sarcoma Patients with Lung Metastases Should not Undergo Pulmonary Resection? 1852 29
We report a case of a 78-year-old patient with penile leiomyosarcoma, treated by radical penectomy. Two years after the operation the patient is without evidence of local recurrence or
metastatic disease
.We also discuss the treatment options and attempt a review of the literature.
Sarcoma
2002
PMID:Leiomyosarcoma of the penis. 1852 32
Gastrointestinal stromal tumour (GIST) is the commonest mesenchymal tumour to affect the gastrointestinal tract. Appropriate management requires accurate diagnosis and the skills of a multidisciplinary team. Surgery is the only curative treatment option and should be performed whenever feasible, by experienced personnel. For patients with advanced unresectable or
metastatic disease
, the receptor tyrosine kinase inhibitor imatinib offers effective therapy and can provide effective palliation for the majority of patients with this disease. The background to this recent development and a guideline for the management of GIST is proposed.
Sarcoma
2002
PMID:A Guideline for the Management of Gastrointestinal Stromal Tumour (GIST). 1852 37
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