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 charts of 285 patients diagnosed as metastatic cancer from an undetermined primary site were reviewed. An attempt was made to characterize this disease entity more specifically, and to evaluate the various modes of therapy utilized in such patients. Adenocarcinoma is the most common histologic type overall; squamous cell carcinoma is most common in 5-year survivors. Lymph nodes are the most common metastatic site overall and in 5-year survivors. The mean overall survival is 8.69 months with 8.7% 2-year survivors and 2.8% 5-year survivors. Surgery alone, radiation alone or in combination, and chemotherapy alone or in combination were utilized in these patients with 5-year survivals of 11, 3.7, and 1.1%, respectively. The 5-year survivors all had therapy initiated immediately after histologic diagnosis and medical workup, and all of their tumors were less than 8 cm in diameter. In view of this data, patients with metastatic cancer from an undetermined primary site should always be considered for early, aggressive therapy.
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PMID:Metastatic cancer from an undetermined primary site. 685 44

Adenocarcinoma of the prostate commonly metastasizes to lymph nodes and bones, with occasional visceral deposits; lesions in the brain are rare. Although leptomeningeal carcinomatosis secondary to prostatic tumor has been reported, discrete cranial dural metastases from prostatic adenocarcinoma have not been described previously. The case of a patient having a unique adenocarcinoma of the prostate with bone, lymph node, and subdural metastatic lesions is presented.
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PMID:Subdural metastases from prostatic adenocarcinoma. 728 Sep 85

Periampullary tumors, especially carcinoma of the ampulla of Vater and, to a lesser degree, carcinoma of the distal common bile duct and duodenum, are potentially and theoretically curable, even in the presence of regional lymph node metastases. Adenocarcinoma of the anatomic head of the pancreas or of the uncinate process, regardless of the status of the local lymph nodes, may be an incurable tumor because of its late clinical presentation. The treatment of choice for selected, curable carcinomas of the periampullary region is radical pancreatoduodenectomy. Carcinoma of the head of the pancreas should be resected when careful dissection does not reveal regional or distant lymph node involvement. Other presumed curable malignancies presenting as a mass in the pancreatic head, such as cystadenocarcinoma, islet cell carcinoma, and rare connective tissue sarcomas, also should be treated by the Whipple operation. If the remaining, distal pancreatic duct is unsuitable for anastomosis, total pancreatectomy should be completed. The so-called "regional pancreatectomy," as well as resection of portal and superior mesenteric veins, can be performed, but the value of these procedures has not been proved. Palliative bypass procedures should be performed for all malignant masses in the head of the pancreas if distant spread of disease is evident. The only exception is an islet cell carcinoma; this tumor can be resected with satisfactory palliation of symptoms of hypoglycemia despite the presence of advanced disease. Biliary enteric bypass also should be employed when diseased regional lymph nodes are associated with carcinoma of the head of the pancreas or large carcinomas of the periampullary duodenum. A side-to-side choledochojejunostomy is the preferred method of decompression. Gastrojejunostomy is a frequent companion procedure.
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PMID:Mass in the head of the pancreas: a practical approach. 738 71

Carcinoma of the pancreas ranks in the 4th place among the causes of death due to tumour in the U.S.A. and the 5th in Geneva. 177 cases of pancreatic carcinoma (necropsies, resections and biopsies) were examined at the Geneva Departement of Pathology between July 1st, 1971 and December 31st, 1978. There was an equal sex distribution among the post-mortem cases while a female predominance (1.5x) was found in the cases obtained by biopsy or surgical resection. The mean age was higher in necropsy cases (69.6 years) than in surgical cases (61.2 years). The most common site was the head of the pancreas (57.5%). Adenocarcinoma was the predominant histologic type (86.5%). The majority of metastases found at necropsy were in the liver (61.3%), regional lymph nodes (51.1%), peritoneum (27.7%) and lungs (26.3%). The most frequent causes of death were lung embolism (24%), bronchopneumonia (16%), tumour or metastases (14.6%) or cachexia (8.8%). Prognosis was always severe, with an average survival time varying between 4 and 10 months depending on the type of surgical treatment (palliative surgery or resection). These results are similar to those of other series in the literature.
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PMID:[Pancreatic cancer in Geneva. Anatomic-clinical study on 177 cases]. 739 71

The rate of metastasization was estimated by calculating the coefficients of the metastases involved lung mass and the number of metastatic nocules. The experiments with melanoma B-16 and Lewis carcinoma have shown a marked stimulating effect of removing the primary tumor node on metastases growth, the number of metastatic nodules in the lung being less compared with control, but these were larger. In experiments with carcinoma RL-67 the removal of the primary node would not stimulate the growth of metastases. Adenocarcinoma 755 showing no metastases in routine percutaneous inoculation would not give metastases too after the removal of the primary tumor.
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PMID:[Effect of resection of the primary focus on matastasis of transplantable tumors]. 740 3

Adenocarcinoma of the pancreas is becoming an increasingly common disease. The differential diagnosis of pancreatic adenocarcinoma is that of obstructive jaundice. Suspicious findings on history and physical examination can be confirmed with appropriate laboratory and radiologic testing. Approximately 20% of patients with small lesions and no metastatic disease may be cured with resection. The operative mortality and morbidity for major pancreatic resections is now sufficiently low to warrant a more aggressive approach to these patients.
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PMID:Pancreatic adenocarcinoma: a review for primary care physicians. 750 97

The operative specimens from 43 patients undergoing en bloc esophagectomy for adenocarcinoma of the lower esophagus or cardia were analyzed. Depth of invasion of the tumor and extent and location of lymph node metastases were determined. Postoperative recurrence was identified from positive findings on successive 3-month computed tomographic scans. Positive nodes occurred in 33% (2/6) of intramucosal tumors, 67% (6/9) of intramural tumors, and 89% (25/28) of transmural tumors (p < 0.01). Commonly involved nodes were those in the lesser curve of the stomach (42%), parahiatal nodes (35%), paraesophageal nodes (28%), and celiac nodes (21%). Excluding perioperative deaths, follow-up was complete for 38 patients. Twenty patients had recurrence. Fifteen patients (40%, 15/38) had nodal recurrence: cervical, 7.9% (3/38); superior mediastinal, 21% (8/38); and abdominal, 24% (9/38) (retropancreatic in 7 and retrocrural in 2). Of 5 patients with nodal recurrence alone, 3 (60%) had recurrence at sites outside the margins of resection. Patients with four metastatic nodes or less had a survival advantage over those with more than four (p < 0.05). There was no difference in survival according to location of nodal metastases. Two (22.2%) of 9 patients with celiac node metastases survived longer than 4 years. Adenocarcinoma of the lower esophagus and cardia spreads widely to mediastinal and abdominal nodes, and death can occur from nodal disease. Rates of lymph node metastases increase with the depth of the primary tumor. Patients with lymphatic metastases can be cured particularly if there are fewer than four nodes involved. Curative surgical therapy necessitates wide lymph node resection to ensure removal of all metastatic nodes.
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PMID:Nodal metastasis and sites of recurrence after en bloc esophagectomy for adenocarcinoma. 794 84

Adenocarcinoma of the prostate is the most common malignant neoplasm occurring in men. About half of patients present with metastatic disease. The mainstay of the treatment of stage D cancer of the prostate is hormonal therapy. Bilateral simple orchiectomy remains the gold standard with which other therapies must be compared. Luteinizing hormone-releasing hormone analogues and antiandrogens are now most commonly used but are costly. Initiating hormonal therapy immediately on diagnosing metastatic disease appears to have some advantage over delaying therapy until a patient is symptomatic. Total androgen blockade also appears to be beneficial in terms of survival but at high cost.
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PMID:Hormonal therapy for stage D cancer of the prostate. 802 85

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

Adenocarcinoma of the breast rarely metastasizes to the mucosal surfaces of the uterus. We present two patients with endometrial involvement, in one of whom it was the initial manifestation of her breast cancer. Two additional patients with cervical involvement had abnormal Papanicolaou smears and grossly normal cervices. One of these patients underwent a biopsy, the results of which confirmed metastatic adenocarcinoma. Three of the four patients had previously well-established metastatic disease. The presence of genital, especially mucosal, metastases is indicative of widespread disease and imminent demise. This occurred in one of the patients described here; however, another patient survived 30 months. Breast cancer is a chronic disease for which the metastatic behavior is exceptionally unconventional. Tissue acquired by endometrial curettage or colposcopy may require an awareness on the part of the pathologist to such a clinical circumstance.
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PMID:Breast cancer metastatic to the uterus. Clinical manifestations of a rare event. 806 Feb 32


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