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

Local tumor control remains a continuing challenge in the treatment of retroperitoneal soft tissue sarcoma. Though complete resection by means of wide excision or excisional biopsy can be performed in a minority of patients only, aggressive surgical approach remains the treatment of choice. Unresectable sarcoma can rarely be controlled by conventionally applied radiotherapy--only a few percent of patients survive. A superior dose distribution of external radiation is demanded in order to spare healthy tissue. The presumably greatest advantage will occur when radiotherapy is used preoperatively. The possible clinical gain of superior dose distribution is demonstrated by results of the dynamic, 3-D conformal pion radiotherapy at PSI. Between April 1983 and June 1988 a total of 21 patients were treated with high doses (greater than or equal to 30 Gy) for unresectable retroperitoneal soft tissue sarcoma. The follow-up time is 13-74 months, median 24. Fifteen patients were treated with 20 fx, and 19 patients were treated with fraction sizes of 150 or 165 cGy. Except for one patient with thrombocytopenia after chemotherapy, no treatment interruption was necessary. Five patients developed late reactions, caused also by surgery and chemotherapy: two intestinal obstructions, one liver abscess, one leg edema, and one superficial skin necrosis. Nine patients had laparotomy after pion irradiation, five for resection of the previous unresectable tumor; 3/5 sarcoma were completely resected. Morbidity rate after post-pion laparotomy did not increase. Three patients had local tumor progression, 1/3 inside the treatment volume. The actuarial five-year local tumor control rate of these unresectable retroperitoneal sarcoma is 60%, the actuarial five-year survival rate is 33%. Out of the 21 patients, 15 are alive, two have died from local progression, one from peritoneal progression, and three from metastases.
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PMID:Conformal radiotherapy for unresectable retroperitoneal soft tissue sarcoma. 174 Mar 94

Rectal carcinoma remains an enigma to surgical and medical oncologists. The chemo- and radiotherapeutic approaches have been fraught with failure, and when this happens the patient is left to the challenge of the surgical oncologist who sometimes must perform extensive re-resection to include adjacent structures. Experienced surgical judgement is assisted by preoperative and intraoperative criteria, which are contraindications to resection: preoperatively, they include metastases, fixation of tumour to pelvic wall, sciatica, obstruction of both ureters and leg edema. Intraoperatively, metastases within aortic nodes or beyond the pelvis and extension of disease laterally or deep to pelvic wall or to multiple loops of bowel are all contraindications. These tumours are often slow to metastasize so that aggressive local surgical resection is warranted to minimize the morbidity prone complications associated with low-lying perineal or pelvic recurrence of rectal cancer.
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PMID:The management of recurrent rectal carcinoma. 241 73

Leiomyosarcoma of the inferior vena cava is reported with increasing frequency but remains a rare lesion. In this article we report one case and review 69 cases. The disease affects mainly women approximately 50 years of age. The symptoms vary according to the location of the tumor; Budd-Chiari syndrome and leg edema occur in the more centrally located tumors and abdominal pain and swelling are seen in the more peripherally located ones. In 40% of the cases distant metastases are evident at the time of the patients' first presentation and are found most commonly in the liver and/or lungs. After resection the majority of the patients eventually die of metastatic disease with a mean survival of approximately 40 months.
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PMID:Leiomyosarcoma of the inferior vena cava. Case report and review of the literature. 395 63

Between 1970 and 1982, 126 inferior vena cava (IVC) balloon occlusions were performed for complications of venous thromboembolism (VTE). Forty, or 32%, were in patients with cancer. There were 20 men and 20 women. The average age was 60.8 +/- 2 years. Cancers of the brain, lung, and breast, along with diffuse metastatic disease with unknown primary disease, were equally common and represented 50% of our cases. Indications for IVC occlusion included pulmonary embolus despite anticoagulation (AC); 50% VTE and contraindication to AC, 38%; and complications of AC, 12%. Three patients died from ongoing complications of previous AC. Eight additional patients died of cancer, for a hospital mortality rate of 28%. Twenty-nine patients were discharged an average of 28.4 +/- 4.3 days after IVC balloon occlusion. Twenty of these patients subsequently died of cancer an average of 13 +/- 4.7 months after hospital discharge. Eight patients remain alive, four for more than 4 years. Pulmonary emboli did not occur after balloon occlusion, and there were no balloon complications. Only 4 of 29 discharged patients had mild leg edema. Hunter balloon occlusion of the IVC represents a safe and effective method for managing complications of VTE in patients with cancer. Early hospital discharge is possible, treatment is permanent, and future chemotherapy is not compromised by the need for long-term anticoagulation.
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PMID:Thromboembolism and cancer: treatment with the Hunter balloon. 623 42

Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. Tumor doses most commonly used were 4500-5000 rad/5 weeks (180 rad to 200 rad per fraction). With a minimum two-year follow-up, there were only two regional failures in patients whose primaries were controlled; both failures occurred outside of the radiation fields. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One patient with moderate fibrosis had bilateral mild leg edema that was questionably related to irradiation. No other instances of leg or genital edema were noted. Complications were dose-related. The advantages and disadvantages of elective ilioinguinal node irradiation versus elective inguinal lymph node dissection or no elective treatment are discussed.
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PMID:Elective ilioinguinal lymph node irradiation. 642 97

A 65-year-old female was admitted with leg edema by retroperitoneal fibrosis and tricuspid valve incompetence by fibrosis, cutaneous fibrosis, moderate flushing over the upper body without diarrhea. It revealed an ileal carcinoid tumor with hepatic metastases. Octreotide (Sandostatine), tumor excision and interferon alpha 2b treatment led to a regression of flushing and edema, a reduction of fibrosis and a stabilization of the metastatic carcinoid, with normal serotonin levels.
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PMID:[Edema caused by retroperitoneal and tricuspid fibrosis with sclerodermatous cutaneous involvement disclosing carcinoid tumor. Apropos of a case and review of the literature]. 918 47

Prostate cancer survivors frequently seek natural remedies for elevated or rising PSA concentrations to forestall the necessity for more definitive modalities. PC-SPES is one of the most widely used of the complementary medicines. It consists of eight Chinese herbs, and although it contains no estrogen, it does exhibit some estrogenic effects. For this reason, UsToo was anxious to determine just how successful the product is and whether any side effects are present. A four-page survey form was designed and pretested on a dozen patients. After refinement, the form was sent to 200 PC-SPES users, mostly UsToo members, with anonymity assured. In only five cases did respondents not identify themselves. After 102 responses had been received, a compilation form was designed to simplify computer database entry of the survey results. This produced a spreadsheet of all 102 respondents' categorized answers. Final analysis followed, with emphasis on prostate specific antigen (PSA) concentrations before and after PC-SPES use, quality of life (QoL), side effects, dosage, and relation to concurrent treatment modalities. Graphs were then constructed on each respondent for study of slope data and PSA changes. Twenty respondents provided insufficient data for analysis; the remaining 82 surveys gave us a good picture of PC-SPES usage and results, as well as information on commingling of other modalities with PC-SPES. Beneficial effects were reported by 77% of the respondents, with 23% reporting more limited or marginal results. Side effects reported were breast tenderness and lowered libido, with three respondents also reporting leg edema. There were no reported cases of circulatory problems or thrombosis. Declines in PSA were reported of as much as 70 ng/mL that were sustained for as long as the respondents have been using PC-SPES, approaching 2 years in some cases. No clinically significant adverse effects were observed. For some men, PC-SPES provides an alternative to hormonal therapy; has a palliative effect when used by patients with advanced, metastatic disease; and overall has a reported 77% effectiveness, with 87% effectiveness when recommended dosages are adhered to.
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PMID:Survey of UsToo Members and Other Prostate Cancer Patients to Evaluate the Efficacy and Safety of PC-SPES. 1085 41

There are few cases, to our knowledge, that report the successful treatment of iliac venous stenosis due to gynecologic malignancies with the use of self-expanding metallic endovascular stents. Our patient, who had right lower limb edema, had iliac lymph node metastases which caused iliac vein stenosis by direct invasion from endometrial cancer. The patient was not considered to be a good surgical candidate. A 10-mm diameter self-expanding metallic endovascular stent was placed in the external iliac vein. The patient's symptoms of right lower limb edema improved dramatically, and she was discharged at 3 weeks after stent placement. The patient had no further symptoms, with continued resolution of the right leg edema during the 10 months following stent placement, at which time she died from the primary disease. The treatment to this patient with a self-expanding metallic endovascular stent proved to be very efficacious and less stressful than direct venous reconstruction or femorofemoral venous bypass grafting. In addition, this procedure dramatically improved the patient's quality of life.
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PMID:Treatment with a metallic endovascular stent in a patient with iliac venous stenosis due to endometrial cancer. 1098 25

Gastrointestinal stromal tumors (GISTs) are a group of neoplasms arising from mesenchymal stem cells of the gastrointestinal tract. The prognosis of metastatic or recurrent GISTs is poor, because these tumors resist chemotherapy and radiotherapy. We report a patient with recurrent GIST who underwent molecularly targeted therapy with imatinib, a novel oral tyrosine kinase inhibitor. A 50-year-old woman presented with a huge intra-abdominal mass. The patient had a history of gastrectomy for GIST and hepatectomy for its metastases. She also underwent surgery for resection of peritoneal metastases 9 months before. The abdominal mass was 26 x 17 x 12 cm in size, as determined by magnetic resonance imaging, and was diagnosed as a peritoneal relapse of GIST. Treatment with 400 mg of imatinib daily was started. After 1 week of treatment with imatinib, reduction of the abdominal tumor began to be recognized on palpation. Computed tomographic scanning on day 28 revealed that the tumor had liquefactively regressed and had reduced in size by 66%. The major side effect was leg edema, which was easily manageable with furosemide. The patient has been receiving imatinib treatment in our outpatient clinic, and the tumor regression has continued for 9 months. Imatinib shows promise as a safe and effective drug for the treatment of patients with recurrent GISTs.
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PMID:A successful case of oral molecularly targeted therapy with imatinib for peritoneal metastasis of a gastrointestinal stromal tumor. 1285 43

Although studies suggest that microinvasive cervical adenocarcinoma has an excellent prognosis, none has reported treatment-related complications and many have lacked detailed measurement criteria. Our study looks at the rate of lymph node metastases and outcome, including complications, in patients with FIGO 1A1 and 1A2 adenocarcinomas of the cervix. Invasion was strictly defined, and the method of measurement was standardized. Villoglandular, papillary serous and clear cell carcinomas were excluded, as were tumors in which invasion exceeded 7 mm in width or 5 mm in thickness, with tumor thickness measured from the basement membrane of the overlying endocervical or ectocervical surface to the deepest focus of invasive tumor. A mean follow-up of 54 months (range, 5-159 months) was available for 31 of 32 (97%) patients. A total of 29 of 32 patients underwent hysterectomies, 2 patients had radical trachelectomies, and 1 patient was treated by cone biopsy. One patient received adjuvant radiotherapy. A total of 27 of 32 patients had bilateral pelvic lymph node dissections, and no lymph node metastases were identified. No recurrences have been reported to date. One patient died of metastatic ovarian carcinoma 82 months after her diagnosis of cervical carcinoma. Two of 27 (7%) patients have chronic leg edema secondary to lymph node dissection. Given the excellent prognosis of this tumor, the absence of lymph node metastases and a lymph node dissection complication rate of 7%, less radical surgery should be considered in this low-risk patient population.
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PMID:Microinvasive cervical adenocarcinoma (FIGO stage 1A tumors): results of surgical staging and outcome analysis. 1653 58


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