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)

From July 1986 to July 1989, 40 patients (92% pretreated) with deep-seated, advanced soft tissue sarcomas (STS, 25 patients), Ewing's sarcomas (ES, eight patients), osteosarcomas (OS, three patients) and chondrosarcomas (ChS, four patients) were treated at the University of Munich in a protocol involving regional hyperthermia (RHT) combined with ifosfamide plus etoposide. A total of 265 RHT treatments (mean, 6.6 RHT per patient) were applied including 33 pelvic, four extremity, and three abdominal sites. The mean tumor volume was 537 cc (range, 50 to 2,980 cc). For systemic chemotherapy, all patients received ifosfamide (1.5 g/m2, days 1 to 5), etoposide (100 mg/m2, days 1, 3, and 5), and mesna (300 mg/m2 x 4, days 1 to 5) with RHT given only on days 1 and 5 in repeated cycles every 4 weeks. Acute toxicity consisted primarily of pain (57%) combined with local discomfort within the annular phased array applicator (AA) of the BSD hyperthermia system (BSD Medical Corp, Salt Lake City, UT). The average maximum systemic temperature was 37.4 +/- 0.5 degrees C, and there was no indication of enhanced bone marrow toxicity due to the addition of RHT to the systemic chemotherapy. Detailed thermal mapping by invasive thermometry was performed in all patients. In 38 assessable patients, the overall objective response rate was 37%: six complete responses (CRs), four partial responses (PRs), and four favorable histologic responses (FHRs) (95% confidence limits, 22% to 54%). Complete responders are alive and disease-free at 40, 35, 23, 19, 19, and 8 months. Of patients with PR and FHR, two died from metastatic disease after 4 and 17 months and one died from other disease after 27 months. The remaining five patients are stable at 37, 25, 21, 13, and 8 months. Eleven patients showed no change (NC), and 13 patients showed local tumor progression (PD). The mean observation time for all patients was 11.6 months. The time-averaged temperatures (Ts) of all RHT treatments calculated as 20% (T20), 50% (T50), or 90% (T90) of measured tumor sites differed significantly between responders and nonresponders (T20, P = .003; T50, P = .006; and T90, P = .004; respectively). These data support activity for ifosfamide-etoposide combined with RHT in pretreated patients with advanced sarcomas.
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PMID:Ifosfamide plus etoposide combined with regional hyperthermia in patients with locally advanced sarcomas: a phase II study. 212 10

Various types of partial mandibulectomy and maxillectomy techniques can be performed to control local tumor growth, but various intraoperative and postoperative problems and complications are associated with these techniques. Intraoperative complications relate mainly to technical problems. Postoperative complications include incisional dehiscence, infection, injury to salivary ducts, subcutaneous emphysema, mandibular instability, abnormal salivation with secondary cheilitis or dermatitis, anemia, pain and discomfort, lingual dysfunction and prehension difficulties, anorexia, ocular problems, cosmetic defects, local tumor recurrence, and distant metastatic disease. The surgeon should be aware of these potential complications and have a clear understanding of their prevention and treatment.
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PMID:Results and complications associated with partial mandibulectomy and maxillectomy techniques. 213 89

Metastatic tumors to the oral region are uncommon and most are located in the mandible, with only a few in the soft tissue of the oral cavity. A review of the literature has revealed only 63 cases of a gingival soft tissue metastases. The prevalent primary site are the lung, the liver and the kidney in that decreasing order. Reported are two lung carcinomas and an esophageal carcinoma all showing a metastases to the gingival soft tissue. The primary lesions of two lung carcinomas were diagnosed after the detection of the gingival lesions. In all cases the diseases had disseminated when the gingival metastases were diagnosed. The longest survival time was only 4 months. The prognosis for such cases is poor, but early diagnosis and treatment is essential in order to prevent the pain and discomfort associated with the ulceration, the infection, and the local tissue destruction by the lesions.
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PMID:[Metastatic tumors of the gingiva--report of 3 cases]. 234 60

This study describes our experience using a percutaneously placed small-bore catheter for drainage of malignant pleural effusions and subsequent instillation of a sclerosing agent to obliterate the pleural space. We treated 15 consecutive patients with known metastatic cancer and a symptomatic pleural effusion. Twelve patients survived for more than four weeks after the procedure; 11 of these 12 patients had a successful objective clinical response. The procedure was well tolerated, with little or no discomfort during catheter placement and the maintenance period. No serious complications were encountered. We conclude that the use of a small-bore percutaneously placed "pneumothorax" catheter in the management of malignant pleural effusions is an effective and more comfortable alternative to large-bore closed-tube thoracostomy.
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PMID:Malignant pleural effusions: pleurodesis using a small-bore percutaneous catheter. 247 59

About 130 Norwegian men (15-45 years old) develop testicular cancer each year. Men with a history of undescended testes, atrophic testes and/or fertility problems probably represent a high risk group. Typical symptoms are tumour, harder consistency and discomfort in the testes, low back pain and gynecomastia. Testicular ultrasonography often helps to establish the correct diagnosis. Seminoma is separated from non-seminoma histologically. Adjuvant radiotherapy to the retroperitoneal lymph nodes is the most frequent treatment in seminoma patients with early disease and is combined with chemotherapy in patients with advanced disease. Chemotherapy and surgery are the main therapeutic modalities in non-seminoma patients. In clinical trials a "wait and see" policy is applicable in selected patients with non-seminoma without metastases, provided that frequent follow-up examinations are feasible. Gastrointestinal side effects, alopecia, peripheral neuropathy and azoospermia are the most frequent acute and reversible side effects of treatment of testicular cancer. Post-treatment paternity can be achieved by at least half of the patients who wish to father a child after treatment. The 5-years' survival rate for young patients with testicular cancer is 95%. Young men should perform testicular self-examination regularly. Medical officers in the Armed Forces and doctors at schools and universities and in occupational health should be aware of testicular cancer in young adults with suspicious clinical findings.
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PMID:[Testicular cancer. A challenge to the health services taking care of young males]. 291 18

Oral cancer currently strikes about 30,000 Americans each year. Survival rates are approximately 50%. However, early detection followed by appropriate treatment can increase cure rates to about 80%, and greatly improves the quality of life by minimizing extensive, debilitating treatments. An early oral cancer can appear as an innocuous red or white change, an ulcer, or a lump, mimicking many benign lesions. Additionally, when the discomfort is minimal, professional consultation often is delayed, increasing the chance for local spread and regional metastases. Vital staining with toluidine blue and exfoliative cytologic examination can aid early detection by accelerating the biopsy of lesions that cannot be classified adequately or made to disappear.
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PMID:Early diagnosis of oral cancer. 316 96

A 63-year-old man developed bilateral conjunctival injection and irritation followed by periocular discomfort and diplopia. Within weeks left proptosis and intermittent fever were noted. Orbital CT scan showed bilateral nodular enlargement of multiple extraocular muscles. Fine needle aspiration biopsy of the extraocular muscles revealed neoplastic cells compatible with a renal cell carcinoma. The bilateral extraocular muscle metastases were the initial manifestations of the underlying malignancy.
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PMID:Bumpy muscles. 323

Three patients with intracranial metastases were studied with magnetic resonance imaging at 1.5 T before and after intravenous administration of 0.1 mmol/kg gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA). Axial pre- and postcontrast images demonstrated a total of six and 38 metastases, respectively. Of the 35 lesions detected only after administration of contrast material, all were less than 10 mm, and none had evidence of surrounding edema. Lesion conspicuity was comparable on postcontrast mixed (T1, proton density, and T2) images and T1-weighted images, indicating the feasibility of effectively screening for metastases with a single postcontrast spin-echo sequence providing mixed and T2-weighted images. Sagittal and coronal images depicted temporal lobe lesions not seen on axial images. No discomfort, side effects, or complications resulted from the contrast medium. The detection of additional lesions with Gd-DTPA increased the radiologic suspicion of metastatic disease, revealed locations more favorable for biopsy, prompted the search for a primary tumor, and modified therapeutic objectives and methods.
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PMID:Increased detection of intracranial metastases with intravenous Gd-DTPA. 331 96

Between January 1980 and December 1985, 121 patients with early breast cancer were referred to the Department of Radiation Oncology at Westmead Hospital for radiation therapy following initial tumour excision. After a median follow-up of 26 months, five patients developed a loco-regional recurrence (4%) and nine developed metastatic disease but with local control. There were 105 eligible patients who were sent a letter/questionnaire which included: a request to attend a clinic, to allow an objective assessment of the cosmetic result of the treated breast by two clinicians, questions regarding breast function as it affected quality of life, and a request that they undertake a self-assessment of the treated breast from a cosmetic point of view. Seventy-six patients attended for assessment of the following factors: whether surgery was optimal as determined by predefined criteria, measurement of breast oedema, arm oedema, breast retraction and telangiectasia, and an overall cosmetic assessment performed independently by both a radiation oncologist and surgeon. A physician not involved in management undertook a cosmetic assessment using standard photographs. Approximately 20% of patients replied that their choice of clothing had been affected by treatment, 10% were embarrassed and 70% experienced some continuing tenderness or discomfort in their treated breast. The extent of surgery was judged to be suboptimal in 22% but that proportion increased to 34% of cases referred from external clinics. The overall incidence of moderate or severe breast oedema was 9%, breast retraction 50%, telangiectasia 16% and arm oedema 21%. Those patients with longer follow-up (i.e., greater than 36 months) had a higher incidence of breast retraction (67%), telangiectasia (30%) and arm oedema (33%) but less breast oedema (7%). As expected, the patients rated the appearance of their breast more favourably than did clinicians. Overall, the result was rated as good or excellent by 75% of patients compared with 55% when the assessment was made by a surgeon or radiation oncologist. The main factor identified as contributing to a poor cosmetic result was the area of the iridium implant. The area of implant was larger when suboptimal surgery had been carried out, the main component of which was excessive length of scar.
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PMID:Early breast cancer: cosmetic and functional results after treatment by conservative techniques. 341 92

Spinal metastases are present in up to 10% of all cancer patients at some time during the course of their disease. Pain is the most common presenting symptom, and neurological function is usually normal at this early stage. The clinical challenge is to detect and treat the spinal disease before the onset of neurological compromise. Myelography has been the standard test for identification of epidural metastases, but the invasive nature of myelography carries inherent risk and produces patient discomfort. Magnetic resonance imaging (MRI) has been useful in the evaluation of other spinal diseases, is noninvasive, and is tolerated well by patients. We evaluated and compared MRI (64 studies in 58 patients) to conventional studies (myelography, computed tomography, bone scanning, plain films) and determined its accuracy in diagnosis and efficacy in clinical decision making. MRI proved superior in detecting bone and epidural involvement by tumor and was valuable in clinical decision making. In addition, MRI provided better visualization of paravertebral soft tissue involvement by tumor. MRI is recommended as the initial study in patients with suspected metastatic spinal disease.
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PMID:Use of magnetic resonance imaging in the evaluation of metastatic spinal disease. 369 1


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