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

Between May 1969 and September 1989, 677 metastatic lesions were resected during 107 operations in 100 patients with pulmonary metastases from various primary sites at the Center for Adult Diseases, Osaka, Japan. Of those patients, 65 underwent conventional lateral thoracotomy, and 35 patients had median sternotomy. No significant difference existed in actuarial survival after the first operation to remove the metastases between the two patients groups. Furthermore, local excision of 418 lesions was performed in 25 patients with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Of those, 18 patients had undergone a one-stage operation for bilateral lesions through a median sternotomy approach. Although our study was not randomized, survival of the 25 patients treated with the Nd:YAG laser tends to be longer than survival of the 75 patients for whom the Nd:YAG laser was not used. We concluded that aggressive excision and evaporation of multiple lung metastases with the Nd:YAG laser under median sternotomy is a safe and promising variation in technique and that this approach will expand the scope of surgical indications for metastatic lung tumors. For a clearer demonstration of the influence of differences in surgical techniques on long-term survival it is necessary to conduct randomized prospective studies of the surgical techniques.
J Thorac Cardiovasc Surg 1991 May
PMID:Surgical management of lung metastases. Usefulness of resection with the neodymium:yttrium-aluminum-garnet laser with median sternotomy. 202 48

The endoscopic examination of the tracheobronchial tree is most helpful in the diagnosis and staging of bronchial carcinoma. Tumors that are endoscopically visible may be confirmed in more than 95% of the cases. In localized peripheral tumors, the diagnostic yield of bronchoscopy is significantly lower; for peripheral metastases, only about 10%. In diffuse interstitial pulmonary diseases other than malignancies, some infections, and histiocytosis X, bronchoscopy including transbronchial biopsy is less successful.
Cardiovasc Intervent Radiol
PMID:The diagnostic yield of bronchoscopy. 204 23

Fine-needle aspiration cytology yields sufficient diagnostic accuracy to compete with histology from punch biopsy for cancers of the lung and the prostate. For tumors of the breast, pancreas, thyroid, salivary glands, and kidneys, fine-needle aspiration cytology yields sufficient sensitivity and specificity when performed preoperatively; the exact tumor typing will follow surgical excision. In palpable lymph nodes, adrenals, and lungs, fine-needle aspiration biopsy is sufficient if metastases from a known primary tumor are suspected. Indications for punch biopsies and histological investigation are tumors of the liver, posterior and anterior mediastinum, retroperitoneum, soft tissues, and bone. In these conditions, cytological investigation alone provides insufficient typing accuracy. Suspected lymphomas in a retroperitoneal or mediastinal location should be punctured and may be classified from punch biopsies if the node is not easily reached by surgery. There are no indications for percutaneous biopsies in tumors of the skin, testes, and ovaries. Percutaneous fine-needle aspiration biopsies in general are associated with significantly lower complication rates than punch biopsies.
Cardiovasc Intervent Radiol
PMID:Cytological vs histological evaluation of percutaneous biopsies. 204 28

Percutaneous bone biopsy has become an accepted means for tissue diagnosis in indeterminate metastatic disease, whereas needle biopsy for the evaluation of primary skeletal neoplasms is controversial. Needle biopsies are also of value in the diagnosis of inflammatory lesions and eosinophilic granuloma. The diagnostic accuracy of this procedure ranges from 50 to 94% in malignant disease, but is less favorable in benign disease. The low complication rate of about 0.2% makes the percutaneous approach an attractive alternative to surgical biopsy.
Cardiovasc Intervent Radiol
PMID:Percutaneous skeletal biopsy. 204 32

Long-term results and patterns of disease recurrences after radical operations for lung cancer between 1975 and 1984 were investigated. Eight hundred fifty-two patients (76.1%) with lung cancer underwent operations during this period. Radical operations were performed on 648 patients. There were 326 (50.6%) pneumonectomies, 314 (48.5%) lung resections (lobectomies), and 8 (1.2%) segmentectomies. Long-term survival rates of 542 patients were studied. In 49.2% of the patients survival was beyond 3 years; in 33% of the patients it was beyond 5 years. Five-year survival was observed in 40.3% +/- 2.5% of patients with N1 and in 19% +/- 4.9% of patients with N2 disease. The differences in survival rates between patients with epidermoid cancer and adenocarcinoma were slight and statistically insignificant. The prognosis was poor in patients with small-cell cancer, large-cell cancer, and dimorphous cancer. The causes of death were studied in 193 patients. Disease recurrence was diagnosed in 75.1% of cases. Bronchopulmonary and concomitant diseases accounted for 19.7% of deaths in these patients. In 5.2% of the patients malignant tumors occurred in other organs. Local-regional recurrences were diagnosed in 33.8% of patients, distant metastases occurred in 55.2% of patients, and 11% of patients had combined disease recurrences. The problem of disease recurrence classification is discussed in the article.
J Thorac Cardiovasc Surg 1991 Jul
PMID:Long-term results and patterns of disease recurrence after radical operations for lung cancer. 207 25

Cardiac involvement by metastatic neoplasms is relatively uncommon and usually occurs with widely disseminated disease. Ninety-five cases with cardiac metastases from autopsies performed over a 14-year period (1974-1987) at Loyola University Medical Center are reviewed. During this period, 3314 autopsies were performed with an average annual autopsy rate of 35%. In 806 (24.3%), a malignant disease was found, and in 95 (11.8%), there was cardiac involvement by tumor. The most common malignancies encountered in order of decreasing frequency were lung, lymphoma, breast, leukemia, stomach, melanoma, liver, and colon. Although the percentage of cardiac metastasis compares favorably with previous reports in the literature, an identical rate was present during both halves of the 14-year period studied. Improved diagnostic capabilities and treatment protocols in recent years have apparently not significantly affected the incidence, distribution, or patterns of metastatic spread to the heart.
Am J Cardiovasc Pathol 1990
PMID:Neoplasms metastatic to the heart: review of 3314 consecutive autopsies. 209 26

Hepatic metastases rather than the primary neoplasm usually dictate the course of the disease and patient's survival. For unresectable disease, intraarterial infusion of chemotherapy, embolization, and chemoembolization are viable alternatives. Intraarterial therapy for hepatic metastases is based on the dual blood supply of the normal liver (portal vein, 75%, and hepatic artery, 25%) and that of the tumors (hepatic artery, 90%). Intraarterial infusion delivers a higher concentration of chemotherapy, whereas chemoembolization adds ischemia and increased contact time with the tumor. Selective vascular occlusion for infusion, redistribution of the blood supply and pulsatile flow enhance the delivery of therapeutic agents to the liver.
Cardiovasc Intervent Radiol
PMID:Hepatic artery infusion and chemoembolization in the management of liver metastases. 212 43

Twenty-seven cases of classical bronchial carcinoid were followed up for at least 10 years after curative resection. Surgery was conservative in 15 cases. True lymph-node metastases were identified at operation in two cases. Distant metastases were confirmed in two patients after 5 and 10 years, respectively. One died of unrelated cause 10 years, and the other is alive 19 years, postoperatively. Radiotherapy relieved bone pain in both cases, and chemotherapy halted disease progression in one of them. In immunostaining the original histologic material, all carcinoids expressed neuron-specific enolase, and most expressed chromogranin A, synaptophysin and serotonin. Demonstration of ACTH and related opiopeptides did not portend a more aggressive course or identify cases with nodal metastases. Despite their low malignant potential, long-term follow-up of bronchial carcinoids is warranted. Even in the rare cases of distant metastases, long-term survival seems to be the rule. The occasional presence of nodal metastases and/or demonstration of ACTH and other opiopeptides, while more frequent in neuroendocrine carcinomas, are not inconsistent with bronchial carcinoids and seemingly do not alter their overall favorable prognosis.
Scand J Thorac Cardiovasc Surg 1990
PMID:Long-term follow-up of classical bronchial carcinoid tumors. Clinicopathologic observations. 216 32

Malignant mediastinal teratoma containing yolk sac elements are rare tumours and invariably have a poor prognosis. An elevated alpha fetoprotein level is a useful indicator of the malignant nature and the invasiveness of the tumour. A case with such a tumour who also presented with precocious puberty is described. This patient was treated with radiotherapy and chemotherapy prior to radical surgical excision, and has now survived for over 64 months without evidence of metastases.
Thorac Cardiovasc Surg 1990 Aug
PMID:Endocrine secreting malignant mediastinal teratoma. 223 88

Because of the small incidence of primary cardiac neoplasms there have been no randomized clinical trials to establish rational therapeutic strategies. Surgery is the first choice of therapy in all patients with small cardiac neoplasms. But it is not known whether adjuvant chemotherapy may be benefitial in patients in whom "curative" surgery has been performed. Chemotherapy must be considered as the first choice of therapy in primary cardiac tumors with extracardiac metastases. Combination of several agents is more effective than single-agent therapy. Radiation should be applied in less sensitive tumors only if surgery is not feasible and prior chemotherapy has failed. In patients in whom cardiac surgery was performed with a curative aim, chemotherapy but not radiation is the adjuvant therapy of choice. Patients with metastatic tumors to the heart should be treated according to the established rules for the involved tumor. Therapeutic strategy depends on the kind of tumor and the cardiac structure involved. Tumor spread to the pericardium will cause pericarditis or pericardial effusion up to pericardial tamponade. Instillation of tetracyclines, isotopes and chemotherapeutic agents in the pericardial space have been successfully applied to prevent recurrent effusion. Radiation did prolong life in patients with pericardial metastases as compared with repeated pericardiocentesis. Additional cardiac damage may be induced by radiation as well as by drugs. A trial with chemotherapy can be useful in all sensitive cardiac tumors.
Thorac Cardiovasc Surg 1990 Aug
PMID:Classification of malignant cardiac tumors with respect to oncological treatment. 223 98


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