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

Computed tomography (CT) of the thorax and upper abdomen was prospectively evaluated in 84 patients with potentially operable lung cancer. Invasion into the thoracic wall and the mediastinal structures was not accurately demonstrated by CT. For metastatic mediastinal lymph nodes, the sensitivity and specificity of CT were, respectively, 86% and 61% and the positive and negative predictive indices 49% and 91%. For T1, T2 and T3 tumours the negative indices were 100%, 96% and 71%. Positive predictive index did not differ between squamous cell carcinoma and adenocarcinoma. Adrenal metastases were CT-suspected in 17 cases and liver metastases in eight, but were verified by ultrasonography in only one and four cases. CT should be used in preoperative investigation of lung cancer, irrespective of stage. Demonstration of thoracic-wall or mediastinal invasion need not exclude tumour resection. Preoperative mediastinoscopy is indicated if CT shows nodal metastases or if there are signs of tumour invasion, but not in CT-negative T1 or T2 tumour. Abdominal metastases indicated by CT should be investigated with CT-guided needle biopsy.
Scand J Thorac Cardiovasc Surg 1990
PMID:Computed tomography and the TNM classification of lung cancer. 229 60

We studied 20 patients with lung cancer that invaded the tracheal carina who were operated on during a recent 12-year period. Fifteen patients underwent sleeve pneumonectomy, two had pneumonectomy, one had lobectomy with wedge resection of the carina, and two patients had sleeve resection of the carina followed by reconstruction of the carina. There were two patients with postsurgical stage IIIA lung cancer, 15 with stage IIIB, and three with stage IV disease that involved intrapulmonary metastases. However, the operations of 13 patients were curative resections in which the surgical margin was negative for disease. Sleeve pneumonectomy was performed only in the last 3 years of the study period, after we had confirmed the safety and good results of bronchoplastic surgery by our experience of 100 cases of sleeve lobectomy. Hence, the period of follow-up in this group is too short to assess long-term survival. Eleven patients are alive, three died within 1 month after operation (15%), three died in the hospital beyond 1 month after the operation, and three died after discharge from hospital. Nine of the 11 surviving patients have no evidence of disease 1 month to 2 1/2 years after the operation, but two are alive with supraclavicular lymph node metastases. The 1-year and 2-year survival rates for 17 cases (excluding the three operative deaths) were both 59% by the Kaplan-Meier method. Two different methods were used to adjust the difference of calibers of the trachea and the bronchus. The first method involved the shift of the edge of the cartilagonous portion of the bronchus against the edge of the cartilaginous portion of the trachea and the other involved cutting the tracheal wall as a wedge-shaped piece to shorten the diameter of the tracheal caliber. To prevent complications after resection of the tracheal carina in 11 recent cases with sleeve pneumonectomy, anastomoses were protected by a pedicle fat flap nourished by internal thoracic artery and vein. No postoperative complications of anastomoses developed in any of these cases.
J Thorac Cardiovasc Surg 1990 May
PMID:Resection of tracheal carina for lung cancer. Procedure, complications, and mortality. 218 88

The prognostic significance of lymph node metastasis was analyzed in 41 patients with locally resectable epidermoid carcinoma of the esophagus. The 5-year survival rate was 50.9% if no metastases or only single node metastasis was present and 29.8% when the lymph node metastasis was confined to one anatomic compartment. All patients with metastasis to two nodes died within 4 years of operation, and all with involvement of three nodes or more died within 3 years. Even with no metastases or single node metastasis, three of 22 patients (13.6%) died of recurrence or metastasis or a combination of the two. Although nodal dissection may be beneficial for selected patients, our results indicate that the survival period is short in the presence of a small number of lymph node metastases, even if the local disease is resectable and despite nodal dissection. Cure is unlikely when cervical or abdominal nodes are involved, and a conservative approach may be indicated for such patients.
J Thorac Cardiovasc Surg 1990 Aug
PMID:Lymph node metastasis in resectable esophageal cancer. 238 31

The enterochromaffin (EC) cell system is distributed throughout the entire gastrointestinal tract. Enterochromaffin cells are the major source of intestinal serotonin (5-HT), but separate subpopulations of EC cells may synthesize and store peptides as substance P (SP), motilin, and enkephalin as well. Of special interest is that 5-HT and SP, which may coexist in EC cells, have several functional similarities, i.e., inhibition of gastric acid secretion, stimulation of intestinal motility, and secretion of water and electrolytes. Carcinoid tumors are derived from the gut endocrine system. Depending on site of origin, carcinoids are divided into foregut, midgut, and hindgut derivatives with different clinical symptoms. A common biochemical feature of midgut carcinoids is the production of 5-HT and SP. Histochemically, midgut carcinoids are characterized by the argentaffin reaction--a direct reduction of silver salts owing to 5-HT. Specific antisera for the immunocytochemical demonstration of secretory products are available as well. Despite their relative infrequency, carcinoids are the most common small intestinal tumors. The common appendix tumors generally have a benign clinical course, whereas the small intestinal tumors have different growth patterns and frequently metastasize with increasing size, and may thus give rise to the carcinoid syndrome (diarrhea, facial flush, right-sided cardiac valvular disease, and asthma). Carcinoid symptoms first appear when hepatic inactivation of 5-HT is exceeded, unless the carcinoid has an extraintestinal localization, for example, ovarian lesions may elicit symptoms in the absence of hepatic disease owing to direct secretion into systemic circulation.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1985
PMID:Serotonin and carcinoid tumors. 241 66

Serotonin (5-HT) and substance P (SP) were assayed in peripheral blood in patients with known midgut carcinoids and hepatic metastases. All patients had supranormal basal levels of 5-HT and SP. The clinical and hormonal response was evaluated by two provocation tests, pentagastrin (PG) injection or calcium infusion. Pentagastrin caused flushing and gastrointestinal symptoms and elevated levels of circulating 5-HT, but not of SP. Pretreatment with a 5-HT2 receptor blocking agent (ketanserin) alleviated gastrointestinal symptoms but had no influence on either 5-HT release or PG-induced flushing. Calcium infusion induced carcinoid symptoms in only two of six patients, which were associated with elevated 5-HT levels (whereas elevated SP levels were seen in only one patient). We conclude that 5-HT is important for the development of gastrointestinal symptoms but not of flushing. Ketanserin may alleviate gastrointestinal symptoms but does not influence PG-induced release of 5-HT. Substance P and 5-HT do not seem to share a common release mechanism. It appears that PG testing is superior to calcium infusion as a provocative test in patients with the carcinoid syndrome.
J Cardiovasc Pharmacol 1985
PMID:The pentagastrin test in the diagnosis of the carcinoid syndrome. 241 67

One hundred malignant pleural mesotheliomas have been treated in our hospital since 1955. Clinical and autopsy findings are analyzed and compared to X-ray changes. The most common symptoms were dyspnea (49%), pain (40%) and cough (36%). The main initial X-ray signs were pleural effusion (62%), pleural thickening (29%) and solitary nodules (6%). Prior to death a combination of effusion and pleural thickening was the usual finding. Histologically there were 49 biphasic, 32 mesenchymal and 18 epithelial malignant pleural mesotheliomas. At autopsy 82% of the cases had distant metastases, most of which had not been expected clinically. The median survival time was 7.3 months following the first clinical symptoms, and only 4 months after the first radiological signs.
Thorac Cardiovasc Surg 1985 Oct
PMID:Follow-up study of 100 malignant pleural mesotheliomas. 241 79

Poor long-term results following the surgical management of small cell carcinoma have contributed to the opinion that small cell carcinoma is a non-surgical disease; polychemotherapy is generally given preference. As nowadays adequate therapy (chemotherapy) achieves control of local tumor growth as well as of extended metastases, surgical resections should be discussed from a different viewpoint: "Does surgery profit from modern chemotherapy?" In our clinic, 1332 patients have been operated on for bronchogenic carcinoma from 1973 to 1983: 170 (12.8%) suffered from small cell carcinoma. The indications for surgery were either non-histologically classified tumors (e.g. peripheral coin lesions) or small cell carcinomas stage I, and only in rare cases for palliative reasons. Lobectomy, including bronchoplastic and arterioplastic resections (n = 108), was the most common procedure. The postoperative mortality was 15%, the average survival 341 days, the latter having improved significantly since 1979 when a postoperative polychemotherapy (ACO) was instigated. Recent results of surgical resection after primary chemotherapy are encouraging. Nevertheless, this new concept is reserved for the few cases of strictly limited disease and must be controlled by future studies.
Thorac Cardiovasc Surg 1986 Feb
PMID:Surgical resection and adjuvant chemotherapy for small cell carcinoma. 242 46

Metastasis of cancer to cancer is exceedingly rare, the most frequent being metastasis from bronchogenic carcinoma to renal carcinoma. A case of breast carcinoma metastasizing to a fibrosarcomatous malignant mesothelioma is presented. Breast carcinoma metastasizing to another carcinoma has been reported 4 times in the past. To our knowledge no case of breast carcinoma metastasizing to a malignant mesenchymal tumor has been published. It is unknown whether metastasis of cancer to cancer is a random occurrence or is due to selective lodging, survival and growth within another malignant neoplasm.
Thorac Cardiovasc Surg 1986 Aug
PMID:Metastasis of cancer to cancer. A case of breast carcinoma metastasizing to a malignant mesothelioma. 242 95

Ninety-two cases of intrathoracic neurogenic tumors operated on between 1950 and 1982 are reviewed. The benign forms (86 cases, 93.5%) included 23 ganglioneuromas, 50 neurilemmomas and 13 neurofibromas. Of the latter, 4 occurred in patients with Von Recklinghausen's disease. A double local recurrence was observed after the removal of a neurilemmoma. One of the patients with generalized neurofibromatosis died 5 months after operation from local sarcomatous degeneration and distant metastases. In this group of benign lesions, no other death was observed which could be attributed to the endothoracic neural tumor. The malignant forms (6 cases, 6.5%) included 4 ganglioneuroblastomas and 2 neurofibrosarcomas. The surgical excisions were described as radical in every case and all the patients were given radiotherapy postoperatively. One patient with ganglioneuroblastoma died from metastases 2 years later, and one with neurofibrosarcoma from local recurrences 7 months later. One patient with neurofibrosarcoma and 3 with ganglioneuroblastomas are alive and well 4, 5, 6 and 11 years, respectively, later. Surgical excision remains the best method of diagnosing and treating endothoracic tumors of neural origin. Of special interest are the "dumbbell" or hourglass tumors and lesions which occur in Von Recklinghausen's disease.
Thorac Cardiovasc Surg 1986 Aug
PMID:Neurogenic intrathoracic tumors. A clinicopathological review of 92 cases. 242 96

Even after the introduction of modern chemotherapeutic regimens and radiotherapeutic approaches in the treatment of small cell bronchial carcinoma (SCLC), the results are still disillusioning. Long-term remissions are rare even in patients with limited disease. We review 66 patients with SCLC (limited disease) which we treated either by single therapies (chemotherapy, radiotherapy, surgery n = 16), or by different combinations of the possible therapeutic measures. Favorable results were achieved by a comprehensive treatment including operation, chemotherapy and prophylactic cranial and local irradiation: 11 of 15 patients survived 3 to 97 months after the onset of therapy, 4 of those more than 24 months. Based on our own experience and the results of other authors we feel that surgical resection should be again included as an essential part of treatment: tumor resection is the rational primary therapeutic approach for cases without lymph node metastases in the mediastinum and for tumors of uncertain histological type. If there is evidence of lymph node involvement in the mediastinum (N2), surgery should be performed after a remission has been successfully induced by chemotherapy (so-called adjuvant surgery).
Thorac Cardiovasc Surg 1986 Oct
PMID:The role of surgery in the combined management of small cell bronchial carcinoma. 243 6


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