Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of surgery in the management of human neoplasias is constantly undergoing reevaluation. Less surgical radicality reduces mutilating side-effects without a decrease in long-term survival if adjuvant chemotherapy is given. On the other hand, the surgical excision of isolated metastases helps to maintain curative intent even in the presence of residual disease after chemotherapy. Many experimental and clinical observations point to a predilection of circulating tumor cells for certain organs. Thus, the metastatic process is not simply a series of random events but rather governed by anatomical determinants such as venous and lymphatic drainage of the primary tumor and also by the intrinsic metastatic potential of the tumor cells themselves. The complex biology of metastasis is discussed with special reference to the surgical removal of isolated metastases.
Thorac Cardiovasc Surg 1986 Nov
PMID:Tumor biology and oncology. 243 81

In 88 operative specimens topography, size and histopathological findings of lung metastases were analyzed. The stages of formation of metastases as the phase of invasion, embolization and implantation were differentiated by postmortem angiographies investigating the neo-vascularization of the metastases by 20 to 60 micron vessels. Analyses of metastases by morphological quantification of tumor regression after cytostatic therapy and immune histochemical examinations of lung metastases in unknown primary cancer have gained clinical importance.
Thorac Cardiovasc Surg 1986 Nov
PMID:Pulmonary metastases. Pathological anatomy. 243 82

The operative findings at 27 thoracotomies in 24 patients were compared with the results of chest X-rays, computerized tomographies and conventional tomographies. Radiological and operative findings corresponded in 15 of 27 cases. The computerized tomography proved to be the most sensitive method for the estimation of the number of metastases. The foci often located close to the pleura repeatedly cause an exudative reaction of the visceral pleura and thus mark the interlobular septa. These changes were most distinctly recognized by conventional tomography and gave indications for the topographic classification of the metastases. Despite the careful evaluation of the imaging techniques small metastases were often not detected.
Thorac Cardiovasc Surg 1986 Nov
PMID:Radiology of pulmonary metastases: comparison of imaging techniques with operative findings. 243 83

Two hundred and sixty-one patients underwent a total of 295 operations for pulmonary metastases between 1972 and 1984. Some characteristics are essential for the surgical strategy of operations on pulmonary metastases: Upon thoracotomy about 40% of the patients show more uni- or bilateral metastases than expected after the most careful preoperative diagnostic examinations. Approximately 25% of the patients exhibit preoperatively undiagnosed metastases on the contralateral side. Bilateral consecutive thoracotomy is associated with the risk of secondary inoperability. The median thoracotomy takes these characteristics more into consideration than all other routes as both pleural cavities, lung and mediastinum can be explored and treated at the same time. The necessary prerequisites for radical resections are obtained only in this way and potential cure should always be the aim of surgery for metastases. Simultaneous bilateral pulmonary resections require careful postoperative intensive care. The advantage for the patient is a one-stage operation and thus less subjective stress, a much shorter hospitalization and the chance to start necessary postoperative chemotherapy as soon as possible. The median thoracotomy allows all standard resection techniques. With 66%, the atypical and segmental resections were the techniques mainly used. The overall mortality was 3.3%.
Thorac Cardiovasc Surg 1986 Nov
PMID:Surgical technique in operations on pulmonary metastases. 243 84

The curing chance of cancer disseminated to the lungs depends on the global curing chance of that specific tumor, the extent and distribution of its systemic spread and the availability of additional treatment modalities besides surgery. Of all tumors occurring in childhood and adolescence only osteosarcoma, Wilms tumor and Ewing's sarcoma preferentially disseminate to the lungs and such are the most promising candidates for successful treatment. In osteosarcoma with pulmonary dissemination surgical removal of the metastases is indispensable. In Wilms tumor chemoradiotherapy may replace or be used as an adjunct to surgery while in Ewing's sarcoma with primary pulmonary metastases chemoradiotherapy is the treatment of choice. Although metachronous lung metastases may still cured in osteosarcoma and Wilms tumor, they tend to be fatal however in Ewing's sarcoma. A small chance of success itself should not contraindicate metastasectomy but only the actual technically impossible intervention or the definite demonstration of tumor progression no longer controllable of different location. However, even palliative metastasectomy may be indicated in an individual patient.
Thorac Cardiovasc Surg 1986 Nov
PMID:Surgical treatment of pulmonary metastases in childhood. 243 85

Between 1972 and June 1983, 21 children (mean age 9 years, range 20 months to 16.5 years) were operated on for pulmonary metastatic disease. Primary malignant tumors were Wilms-tumor (7 patients), osteogenic sarcoma (7 patients), Ewing's sarcoma (4 patients), hepatoblastoma (2 patients), and rhabdomyosarcoma (1 patient). The surgical intervention was part of a therapeutic pediatric oncological concept with curative purpose including chemotherapy and/or radiation in different combinations. Ten out of these 21 children survived disease-free 3 years and more after pulmonary metastasectomy. An aggressive surgical approach towards pulmonary metastatic disease in children thus appears to be justified.
Thorac Cardiovasc Surg 1986 Nov
PMID:Long-term results following surgical removal of pulmonary metastases in children with malignomas. 243 86

Results of resection of solitary pulmonary metastases are good. In 107 patients treated in Amsterdam with a minimal follow-up of 2 years the actuarial 5-year survival rate is 46% and the 10-year survival 32%. Widening of selection criteria seems warranted. The prognostic factors are number and size of the metastases and tumor doubling time. The time interval between treatment of the primary tumor and the metastasectomy did not influence prognosis. The primary/secondary interval should not be used as a selection criterium.
Thorac Cardiovasc Surg 1986 Nov
PMID:Resection of pulmonary metastases--results, prognostic factors, reappraisal of selection criteria. 243 87

Surgical removal of one or several metastases with a potentially curative aim is possible in the case of isolated pulmonary metastases. The surgery is always part of an overall oncological concept. Between 1972 and 1984, surgery was indicated in 295 cases in 261 patients and 304 thoracotomies were performed. The procedure was classified as potentially curative in 76% of the cases. The 5-year survival probability in this patient group amounted to 38% for all organic tumors. The definitely best prognosis with 5-year survival rates of 42% is observed for caval metastatic carcinoma. Due to the excellent chemotherapeutical regimens, testicular teratomas reach the best individual result with a 3-year survival probability of 71%. Decisive for the long-term prognosis is the removal of all visible and palpable metastases. If radical resectability is possible, the number of metastases is only of secondary importance. Besides radicality, metastatic route and type of the primary tumor, duration of the disease-free interval and the size of the metastases are also of prognostic significance. Predominating resection procedures are the atypical and segment resection and the enucleation which yield the best survival rates.
Thorac Cardiovasc Surg 1986 Nov
PMID:Late results of surgical treatment of pulmonary metastases. 243 88

One hundred and fifty-seven patients underwent surgery for pulmonary metastases in our hospital between 1977 and 1985. Potentially curative surgery was possible in 96 cases. We recorded survival rates of 60% after 3 years and 43% after 5 years. The median survival time was 47 months. When compared to radical surgery, the 5-year survival rate for patients treated by palliative operations was less than 6%. The preoperative diagnostic examinations do not permit an exact determination of the number of metastases and their localization. When comparing the suspected number of metastases with the number determined during surgery using sternotomy we found an underestimate in 40% of the patients with suspected solitary metastasis and in 85% of the patients with multiple metastases. We therefore recommend median sternotomy with exploration of both pleural cavities and lungs as standard access also for patients with suspected solitary metastasis.
Thorac Cardiovasc Surg 1986 Nov
PMID:Results of surgical treatment for pulmonary metastases. 243 89

From 1954 to 1985, 150 metastases were removed in 80 patients (55 males, 25 females) with an age range from 8 to 82 years. The role of pulmonary resection for metastatic lesions of the period 1954 to 1975 (group I) was compared to the period 1976 to 1985 (group II). In group I, 48 metastases were resected in 35 patients and in group II, 102 metastases in 45 patients. The surgical mortality in the total population was 1%. The average interval from diagnosis of the primary neoplasm to diagnosis of thoracic metastases was 4 years in both groups. Primary neoplasm localization did not differ in the 2 groups. In both groups approximately 50% of the patients were without symptoms. Wedge resection and lobectomy were the most frequent procedures followed by segmentectomy and pneumonectomy. The median post thoracotomy survival was 21 months in group I and 36 months in group II. Although the tumor-free interval, presenting symptoms and surgery did not differ in the 2 groups, the actuarial 5-year survival in group I was 31%, and 53% for group II. Neither sex, age nor the lung resection type significantly affected the therapeutic results. Good prognostic factors were a non-seminomatous testicular tumor as the primary tumor, a tumor-free interval longer than 60 months and a tumor-doubling time longer than 136 days. Poorer results were obtained in the presence of N2 metastases, and of a large tumor volume. It seems that with the increased effectiveness of chemotherapy, especially in non-seminomatous testicular tumor, the role of surgery is changing. Surgery is now also indicated to resect metastases unresponsive to chemotherapy and to obtain histology of stabilized lesions after chemotherapy.
Thorac Cardiovasc Surg 1986 Nov
PMID:Surgery of pulmonary metastases. 243 90


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>