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)

A multifactorial analysis was used to identify the dominant prognostic variables predicting survival rates of 175 patients with hepatic metastases from colorectal carcinoma. Seven of 22 parameters examined simultaneously were found to independently influence the median survival rate in these patients: (1) elevated alkaline phosphatase (p = 0.0004), (2) elevated serum bilirubin level (p = 0.0005), (3) location of hepatic metastases (unilateral or bilateral, p = 0.0022), (4) number of metastatic nodes involved (0, 1-5, greater than 5; p = 0.0148), (5) depressed serum albumin (p = 0.0217), (6) whether or not the primary colorectal tumor was resected (p = 0.0013), and (7) chemotherapy (given or withheld, p = 0.0439). The prothrombin time, serum lactic dehydrogenase, and the number of hepatic metastases also correlated with survival, but they did not independently predict survival rates after other more dominant factors were accounted for. A mathematical equation for predicting an individual patient's clinical course once they developed hepatic metastases was derived from this statistical analysis. In addition, a simple and clinically useful guide for predicting outcome was developed that integrated the two most important risk factors, alkaline phosphatase and bilirubin.
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PMID:A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma. 666 90

In 220 patients with advanced colorectal carcinoma, objective tumor response to chemotherapy and survival were related to the following parameters: age, sex, performance status, time interval from diagnosis to metastases, initial site of metastases, and initial white blood cell count, lactic dehydrogenase, alkaline phosphatase, and carcinoembryonic antigen levels. Each variable was first evaluated separately. By conventional statistical methods, none of the variables significantly predicted response, although the following parameters significantly (p less than 0.01) predicted survival: Patients with an initially normal level of lactic dehydrogenase versus those with an abnormal level of lactic dehydrogenase had median survivals of 16 and 7.0 months, respectively; normal versus abnormal carcinoembryonic antigen levels, 23 and 9.2 months, respectively; white blood cell count of less than 10,000 versus greater than 10,000 cells/mm3, 11 and 7.0 months, respectively; performance status of greater than 70 versus less than 60, 11 and 6.6 months, respectively; and lung versus liver metastases, 12 and 8.0 months, respectively. By studying the variables together with multivariate analysis, we found that the most important variables in predicting response were the lactic dehydrogenase level and the white blood cell count. In predicting survival, the most important variables were the lactic dehydrogenase level, performance status, and lung involvement. We recommend that future randomized therapeutic trials for advanced colorectal carcinoma should delineate and perhaps stratify for the lactic dehydrogenase level, performance status, white blood cell count, and/or the presence of lung involvement.
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PMID:Prognostic factors in advanced colorectal carcinoma. Importance of lactic dehydrogenase level, performance status, and white blood cell count. 683 2

The records of 94 patients with a known diagnosis of extrahepatic cancer having liver scan, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels, and subsequent liver biopsy within a six-week period were reviewed. The sensitivity, specificity, and accuracy of the scan and biochemical tests in the detection of metastatic liver disease were calculated. The most sensitive single examination was the group of biochemical liver tests. Liver scans performed in the presence of normal biochemical test results were insensitive when compared with the liver scan alone or the liver scan in the presence of abnormal biochemical test results. The specificity and accuracy of all tests and test combinations were statistically equivalent. Screening for hepatic metastases in patients with cancer is best accomplished with the more sensitive and less expensive group of biochemical liver tests, reserving the liver scan for those patients with abnormal biochemical test results.
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PMID:Detection of metastatic liver disease. Use of liver scans and biochemical liver tests. 710 54

The enzyme activities of lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and acid phosphatase (AP) in the rat sarcoma 45 (S. 45) cells and Walker carcinosarcoma (WCS) cells were estimated from the histochemical study. No significant changes were found in the histochemical reaction intensity during the tumour growth but at the late stage of WCS growth the LDH activity increased. WCS metastases were distinguished by the elevated enzyme activity of LDH as compared with the tumour. During the anticoagulant treatment the LDH and SDH activity in S. 45 and WCS cells falls, but the AP activity increases.
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PMID:[Metabolic study of sarcoma 45 and Walker carcinosarcoma cells during the process of growth and exposure to anticoagulants (an enzyme cytochemical analysis)]. 715 64

We reviewed the records of 73 patients with primary melanoma of the choroid and ciliary body with metastasis treated at M. D. Anderson Hospital and Tumor Institute between 1973 and 1979. At time of diagnosis of primary melanoma 71 of 73 patients had tumor localized to the eye and were treated with enucleation of the affected eye. The interval from resection of primary tumor to detection of systemic metastases in the 71 patients ranged from one to 201 months (median 43.5 months). Weight loss and abdominal pain due to hepatomegaly were the most common symptoms, and hepatomegaly was the most common physical sign. The liver was the most common site of tumor recurrence, occurring in 44 of 71 patients. Among liver enzymes, serum lactic dehydrogenase was found to be the most sensitive indicator of liver metastasis and was elevated in 96% of patients with tumor in the liver. Liver involvement with tumor was associated with poor response to chemotherapy and significantly poorer survival than involvement of other extracranial sites. The survival duration from time of development of systemic metastasis ranged between one and 31 months (median seven months), with a one-year survival rate of 29%. The median survival of patients from diagnosis of ocular melanoma was 52 months, with a five-year survival rate of 43%.
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PMID:Prognosis in metastatic choroidal melanoma. 724 14

We have analyzed the survival data for 117 patients with Ewing's sarcoma treated at the National Cancer Institute since 1964. Treatment consisted of local irradiation to the primary site and a series of increasingly intensive systemic chemotherapy regimens. Four protocols were used with varying numbers of patients in each treatment group. When survival results were compared by treatment group, an overall difference in favor of the most recent treatment regimens was demonstrated (P less than 0.03). When results were evaluated by treatment group according to the site of primary disease, a significant difference was found only for patients who presented with primary lesions of the central axis and without metastases (P less than 0.001). However, we noted a statistically significant correlation of survival with 1) site of primary disease (P less than 0.001), 2) serum lactate dehydrogenase (LDH) level at presentation (P less than 0.0001), and 3) metastatic status at presentation (P less than 0.0001), irrespective of treatment protocol. When the results were reassessed after adjustment for these factors, no significant difference in survival remained. We concluded that further studies, in which stratification for site of primary disease and LDH levels would be used, are necessary to clarify the role of intensive adjuvant chemotherapy in Ewing's sarcoma.
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PMID:Influence of prognostic factors on survival in Ewing's sarcoma. 730 Aug 94

We have analyzed the results of treatment of 117 patients with Ewing's sarcoma admitted to the National Cancer Institute since 1964. All patients received local irradiation to the primary site and a series of progressively more intensive systemic chemotherapy regimens using drugs known to be active as single agents in this disease. Four protocols were employed with varying numbers of patients in each treatment group. Initially, there appeared to be a difference among treatment groups with regard to disease-free survival (overall P = .06), with the later regimens having more favorable outcomes. We then undertook a statistical analysis of the influence of five pretreatment variables--age, sex, site of primary disease, serum lactic acid dehydrogenase (LDH), and metastatic status--on disease-free survival. Of these five factors, important indicators of favorable prognosis for the entire group (and for each of the treatment subgroups) were a distal site of primary disease, normal serum lactic acid dehydrogenase (LDH) level at presentation, and the absence of metastatic disease at the time of presentation. When we examined treatment results with respect to these prognostic factors, we found that the subgroups treated with the more agressive regimens contained higher proportions of patients with favorable prognostic factors. After adjustment for differences in composition of treatment groups with respect to prognostic factors, the apparent difference in disease-free survival vanished (P = .62). These results indicate that in the case of Ewing's sarcoma, prognostic factors must be carefully considered in the design of treatment protocols and the subsequent analysis of end results.
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PMID:Determination of prognostic factors and their influence on therapeutic results in patients with Ewing's sarcoma. 737 Sep 62

The records of 111 consecutive cases of carcinoma of the breast were reviewed and yielded 66 patients who had undergone liver scanning and determination of the serum alkaline phosphatase (alk p'tase), lactic dehydrogenase (LDH), and serum glutamic oxaloacetic transaminase (SGOT). Four of the 66 patients (6.1%) had a focal defect on the liver scan. Two of those two had normal enzymes and two had at least one enzyme elevation. The two with normal enzymes have enjoyed prolonged disease-free survivals. The two with an elevated enzyme have both expired due to metastatic disease. No correlation could be found between the number of involved axillary nodes at surgery and the risk of having a focal defect on the liver scan. This study suggests that routine radionuclide liver scanning in the perimastectomy period does not add useful information in the face of normal alk p'tase, LSH, and SGOT.
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PMID:Liver scanning in newly diagnosed breast carcinoma. 737 60

Lysosomal enzymes were elevated about two-fold in primary s.c. Lewis lung carcinoma as compared with metastatic nodules in the lung. In a time course experiment, a general two-fold elevation of acid phosphatase and several glycosidases was observed in the primary tumor between the 14th and 17th postimplant day following s.c. inoculation of Lewis lung carcinoma. This increase in hydrolytic enzyme activity was not due to necrosis in the primary tumor since a comparison of enzyme activities in the nonnecrotic and necrotic areas demonstrated much higher activities in the nonnecrotic areas. No increases in lysosomal enzyme activity were observed with time in Sarcoma 180, a tumor which does not metastasize. There was no change with time in primary Lewis lung tumor lactate dehydrogenase activity while a 7-fold increase in serum lactate dehydrogenase activity was observed in tumor-bearing mice. Mitochondrial succinate-2-(p-iodophenyl)-3-(p-nitrophenyl)-5-phenyltetrazolium reductase levels fell in the primary Lewis lung tumor as the tumor size increased. A positive correlation was observed between the time of the elevations of tumor lysosomal enzymes in Lewis lung carcinoma and the appearance of micro- and macrometastatic lesions in the lungs. The mechanisms accounting for the increased intratumoral lysosomal enzymes are unknown, but they may be related to macrophage infiltration or other tumor-host interactions which may facilitate the dissemination of tumor cells.
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PMID:Elevation of lysosomal enzymes in primary Lewis lung tumor correlated with the initiation of metastasis. 742 42

Although infants (age less than 1 year) with neuroblastoma have a favorable overall prognosis, metastatic disease is associated with poorer treatment outcome. To assess the role of surgery in these patients, the authors reviewed survival data for 151 infants treated for neuroblastoma, focusing on patient and tumor characteristics, biological markers, and surgical management among the 99 patients with metastatic disease. Patients were divided into early (1961 to 1978) and contemporary (1979 to 1993) treatment eras. Potential prognostic factors were statistically tested to determine their significance in affecting survival. Five-year survival by Pediatric Oncology Group stage was: A, 100% (+/- 0%); B, 94% (+/- 6%); DS, 77% (+/- 9%); C, 73% (+/- 9%); and D, 61% (+/- 8%). Survival for infants with metastatic disease (stages C, D, and DS) was affected significantly by treatment era (P = .0001). Analyses restricted to patients treated during the contemporary era showed prognostic significance for DNA index (P = .02), N-myc copy number (P = .007), serum lactate dehydrogenase level (P = .001), and extent of resection (P = .01). A > or = 95% resection of the primary tumor was found to be associated with improved survival. Significantly more surgical complications were associated with resections performed at the time of diagnosis (P = .007), and delaying surgery until after several courses of chemotherapy did not decrease survival. In conclusion, multiple factors affect the outcome of treatment for infants with metastatic neuroblastoma, and whenever feasible, a > or = 95% resection of the primary tumor should be performed in this patient subgroup.
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PMID:Infants with metastatic neuroblastoma have improved survival with resection of the primary tumor. 747 48


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