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)

Forty-four patients with nonseminomatous germ cell tumors with "poor prognostic features" were entered on the VAB-5 regimen and 38 are evaluable. VAB-5 represents an intensified version of the VAB-4 protocol. Poor prognostic features were considered to be bulky metastases ( greater than 5 cm in diameter), palpable retroperitoneal disease, liver metastases, brain metastases, involvement of two or more parenchymal organs, pure choriocarcinoma, alpha fetoprotein or human chorionic gonadotropin serum levels over 1000 ng/ml, lactic acid dehydrogenase serum levels over 400 mg/dl, and failure to prior chemotherapy. Eighteen of 38 evaluable patients became free of neoplasm, 11 with chemotherapy alone, and seven with combined chemotherapy and surgery. Fourteen of 18 complete responders remain alive and free of disease with a median follow-up of 50 months. Complete remission with testis tumor occurred in 13/15 without and 5/15 with prior chemotherapy and in none of eight patients with primary extragonadal germ cell tumors. Thirty-one patients received antibiotics when they developed fever during myelosuppression. Ten patients developed transient serum creatinine levels over 2 mg/dl after cis-platinum and one required hemodialysis with subsequent recovery. All patients had severe mucositis after induction. An apparent improvement of results over prior VAB protocols in patients with poor prognostic features was compromised by significant increases in toxicity and such patients require special study to improve cure rates.
 ...
PMID:VAB-5 combination chemotherapy in prognostically poor risk patients with germ cell tumors. 618 11

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.
 ...
PMID:Determination of prognostic factors and their influence on therapeutic results in patients with Ewing's sarcoma. 737 Sep 62

A 42-year-old male presented with bilateral scrotal swelling and sense of abdominal fullness. Ultrasonography and computed tomographic (CT) scan showed right testicular tumor, left scrotal hydrocele and excessive ascites, but no distant metastases. The serum lactic acid dehydrogenase (LDH) value was as high as 4,060 IU/L and beta human chorionic gonadotropin (hCG) value was 4.0 ng/ml while alpha fetoprotein (AFP) value was within the normal range. Right high orchiectomy was performed as well as the ascites and the left scrotal fluid sampling. Histological examinations revealed anaplastic seminoma in the right testis, and similar cells were found in the ascites and the left scrotal fluid. The patient received three courses of BEP chemotherapy consisting of bleomycin, VP-16 and cisplatin. The ascites and tumor markers (LDH and beta hCG) decreased markedly. Intraperitoneal dissemination of the tumor cells seems to be caused by invasion along the right spermatic cord, but the route of dissemination into the left hydrocele fluid is not known. To the best of our knowledge, this is the first case report of testicular tumor that showed intraperitoneal dissemination without any evidence of metastasis to the lymph nodes or distant organs.
 ...
PMID:[Intraperitoneal dissemination of testicular tumor: a case report]. 971 44

Liver metastasis of colorectal cancer is a life-threatening prognostic factor. Hepatic resection, when possible, is the best therapeutic modality, although the overall survival rate is still low (30%). The diagnosis has been carried out by clinical examination, abnormal alkaline phosphatase, lactic acid dehydrogenase and tumor markers, abdominal liver echography and computed tomography scan. Angiography and intraoperative echography are useful for resection. The number of hepatic metastases and the surgical margin are probably the most significant prognostic factors. Colorectal cancer may spread predominantly to the liver making regional treatment strategies viable options. Subtotal hepatic resections and segmentectomies are potentially curable procedures for single or small numbers of hepatic metastases without other sites of disease. However, there have been no prospective randomized trials comparing patients with unresected liver metastases and resected metastases. Regional chemotherapy with floxuridine seems useful combined with hepatic resection or as palliative therapy. Gastric ulcer and biliary sclerosis are the main related toxicities. Patients with localized, unresectable hepatic metastases or concomitant bad medical condition may be candidates for radiation, percutaneous ethanol injection, cryosurgery, radiofrequency, hypoxic flow-stop perfusions with bioreductive alkylating agents, hepatic arterial ligation, embolization and chemoembolization. These new hepatic-directed modalities of treatment are being investigated and may offer new approaches to providing palliation and prolonging survival. This review reports the possibilities of intraarterial chemotherapy and other novel hepatic directed approaches to the treatment of liver metastases from this common disease.
 ...
PMID:Locoregional therapy for liver metastases from colorectal cancer: the possibilities of intraarterial chemotherapy, and new hepatic-directed modalities. 1137 96