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)

Expression of binding sites for fucose binding proteins (FBP) of Lotus tetragonolobus were immunohistochemically analyzed in surgically extirpated specimens from patients with transitional cell carcinoma of the bladder. The degree of expression of FBP binding sites in the primary cancerous region correlated with the occurrence of lymph node metastasis. Thus, lymph node metastases occurred in 15 of 34 cases with high expression of FBP binding sites, but did not in 17 cases with low or no FBP binding site expression. All metastatic lymph nodes strongly reacted with FBP. In addition, primary lesions at the pT3b or pT4 stage more frequently reacted with FBP as compared with those at the pTa, pT1 or pT2 stage. Although FBP is known to react both with Gal beta 1----4(Fuc alpha 1----3)GlcNAc and Fuc alpha 1----2Gal sequences, comparative staining of other carbohydrate markers revealed that the latter structure is not related with metastatic potential and stages.
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PMID:Reactivity to fucose-binding proteins of Lotus tetragonolobus correlates with metastatic phenotype of transitional cell carcinoma of the bladder. 135 Jun 44

In 1983, The German Breast Cancer Study Group, sponsored by the Federal Ministry of Research and Technology, started a prospective multicenter trial on the treatment of early breast cancer pT1 pN0 M0. Treatment consisted of initial tumorectomy with microscopically free margins and lower axillary dissection. After conformation of a pT1 pN0-stage, additional treatment was either mastectomy or adjuvant radiotherapy (50 Gy in 25 fractions to the entire breast plus 12 Gy electron boost). In medially located tumors, the parasternal and supraclavicular area was also irradiated with 50 Gy. A randomization between both treatment modalities was initially planned but was not feasible and abandoned. Nearly all patients were treated according to their own choice. From November 1983 through December 1989, 1119 patients were recruited. Eighty-three were excluded from the protocol. Out of the remaining 1036 patients, 733 (71%) underwent breast preservation and 303 (29%) mastectomy. A detailed pathohistological examination of all tumorectomy specimens was performed in a pathologic reference center. Oncogen overexpression was evaluated by immunohistological detection of the transmembrane protein p-185 (corresponding to c-erb-B2) in 425 cases. After a median follow-up of 48 months, the frequency of local recurrences (4.7%), regional recurrences (1%), and distant metastases (5.4%) was the same in the breast preservation group and the mastectomy group. The 3-year disease-free survival was 90% after breast preservation and 88% after mastectomy (p = 0.21). In the breast preserving group, 24 patients with microscopically involved margins had a poorer disease-free survival than the study group (75% vs 90% after 3 years). The width of the margins had no impact on prognosis. Other prognostic factors in an univariate and multivariate analysis were tumor size and tumor grade. Age, menopausal status, hormone receptor status, histological tumor type, and treatment (mastectomy vs breast preservation) were not significant. P-185-expression was dependent on tumor grade and was the strongest prognostic factor in an univariate and multivariate analysis (p less than 0.001). The results emphasize the central role of tumor grade for prognosis and suggest the independent prognostic significance of the c-erb-B2 oncogen (corresponding to p-185) in pN0-patients.
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PMID:Therapy of small breast cancer: a prospective study on 1036 patients with special emphasis on prognostic factors. 147 9

Between 1982-1990 we treated 461 patients with adenocarcinoma of the pancreas or the periampullary region. 125 (68 ductal pancreatic and 57 periampullary carcinomas) of these patients (27.1%) underwent resection. Hospital lethality was 3.6% (n = 4). Distribution of pT stages (UICC 1987) and frequency of complete resection (R0 vs. R1/R2) were significantly different between the periampullary and pancreatic tumors. This appeared to be due to the high frequency of pT1/2 periampullary tumors (49.2%) as compared to the prognostically equivalent pT1 tumors of the pancreas (1.9%). The absence of lymph node metastases significantly improved survival of periampullary tumors. This was not observed in tumors of the head of the pancreas. This data indicate that the poor prognosis of ductal pancreatic compared to periampullary cancer is primarily caused by their advanced stage at the time of diagnosis. In addition current resection techniques only inadequately respect the complex lymphatic drainage of the head of the pancreas.
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PMID:[Analysis of prognosis-associated factors in pancreatic head and peri-ampullary cancer]. 137 55

Interstitial irradiation is a technique currently used in the treatment of bladder cancer. We report the data on 205 patients (177 men and 28 women) treated in eight French centers. The patients had received the following treatment: a short course of pre-operative pelvic irradiation, followed by surgery consisting of partial cystectomy or tumor resection, and implantation of plastic tubes filled with inactive lead wires, which were replaced by iridium 192 wires. The tumor characteristics were: transitional cell carcinoma, 88.8%; mean size of the tumor, 29 mm; pathological stages: pTis, 1; pT1, 98; pT2, 66; pT3a, 26; pT3b, 9; pT4, 1; unknown, 4 respectively; surgical lymph node status: N+, 3; N-, 118; no node dissection, 84. The mean follow-up was 51 months. Intravesical failures were seen in 35 patients (17.0%), 25 (71.4%) of them without metastases or regional recurrences. Twenty-one patients (10.2%) presented distant metastases, 2/3 of them suffered no bladder relapse. The 5-year survival, calculated according to the Kaplan-Meier method (all causes of death taken together) was 77.4% for the T1, 62.9% for the T2, and 46.8% for the T3. Fifty-three patients had immediate side-effects and three died from surgical complications. Twenty-nine patients had delayed bladder side-effects (haematuria, fistula, chronic cystitis). Six patients presented an ureteral stenosis. Of the disease-free survivors, 96.1% retained the bladder function. Three factors were significantly predictive of delayed side-effects: partial cystectomy, pre-operative radiotherapy total dose, and linear activity of the wires (p < 0.01). Comparing our results to different authors' series interstitial irradiation is likely to provide a high local and general control of the disease and good quality of life in patients with selected tumors.
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PMID:Interstitial iridium-192 for bladder cancer (a multicentric survey: 205 patients). 139 32

Esophageal carcinomas are visualized endosonographically as localized thickenings of the gullet wall with disruption of its echo-layers. The pT-stage is correctly assessed by endosonography in 84% (73-92%). In up to 20% overstaging in the early phases may be caused by accompanying inflammation. The sensitivity for diagnosing local lymph node metastases is 80% (69-90%). The method is well suited for monitoring the course during radio-chemotherapy and for detection of a relapse after operation. At the present time endosonography is the most efficient method in the locoregional staging of esophageal carcinomas. Especially in early tumor stages pT1 and pT2 it is clearly superior to computed tomography. In advanced stages (pT4) in up to 40% of cases marked tumor stenosis, that cannot be passed with the ultrasonic probe, prevents endosonographic staging. However, despite its excellent detail resolution the etiology of a circumscribed wall thickening cannot be determined with absolute accuracy by intraluminal sonography. Based on the echo-pattern inflammatory alterations and scar tissue cannot be definitely distinguished from malignant tumors.
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PMID:[Endoscopic sonography in esophageal cancer]. 140 13

58 patients with advanced bladder cancer were treated with MVEC chemotherapy (methotrexate, vinblastine, epirubicin and cisplatinum). 22 patients suffered from locally advanced disease (pT3-4 M0 N0), in 20 patients regional lymph node metastases were found (pT3-4 N1-3 M0). In 16 patients distant metastases were noted (pT1-4 N0-1 M1). In 89% transitional cell and in 11% squamous cell cancer or anaplastic carcinoma was seen. Complete response was noted in 45%, partial response in 23% and no response in 32%. Tissue polypeptide antigen (TPA) was registered before each course of chemotherapy and 3 months after the last application. The sensitivity for (pT3-4 N0 M0) tumors was 90.9%, for (pT3-4 N1-3 M0) 100% and for tumors with distant metastases 100% also, overall 96.6%. No statistically significant different values between each tumor group were found. In 85.7% a concordant reaction of TPA values and clinical status was notable. In conclusion, TPA has been proven as a valuable and a reliable marker for monitoring therapeutic efficacy of chemotherapy for advanced bladder cancer.
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PMID:Tissue polypeptide antigen for monitoring of advanced bladder cancer after MVEC chemotherapy. 142 31

50 patients, suffering from carcinoma of the breast pT1-3 with concomitant metastatic affection of the lymph nodes with no evidence of distant metastases, and who received adjuvant chemotherapy (either CMF od AC/EC) were examined. Somatic and psychic interferences, the feeling of well-being and general condition, as well as a critical estimation of the clinical situation were assessed. Besides nausea and vomiting, and still prior to hair fall out, chemotherapy activated the memory of the carcinoma. 92% of the patients agreeing to chemotherapy described their decision as having been based exclusively on the medical information. Nevertheless, 30% feel insufficiently informed, so the fear of side effects, the waiting period prior to application, and the confrontation with the seriously ill, were described as a negative experience. An optimistic view with respect to improving the prognosis of the disease were correlated with chemotherapy: 74% would agree to a further chemotherapy. Psychic abnormalities, e.g. depressions, could not be shown following chemotherapy when compared to a reference population.
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PMID:[Subjective stress of adjuvant chemotherapy in breast cancer patients]. 145 6

In a total of 1665 patients with malignant thyroid neoplasms 90 oxyphilic thyroid carcinomas (OTC) were found of whom 55 could be re-examined and newly classified. Morphological and clinical parameters influencing the clinical course were determined. During a mean follow-up period of 6.5 y metastases or local recurrent disease occurred in 12 patients (24%). Apart from 3 early manifestations of metastases, 9 patients developed recurrent disease within, on average, 4.7 y after thyroidectomy: local lymph node metastases and local recurrences occurred within an average of 5.4 y, distant metastases after only 2.7 y. Thyroglobulin proved to be reliable for follow-up with a sensitivity of 88% on levothyroxine and 75% on endogenous TSH-stimulation (specificity: 98%). The frequency of metastases and local recurrences correlated with age at the time of tumor diagnosis, the degree of invasiveness and the local tumor extension (pT4 vs. pT1-3), whereas other factors such as the absolute diameter of the tumor or patient's sex had no influence on the clinical course. The survival probability for 5 and 10 years was 95 and 75%, respectively. All OTC patients should be examined regularly at least once a year by cervical sonography and thyroglobulin measurement. Because 18% recurrences occurred within 4.7 y such examinations should be repeated beyond year 5 after thyroidectomy.
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PMID:[The clinical course of oxyphilic carcinoma of the thyroid]. 149 62

This study was designed to investigate issues concerning "inapparent carcinoma" of the gallbladder and the effectiveness of a radical second operation in the treatment of inapparent carcinoma. Ninety-eight patients with inapparent carcinoma were analyzed according to the "pT" category of TNM (tumor, nodes, and metastases) classification. Eighty patients underwent cholecystectomy alone, and 14 patients had a subsequent radical operation. After cholecystectomy alone it was found that (1) Patients with pT1 cancer had a 5-year survival rate (5ysr) of 100%; (2) In patients with pT2, 5ysr was 40%; and (3) Patients with pT3 showed 5ysr of 0%. Results of a radical second operation showed that (1) Patients with pT2 cancer showed a 5ysr of 90%, significantly better (p less than 0.05) than pT2 treated with cholecystectomy alone; (2) There was a prolongation of survival in patients with pT3 or pT4. It was concluded that a radical second operation should be carried out for pT2 or more advanced inapparent carcinoma, whereas follow-up without a second operation is recommended for pT1 cancer without positive margin.
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PMID:Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. 155 12

The data of 740 patients who were operated on for renal cell carcinoma between 1975 and 1986 have been evaluated. We studied the relation between tumour size and other factors influencing the prognosis, such as tumour stage, infiltration of renal veins and incidence of metastases at the time of nephrectomy, and between tumour grading and postoperative survival. Sixty-six patients with small tumours were divided in groups according to tumour size: less than 20 mm, less than 25 mm, less than 30 mm, less than 40 mm. All 740 patients were separated into groups according to tumour size: less than 4 cm, 4-6 cm, 6-8 cm, 8-10 cm and greater than 10 cm. Stage pT1 carcinomas (less than 25 mm) occurred in 1.4% of patients and tumours exceeding 10 cm in size in 30%. The prognosis with regard to survival becomes worse the greater the diameter of the tumour: the incidence of renal vein involvement, metastases and higher grades of malignancy increases. Postoperative survival decreases in relation to the increase in tumour size. Carcinomas less than 30 mm in diameter were found to have distant metastases in only 1 case, while invasion of renal veins occurred in 2 cases. In tumours up to 3 cm in diameter, a kidney-preserving tumour resection seems possible without limiting the radicalness of the surgery.
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PMID:[The significance of tumor diameter in renal cell carcinoma]. 156 29


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