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)

During 7 years and 3 months from October 1983 to December 1990, 68 patients underwent radical cystectomy for primary bladder cancer at Yamanashi Medical College. Of these 68 bladder cancers, 16 were superficial and 52 were invasive. Among the 52 patients with invasive cancer, a combination chemotherapy of methotrexate and cisplatin and/or radiotherapy were given in 18 as an adjuvant therapy. All the adjuvant therapies were performed after the operation except for 2 patients with T4 bladder cancer who received chemotherapy before the operation. There were 23 recurrences and 25 deaths, 20 from bladder cancer and 5 from other causes. Of 20 bladder cancer deaths, 17 deaths (85%) were observed within 2 years after the operation. The 5-year survival rates were 92% for stage pTa-pT1, 83% for stage pT2, 80% for stage pT3a, 24% for stage pT3b and 43% for stage pT4-T4, respectively. A significant difference (p < 0.05) in survival curve was observed between pT3a and pT3b. The 5-year survival rate for pT2-pT3a without nodal metastases was as high as 89% (95% confidence limits 75 to 100%) although 18 out of 19 patients received no adjuvant therapy. On the other hand, the 5-year survival rate for pT3b-pT4 without nodal metastases (25%) was as low as that of patients for any T category with nodal metastases (35%). Most patients with tumor confined within bladder wall seemed to be cured by surgery only. Therefore, any adjuvant chemotherapy with severe side effects seemed not to be justified for these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Results of radical cystectomy for bladder cancer]. 817 76

In 127 patients with urothelial carcinoma of the bladder the ploidy, deoxyribonucleic acid (DNA) heterogeneity and counts of cell cycle phases in the tumor were analyzed by means of single cell DNA cytophotometry with the intention of finding new prognostic factors in addition to those already known (stage and grade). Patients were followed for 1 to 9 years. The results of the DNA analyses were related to the tumor categories, histopathological grading of the tumor and clinical course. Tumors were histologically classified as grade 1--DNA frequency peaks in the diploid range, grade 2--heterogenous DNA distribution patterns, and grade 3-73% aneuploid and 27% tetraploid DNA values. The proliferation rate of the tumor cells was statistically greater in cases of histological grades 2 and 3 malignancy than in grade 1 malignancy. There was also a positive correlation between tumor stage and DNA ploidy. The cell lines were aneuploid in 38% of the patients with stage pT1, 64% with stage pT2 and almost 85% with stage pT3 tumors. A significant correlation was found between the results of DNA cytophotometry and the clinical course of the disease. Patients with diploid tumor cell lines had no metastases and no local tumor progression for up to 9 years, whereas patients with multiple aneuploid tumor cell lines suffered recurrence and local tumor progression within 6 to 36 months. On the average, the patients died of the tumors 26 months after primary diagnosis. The difference in tumor recurrence and in tumor progression between patients with aneuploid and diploid tumors was highly significant (p < 0.001). The prognosis for patients with grade 1 tumors is good, whereas it is unfavorable in the case of grade 3 tumors. For these 2 groups DNA ploidy affords no additional prognostic information. Grade 2 tumors, on the other hand, are heterogeneous in respect to DNA ploidy, although they exhibit the same degree of histomorphological differentiation. These tumors can be subclassified as aneuploid (biologically aggressive) and diploid or tetraploid (biologically less aggressive). In terms of multivariate Cox regression analysis, DNA ploidy compared with grade and tumor stage was the strongest predictor of survival.
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PMID:Deoxyribonucleic acid content and survival rates of patients with transitional cell carcinoma of the bladder. 825 29

Since 1979, 109 patients underwent bilateral mediastinal lymph node dissection through a median sternotomy as a routine procedure in the treatment of left lung cancer, because of the high possibility of contralateral mediastinal node involvement in cases of left lung cancer. The five-year survival rates of the initial 50 patients who underwent this operation from Oct. 1979 till Mar. 1988 were 76.5% in N0 (n = 17), 69.2% in N1 (n = 13), 50.0% in N2 (n = 10) and 20.0% in N3 (n = 10). The five-year survival rate of 7 patients with pT1-2 N2M0 disease was 71.4%. This survival rate was only slightly different from that of the pT1-2N0-1M0 group. From May 1985 till April 1993, 20 patients who had the cervical or the highest mediastinal lymph node involvement underwent cervical and bilateral mediastinal lymph node dissection through a cervical collar incision and median sternotomy. Two patients with the scalene node involvement (one each of right and left lung cancer) are surviving for five years or more after surgery. Extended ipsilateral mediastinal lymph node dissection (R2b) has been adopted as a routine procedure in the treatment of right lung cancer in our institute since 1990. The survival rate at forty months in 15 patients with N2 disease who underwent R2b operation was 51%. In 3 of these fifteen patients the anterior mediastinal lymph node metastases were revealed by post-operative pathological investigation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The necessity of extended systemic dissection of the regional lymph node in radical operation for lung cancer]. 827 32

In 86 patients with histologically proven oesophageal carcinoma endoscopic ultrasonography (EUS) and computerised tomography (CT) were performed during TN-staging (UICC 1987). 44 patients were operated on and the histological findings were compared with the results of preoperative staging. The T-stage was correctly determined with EUS and CT in 35 (80%) and 24 (55%) patients, respectively. The accuracy of EUS was 75%, 71%, 91% and 67% in stages T1 to T4. The sensitivity of EUS in the diagnosis of lymph node metastases was 91%, that of CT 42%. The specificity of EUS and CT was 64% and 100%, respectively. The accuracy for pN staging (N0/N1) was 84% with EUS and 57% with CT. The presence of local lymph node metastases was closely correlated to the pT-stage (1 patient [14%] with pT1-, 5 patients [71%] with pT2-, 21 patients [95%] with pT3- and 6 patients [100%] with pT4-stage). In 12 out of 34 patients (28%) tumour induced stenosis prevented a complete oesophageal passage of the EUS probe. This fact, however, did not compromise TN-staging significantly. Our study demonstrates that EUS is an efficient method in the locoregional staging of oesophageal carcinoma. Especially in the early tumour stages T1 and T2 and in the demonstration of local lymph node metastases EUS is superior to CT.
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PMID:[Endoscopic ultrasound in preoperative TN staging of esophageal cancer. A comparative study between endosonography and computerized tomography]. 833 78

Metallothioneins (MTs) are ubiquitous low-molecular-weight proteins with a high affinity for heavy metal ions such as zinc, copper and cadmium. MT over-expression has been associated with resistance against anticancer drugs. In the present study we investigated 86 cases (45 cases of tumour category pT1 and 41 of category pT2) of routinely fixed and paraffin-embedded primary breast carcinomas immunohistochemically with a monoclonal antibody to an epitope of MT shared by its I and II isoforms. Immunohistochemically demonstrated MT over-expression was found in the invasive components of 7 of 32 pT1 and 17 of 28 pT2 invasive ductal carcinomas, whereas all 26 invasive lobular carcinomas gave weak or negative results. Fourteen of 17 pT2 and 2 of 7 pT1 invasive ductal carcinomas with MT over-expression developed metastases during follow-up with poor prognostic outcome. In contrast only 3 of 11 pT2 and none of the 25 pT1 cases without MT over-expression had a poor clinical course (P < 0.001). It is concluded that MT over-expression is associated with significantly poor prognosis particularly in pT2 invasive ductal breast carcinomas.
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PMID:Presence and possible significance of immunocytochemically demonstrable metallothionein over-expression in primary invasive ductal carcinoma of the breast. 838 80

Between September, 1987 and September, 1993, a total of 44 consecutive patients had undergone radical retropubic prostatectomy and pelvic lymphadenectomy for the treatment of prostate cancer. The patients were between 56 and 77 years (mean, 68 years). Eleven patients had clinical state A2 disease, 21 had stage B disease, and 12 had stage C disease. Fourteen of the 44 patients (32%) had positive lymph node metastases. The 5-year survival rate for patients with pT1, pT2 and pT3 was 100%, 71% and 87%, respectively. It was 77% in patients with positive node disease and 90% in patients with negative node disease. The 5-year disease-free survival rate for patients with pT1, pT2 and pT3 was 82%, and 78%, respectively. It was 54% in patients with positive node disease and 88% in patients with negative node disease. In 14 positive node patients, metastases were located in obturater nodes in 8 patients (57%), hypogastric nodes, in 6 patients (43%), external iliac nodes in 6 patients (43%), common iliac nodes in 4 patients (29%) and presacral nodes in 2 patients (14%). We confirmed that radical retropubic prostatectomy is effective treatment for locally confined prostate cancer and removal of obturater, hypogastric lymph nodes and the internal chain of external iliac lymph nodes is important in detecting metastases.
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PMID:[Clinical outcome of radical prostatectomy and pelvic lymph node dissection]. 853 88

Case histories of three patients who underwent laparoscopic cholecystectomy for unexpected gallbladder cancer are reviewed. Port-site recurrence was observed in two of them. In one patient whose abdominal wall recurrent tumor was excised, a new recurrence developed, but after the reexcision she is symptom-free 10 months after the last procedure. The surgeon has to be aware of the fact that the survival rate can be doubled in stage pT2 if cholecystectomy is followed by extended radical operation. Only gallbladder cancer in stage pT1 does not need further procedure, except for excision of port sites. In case of uncertain diagnosis preoperative frozen section is recommended. Port-site recurrence does not mean an incurable stage of the disease or a sign of diffuse metastases. Even after reexcision of abdominal wall metastasis patients might be free from other detectable recurrences.
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PMID:Unexpected gallbladder cancer and laparoscopic surgery. 855 36

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was performed during the follow-up of 33 patients suffering from differentiated thyroid cancer. Among them there were 26 patients with papillary and seven with follicular tumours. Primary tumour stage (pT) was pT1 in six cases, pT2 in eight cases, pT3 in three cases and pT4 in 14 cases. FDG PET was normal in 18 patients. In three patients a slightly increased metabolism was observed in the thyroid bed, assumed to be related to remnant tissue. In one case local recurrence, in ten cases lymph node metastases (one false-positive, caused by sarcoidosis) and in three cases distant metastases were found with FDG PET. In comparison with whole-body scintigraphy using iodine-131 (WBS) there were a lot of discrepancies in imaging results. Whereas three patients had distant metastases (proven with 131I) and a negative FDG PET, in four cases 131I-negative lymph node metastases were detectable with PET. Even in the patients with concordant "staging", differences between 131I and FDG were observed as to the exact lesion localization. Therefore, a coexistence of 131I-positive/FDG-negative, 131I-negative/FDG-positive and 131I-positive/FDG-positive malignant tissue can be assumed in these patients. A higher correlation of FDG PET was observed with hexakis (2-methoxyisobutylisonitrile) technetium-99m (I) (MIBI) scintigraphy (performed in 20 cases) than with WBS. In highly differentiated tumours 131I scintigraphy had a high sensitivity, whereas in poorly differentiated carcinomas FDG PET was superior. The clinical use of FDG PET can be recommended in all cases of suspected or proven recurrence and/or metastases of differentiated thyroid cancer and is particularly useful in cases with elevated serum thyroglobulin levels and negative WBS.
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PMID:Fluorine-18 fluorodeoxyglucose positron emission tomography in the follow-up of differentiated thyroid cancer. 859 63

The results of surgical treatment of 65 patients with pT1 squamous cell carcinoma of the esophagus and the histologic workup of the specimens were analyzed. The treatment of choice was transthoracic enbloc esophagectomy (n = 45); in 16 patients with very distal carcinoma and restrained lung function transhiatal esophagectomy was performed. Two patients with concomitant early gastric carcinoma or lymphoma had total esophagogastrectomy, and in 2 other patients cervical esophagectomy was performed. The postoperative 30-day mortality was 6.1%. 74% of the cases had an infiltration of the submucosa, whereas in 26% the carcinoma was limited to the mucosa. No patients with mucosal carcinoma had lymph node metastases, whereas 23% of the patients with submucosal infiltration showed lymph node involvement. Tumors of other organs, especially stomach and hypopharynx, were found in 15.4% of the patients. The 5-year survival rate of the total group of 65 patients was 61.3%. As 3 patients with mucosal carcinoma died during long-term follow-up due to recurrence or second cancer, no significant prognostic difference was found between patients with mucosal or submucosal infiltration. The survival curves of patients with pN0 and those with pN1 tumors were not significantly different.
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PMID:[Early squamous epithelial carcinoma of the esophagus--multicentricity, metastatic pattern and prognosis]. 864 21

Nine monoclonal antibodies, lectin from Ulex europaeus and neuraminidase enzyme were employed to demonstrate the occurrence of type 1 and type 2 blood group antigens in 104 cases of papillary carcinoma of the thyroid. The reagents applied, recognize the following blood group related antigens: CA-50 (sialylated type 1 precursor), CA-19-9 (sialylated Le(a)), Le(a), Le(b), A, B, H, Le(x), sialylated Le(x), and Le(y). Immunohistochemical studies revealed that papillary carcinoma of the thyroid, in contrast to histologically normal thyroid tissue, is characterised by a progressive expression of blood group antigens. Most tumours (84%) reacted with C-50 antibody, whereas only a minority of the tissues demonstrated the CA-19-9 antigen (38%). Type 2 structures Le(x) (47%) and Le(y) (13%) were found less often than their corresponding type 1 isomers Le(a) (71%) and Le(b) (62%). Desialylation with neuraminidase increased the Le(a) and Le(x) staining intensity in 27 and 44 case, respectively. Of the A, B, H antigens the A determinants encountered most frequently (24%). Comparative examinations of sequential sections of the same tumour revealed coexpression of type 1 antigens in the same areas. In carcinomas showing type 1 and type 2 antigen reactivity, a complementary distribution of the structures in different tumour areas was often demonstrated. Some tumours presented combined type 1 and type 2 antigen expression in the same cells, however, in distinct areas within the cell. A follow-up examination was carried out in 68 of the 104 cases. The observation time ranged from 12 to 217 months. Thirteen patients suffered from recurrence, of which 7 died. While lymphatic metastases occurred in 39 tumours, distant metastases were detected in 6 patients. Most of the recurrences were found in patients with tumour classification pT4 (n = 19), whereas none of the pT1 carcinomas (n = 20) showed recurrence. The clinical results were compared to the blood group antigen expression results. There was no correlation between antigen expression and differentiation degree of the tumour. The pT4 tumours showed a significant higher expression of the CA-50, CA-19-9, Le(a) and Sialyl Le(x) structures. Carcinomas expressing the Le(y) antigen were associated with a significant higher level of metastasizing capacity. The Le(y), H type 1 and H type 2 antigens occurred more frequently in recurrent tumours (n = 14). In contrast, none of the patients whose carcinomas expressed the A-antigens (n = 14) suffered from a recurrence or hematogenous metastasis. Multiple stepwise regression analysis was carried out to check the importance of each staining and clinical factor. In this analysis, "distant metastasis' was the most important parameter, whereas the staining results were of minor statistical importance.
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PMID:[Blood group antigen expression in papillary carcinoma of the thyroid gland. An immunohistochemical and clinical study of expression of Lewis, ABO and related antigens]. 864 24


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