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 retrospective study is described according to which 319 outpatients had been operated on for suspected carcinoma because of breast lesion, in the course of three years in this hospital. In 113 cases (35.4%) the lesion was palpable, in 206 cases (64.6%) it was not. In the non-palpable cases, mammography was indicated in 98 patients (47.6%) undergoing controls for mastopathy, in 41 patients (19.9%) undergoing a first mammography in the course of preventive check-ups, and in 33 patients (16.0%) undergoing a check-up after operative therapy of breast cancer. Prior to operation, 84.0% (n = 173) of the non-palpable lesions were marked by mammography, 11.2% (n = 23) by sonography, and 4.8% (n = 10) by magnet resonance imaging (MRI). Intraoperative specimen mammography was made in every case marked by mammography. In 19.4% (n = 40) out of the 206 cases of marked though non-palpable focuses a tumour was found. 25% (n = 10) of all marked tumours were diagnosed and treated as in-situ stage tumours, 65% (n = 26) were diagnosed and treated as tumours in the pT1 stage. As regards the nodal stage, 85% (n = 34) of the tumours were diagnosed and treated as being pN0 tumours, and 100% (n = 40) were found to be free from any distant metastases. Consequently, for improving prognosis and, at the same time, for reducing the rate of breast amputations as a means of curative therapy of breast cancer, regular screening in defined risk groups is necessary. Surgical treatment of patients with small and non-palpable findings should be reserved for departments with marking and quick-freezing facilities.
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PMID:[Improved prognosis in breast carcinoma by excision of non-palpable carcinoma-suspected lesions. Analysis of 319 ambulatory surgery operations]. 1098 46

In this retrospective study the efficacy of tumor dispensaire in patients with superficial transitional cell carcinoma of the bladder was investigated in a population of 246 patients. Special attention was payed to follow up cystoscopy. Furthermore our goal was to identify and confirm prognostic factors relevant to recurrence rate and tumor progression. After transurethral resection 241 patients suffering from superficial bladder cancer were enclosed. The first of them were diagnosed in 1984 with a mean follow up range of 6.1 years and a minimum of 1 year. The evaluation was closed in 1995. The 1-year recurrence free rate of all cases amounts to 60%, whereas 42% of patients with a pT1-primary tumor and 45% with a pTa-primum developed a relapse within 2 years after the first diagnosis. All in all more than 50% of all recurrent tumors occurred within the first two years if illness. Patients with pTa and pT1 tumor are progressed in 10.7% and 18%. In 8% we saw lymphogen metastases in patients with pT1 carcinoma. 149 patients (62%) were followed up exactly (+/- 1 cystoscopy) according to the investigation schedule. More than +/- 3 aberrant cystoscopies contrary to the follow up instructions happened very seldom. Prognostic factors to be found of significance for tumor progression and recurrence risk are: tumor staging and grading, multiplicity in occurrence, period of time between first diagnosis and first relapse, associated dysplasia or carcinoma in situ. Chest X-ray and urography should be performed in accordance to the patients individual clinical situation, not routinely (2 cases of pulmonary metastasis occurred after pT1G2-3 tumor progression in 496 regular chest X-rays and 1 ureter tumor was diagnosed by routine urography). As a main result of our investigation we defined two groups of patients with superficial bladder cancer: a "low risk" group (pTa, G1-2, late recurrence (> 2 yrs.) and a "high risk" group (pT1, G3, early recurrence (< 2 yrs.), multifocal occurrence). Group 1 ("low risk") should be followed up for 5 years and group 2 ("high risk") for 10 years. Cystoscopic investigations are scheduled with regard to the group risk of recurrence and tumor progression. For patients of both groups the need of chest X-ray and urography should be evaluated individually.
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PMID:[Modern follow-up strategies for the treatment of patients with superficial bladder carcinoma]. 1099 43

Cytogenetic investigations of bladder cancer suggested that development and progression is characterized by specific chromosomal aberrations. In order to identify genetic changes linked to muscle invasive tumors and metastatic growth we analyzed 67 bladder carcinomas (30 pT1 and 37 pT2-4) by means of comparative genomic hybridization (CGH). The most frequent changes were gains of chromosome 1q (54%), 8q (54%), 17q (49%), 2p (30%), 12 (30%), 5p (25%), 3q (24%) and 6p (24%) as well as losses of 11p (43%), 8p (42%), 9p (36%), 11q (34%), 2q, 4q, 5q (30% each), 9q (27%) and 10q (27%). Previously not described amplifications were found at 5p11-p13, 7q21-q31, 9p24 and 17q24-q25. Gains of 3q, 7p, and 18p were markedly more frequent in pT2-4 in comparison to pT1 carcinomas but the difference did not reach statistical significance. Non-metastatic tumors showed more aberrations on average than metastatic carcinomas, although no particular change was found to be predominating in either group. Our data confirm previous findings of strong genetic similarities between minimally and deeply invasive bladder carcinomas but argue for differences between metastatic and non-metastatic disease.
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PMID:Patterns of chromosomal imbalances in muscle invasive bladder cancer. 1102 8

The cervical and celiac lymph node metastases are defined as distant metastasis (Mlym) from thoracic esophageal carcinoma by TNM (primary tumor, regional lymph nodes, and distant metastasis) classification. The prognostic factors, however, of such distant node metastases are not fully understood. Of 85 patients with node-positive thoracic esophageal carcinoma who were treated with the same modalities of treatment, 31 (37%) had Mlym. Prognostic factors for long-term survival were analyzed by univariate and multivariate analyzes. Three patients are alive and free of cancer, and two patients survived over 5 years. Fifteen patients died of recurrent esophageal cancer and 11 patients succumbed to causes unrelated to esophageal cancer. Two patients with a single Mlym died without recurrence of esophageal cancer at 1.4 years and after more than 5 years, respectively. The 1-, 2-, 3-, and 5-year overall survival rates of all 31 patients were 64.5%, 24.8%, 17.0%, and 12.8%, respectively. The factors influencing survival rate were depth of invasion (pT1,2 vs. pT3,4) and metastatic lymph node ratio (< or =0.104 vs. > or =0.105). The survival rates were not influenced by number of lymph node metastasis, number of Mlym, or by metastatic lymph node ratio of Mlym. Among those two significant variables verified by univariate analysis, independent prognostic factor for survival determined by multivariate analysis was the metastatic lymph node ratio (risk ratio = 3.4, p = 0.0345). The results of this study indicate that a significant number of patients can be cured of esophageal carcinoma by extensive resection along with extended lymph node dissection even when the disease metastasizes to distant nodes.
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PMID:Esophageal cancer with distant lymph node metastasis: prognostic significance of metastatic lymph node ratio. 1112 74

The aim of this study was to evaluate the correlation between serum tumor markers CEA and CA 15-3 in breast cancer (BC) patients with disease relapse and different prognostic parameters at first operation. Sixty-two women (median age 55 years, range 35-83 years) who had undergone curative surgery for pT1-2 pN0-1 M0 breast cancer developed local recurrences, distant metastases or contralateral BC during a median relapse time of 53 months (range 25-149 months). Sensitivity of CEA, CA 15-3, and CEA + CA 15-3 together was 40.3%, 41.9% and 59.7%, respectively. No correlation (p = NS) was found between tumor markers sensitivity and type of recurrence, surgical procedure, histologic subtypes and hormone receptors rate. CEA significantly (p < 0.01) correlated with the size of the tumor and axillary node status and CA 15-3 with the age of the patients. In conclusion, CEA and CA 15-3 should be considered complementary in detecting BC recurrences but their sensitivity is low and independent of the majority of the prognostic parameters that may be considered before relapse.
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PMID:Sensitivity of serum tumor markers CEA and CA 15-3 in breast cancer recurrences and correlation with different prognostic factors. 1120 12

Genetic testing for RET germline mutations affords rapid identification of germline carriers, offering the prospect of cure before C-cell hyperplasia (CCH) has progressed to medullary thyroid carcinoma (MTC). Although nonindex RET mutation carriers have a better prognosis than do the index patients, it remains to be ascertained whether age represents a risk factor for MTC when screening patients. The current institutional study (October 1994 through June 1999) was set up to compare asymptomatic nonindex patients who were grouped by age: < 20 years and > or = 20 years. Inclusion criteria were confirmed RET mutations in the germline, with no MTC being more advanced than pT1pN1M0. Adult patients (> or = 20 years) had MTC significantly more often (84% vs. 43%), significantly larger tumors (5 mm vs. 3 mm), and significantly higher basal calcitonin levels preoperatively (78.0 vs. 9.7 pg/ml) than their pediatric/adolescent counterparts (< 20 years). There was a close correlation between pT1 MTC and an elevated basal serum calcitonin level (r = 0.67; Spearman's rho). All three patients with lymph node metastases from MTC had elevated basal calcitonin levels. The two groups did not differ in terms of multifocality of MTC (pT1b), lymph node involvement (pN1) or bilateral lymph node metastasis (pN1b), or preoperative stimulated and postoperative basal and stimulated serum calcitonin. Prophylactic thyroidectomy should not be postponed beyond the age of 20, and it should be performed before basal serum calcitonin has turned positive. Pathologic conversion of stimulated serum calcitonin obviously marks the time in carriers of RET germline mutations when surgery should be scheduled at the latest to be prophylactic.
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PMID:Importance of early screening and prophylactic thyroidectomy in asymptomatic nonindex RET germline carriers. 1137 4

The precise staging of hepatocellular carcinoma (HCC) based on the size and number of lesions that predict recurrence after orthotopic liver transplantation (OLT) has not been clearly established. We therefore analyzed the outcome of 70 consecutive patients with cirrhosis and HCC who underwent OLT over a 12-year period at our institution. Pathologic tumor staging of the explanted liver was based on the American Tumor Study Group modified Tumor-Node-Metastases (TNM) Staging Classification. Tumor recurrence occurred in 11.4% of patients after OLT. The Kaplan-Meier survival rates at 1 and 5 years were 91.3% and 72.4%, respectively, for patients with pT1 or pT2 HCC; and 82.4% and 74.1%, respectively, for pT3 tumors (P =.87). Patients with pT4 tumors, however, had a significantly worse 1-year survival of 33.3% (P =.0001). An alpha-fetoprotein (AFP) level > 1,000 ng/mL, total tumor diameter > 8 cm, age > or = 55 years and poorly differentiated histologic grade were also significant predictors for reduced survival in univariate analysis. Only pT4 stage and total tumor diameter remained statistically significant in multivariate analysis. Patients with HCC meeting the following criteria: solitary tumor < or = 6.5 cm, or < or = 3 nodules with the largest lesion < or = 4.5 cm and total tumor diameter < or = 8 cm, had survival rates of 90% and 75.2%, at 1 and 5 years, respectively, after OLT versus a 50% 1-year survival for patients with tumors exceeding these limits (P =.0005). We conclude that the current criteria for OLT based on tumor size may be modestly expanded while still preserving excellent survival after OLT.
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PMID:Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. 1139 28

The exact roles of PET in the imaging management of patients with known or suspected breast cancer are still in evolution. For assessing primary lesions, it is sometimes possible with PET to detect cancers occult on standard methods. This could be useful in high-risk patient populations, but in dense breasts, background FDG uptake is often higher than in women with fatty breasts, making identification of lesions < 1 cm in size improbable with current technologies. Distinguishing malignant from benign primary breast disease would seem better addressed by biopsy. With a positive predictive value of FDG PET for cancer over 96%, any FDG-avid breast lesion is highly suspicious and merits biopsy. Although PET in theory should be useful for depicting multifocal disease before surgery, the limitations in detecting small lesions in the breast limit the contribution of PET at present. It is most likely that PET will have a greater role in depicting primary breast lesions as dedicated PET imaging devices for the breast evolve. For axillary and internal mammary nodal staging, results with FDG PET are variable. Small nodal metastases < or = 5 mm will be missed by PET, whereas larger ones are more likely to be detected. PET can depict internal mammary nodes, but the accuracy of the method in this setting is not known, nor is there consensus on how identifying internal mammary node metastases will change treatment. Based on the available data, for pT1 breast lesions, PET, if negative, is not an adequate replacement for sentinel node surgery or axillary dissection. Results from the multicenter trial will be of great interest. Clearly PET can stage metastatic disease well. Bone scans with 18F- are exquisitely sensitive for metastases, and FDG is also very good. However, FDG PET can miss some blastic metastases to bone so at present FDG is not capable of excluding the presence of bone metastases. PET seems very well suited to detecting recurrences in soft tissues and the brachial plexus region in particular. The utility of PET in planning the treatment of individual patients appears promising. Although results must be confirmed in larger studies, it appears safe to conclude that failure of a chemotherapy regimen to decrease FDG uptake promptly in a breast cancer portends poor response. This does not hold true for hormonal therapy. At present, labeled estrogens are not widely available and cannot be recommended for clinical use. Thus, PET has shown considerable promise in breast cancer imaging, but in the author's experience is best applied to solve difficult imaging questions in specific patients and is not recommended for routine evaluation of the breast cancer patient. However, in larger primary tumors, the ability to use PET for staging and to plan treatment response suggest it will be more widely used. Additional studies with newer PET imaging devices and FDG and other tracers will help us better determine the role of PET in routine clinical care of the patient with known or suspected breast cancer. Certainly, this represent a fertile area for translational research studies over the next several years with the potential to significantly alter the way breast cancer is imaged and managed.
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PMID:Current status of PET in breast cancer imaging, staging, and therapy. 1147 71

Gain of the long arm of chromosome 8 (8q) is one of the most common gains found in the advanced prostate cancer by comparative genomic hybridization. We have previously identified a putative target gene for the 8q gain, EIF3S3, that encodes a p40 subunit of eukaryotic translation initiation factor 3 (eIF3). Here, we studied the frequency of the EIF3S3 amplification in different stages of prostate cancer and co-amplification of EIF3S3 and oncogene MYC. In addition, prognostic utility of the EIF3S3 copy number alteration was evaluated. The analyses were done with fluorescence in situ hybridization and tissue microarray technology. High-level amplification of EIF3S3 was found in 11 of 125 (9%) of pT1/pT2 tumors, 12 of 44 (27%) of pT3/pT4 tumors, and 8 of 37 (22%) of lymph node metastases as well as in 26 of 78 (33%) and 15 of 30 (50%) of hormone refractory locally recurrent tumors and metastases, respectively. The amplification was associated with high Gleason score (P < 0.001). One of the 79 tumors with EIF3S3 amplification had only two copies of MYC, whereas all tumors with amplification of MYC had also amplification of EIF3S3 indicating common co-amplification of the genes. Gain of EIF3S3 was associated with poor cancer-specific survival in incidentally found prostate carcinomas (P = 0.023). In the analyses of prostatectomy-treated patients, the amplification was not statistically significantly associated with progression-free time. In conclusion, amplification of EIF3S3 gene is common in late-stage prostate cancer suggesting that it may be functionally involved in the progression of the disease.
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PMID:Amplification of EIF3S3 gene is associated with advanced stage in prostate cancer. 1173 59

Nephroureterectomy is the standard treatment of tumors in the upper and middle third of the ureter. Whereas, resection of the distal ureter and uretercystoneostomy is the treatment of choice of tumors in the lower third, as long as there is enough renal function which is worthwhile to be preserved. Lymphadenectomy should be performed in all patients suspicious for invasion of the ureteral wall since already 10% of patients with pT1 and pT2 tumors will present with metastases to the lymphnodes. In case of functional or anatomic single kidney therapy has to be adapted to the patient and tumor appropriately. Endoscopic resection, partial or complete resection of the ureter with substitution by ileum or autotransplantation with pyelovesicostomy are the operative options. Elective endoscopic treatment of ureteral tumors should be done in patients with G1 tumors only. However, the recurrence rate is as high as 30 to 60% and the mean interval to recurrence is about 9 months. Regular followup by means of cytology and endoscopy is mandatory. Laparoscopic nephroureterectomy is still a experimental treatment at present time and should be not considered in the treatment of ureteral tumors because of the complexity of the procedure and the risk of tumor spillage.
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PMID:[Therapy of ureteral tumor]. 1176 Mar 50


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