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)

Optimal conditions for expanding tumor-infiltrating lymphocytes (TILs) specifically cytotoxic for autologous melanoma for clinical use have not yet been identified. In several small studies, interleukin (IL)-4 was reported to promote the growth of such TILs in IL-2. Given the potential implications for TIL therapy, we attempted to confirm these findings in a larger study. Baseline data were first obtained on the proliferation, immunophenotype, and cytotoxic reactivity to autologous melanoma of TILs cultured in IL-2 alone. Similar studies were performed with TIL cultured concurrently in either IL-2 alone or in a combination of IL-2 and IL-4. TILs were obtained by excisional biopsy of tumors from 52 patients with metastatic malignant melanoma; TILs from 38 patients were expanded in IL-2 (1,000 U/ml). TILs from 19 biopsies were maximally expanded 6- to 24,000-fold (median, 300-fold) over 4-10 weeks. Expansion did not correlate with the weight of, or number of lymphocytes in, the biopsy specimen, or the site of the biopsy (lymph node vs. subcutaneous metastases). During weeks 5-8, TILs from 19 of 25 biopsy specimens lysed autologous melanoma with little or no lysis of allogeneic melanoma. Lysis of autologous tumor was blocked by antibody to class I antigens. Twenty-four TIL specimens were cultured concurrently in IL-2 alone and in IL-2 plus IL-4 and tested for growth and for lysis of autologous and allogeneic melanomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Growth and autologous tumor lysis by tumor-infiltrating lymphocytes from metastatic melanoma expanded in interleukin-2 or interleukin-2 plus interleukin-4. 828 Jul 15

Giant cell tumor is a lesion that usually presents with a radiographically characteristic appearance in a predictable location and patient population. It has a few rare presentations such as pulmonary metastases and multifocal lesions. Prognosis of ultimate tumor behavior is dependent on surgical staging (which requires careful radiographic analysis to detect cortical breakthrough and joint involvement) and type of treatment. The recurrence rate is relatively high with simple curettage but decreases with adjuvant treatment at the tumor site. Optimal therapy for the more aggressive lesions is wide resection, but compromise is frequently required when such a resection would sacrifice joint function because of the subarticular location of the giant cell tumor. Radiation therapy is reserved for surgically inaccessible or otherwise inoperable lesions because of a relatively poor radiosensitivity and concerns about induction of high grade sarcomas. Radiographic follow-up evaluation for recurrence is recommended for approximately 5 years but may be difficult to interpret in individual patients because of an overlap in the appearance of healing and recurrence.
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PMID:Giant cell tumors of bone. 844 51

Synchronous primary lung cancers (SPLCs) occur in up to 0.5% of patients with lung cancer. They are first diagnosed intraoperatively or upon pathologic examination of resected tissue in up to 40% of patients with SPLCs. Complete surgical resection is possible in over 90% of patients, with an operative mortality of 2.1%. Despite a high frequency of early stage disease (two thirds of patients have either stage I or II tumors), surgical therapy yields an overall 5-year survival of only 20%, far lower than expected. These findings suggest that the biology of SPLCs is different from that of ordinary lung cancers, or that the diagnosis of SPLCs is being made too often, and that in some patients the second cancer focus actually represents metastatic disease. The use of newer techniques of identifying the molecular and biologic characteristics of these cancers, including analysis of DNA ploidy patterns, may more accurately define SPLC patients. Optimal interventional and preventive therapies remain to be determined.
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PMID:Synchronous primary lung cancers. 846 33

Management of the axillary lymph nodes in patients with screen-detected breast cancer is controversial. Optimal treatment should combine accurate determination of node status and avoidance of unnecessary morbidity. This study attempted to determine whether axillary node status could be accurately predicted using selected criteria in women with screen-detected breast cancer. Of 223 breast cancers excised in the Greater Manchester breast screening programme, 180 were invasive and 40 of these had associated lymph node metastases. The presence of involved nodes was associated with large tumour size, high tumour grade and the absence of mammographic microcalcification. Multiple logistic regression analysis revealed that each of these three factors was independently significant. Women with a screen-detected breast cancer < 1 cm in diameter or those with grade I tumours < 3 cm (35 per cent of the total) could be spared axillary surgery with an expected reduction in morbidity and operating time.
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PMID:Treatment of the axilla in patients with screen-detected breast cancer. 849 3

Optimal use of radiation therapy for the treatment of animal tumors necessitates accurate clinical evaluation, diagnostic imaging, and pathology. This requires a coordinated effort between the clinical and radiation oncologist, radiologist, and pathologist. The histological appearance of the tumor, tumor grade, and tumor stage are important diagnostic criteria that need to be established. Diagnostic imaging, including radiographic, computerized tomographic, magnetic resonance imaging, and ultrasound studies are helpful in establishing an accurate tumor location and diagnosis. Biopsy and histological examination of tumor tissue are necessary for final diagnosis of tumor type. Determination of tumor type is critical because different tumor types vary in regard to radiosensitivity, local behavior, and propensity for regional and systemic metastasis. The histological grade of many tumors is an important indicator of the potential for local invasion or systemic metastases, and may influence treatment response. Tumor staging as determined by clinical evaluation, imaging studies, and histological evaluation is necessary to establish the extent of the tumor, both locally, regionally, and systemically. The clinical oncologist should have an understanding of the procedures involved in tumor diagnosis, tumor grading, and tumor staging. This provides a better understanding of the neoplastic condition and recognition of the limitations of diagnostic procedures. Tumor type, grade, and stage all impact radiation treatment planning and the need for adjuvant regional or systemic therapy.
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PMID:Tumor diagnosis, grading, and staging. 853 71

N-(2-Diethylaminoethyl)-4-iodobenzamide (BZA) is a radiopharmaceutical recently developed in our laboratory for the scintigraphic detection of melanoma and metastases. Optimal time for imaging was between 18-24 h p.i. of [123I] BZA. With a view to selecting compounds able to provide quality images shortly after the injection, synthesis of an initial series of BZA derivatives and their evaluation in B16 melanoma bearing mice have been carried out. The [125I] radiolabeled products were obtained by a simple isotopic exchange procedure with high radiochemical yields (85-95%). After i.v. administration of the compounds we observed a good tumoral targeting ability. Tumoral activity peaked at 2.6 to 7.70% injected dose per g within 1 h post-injection. One of the benzamides with a blood clearance faster than that of BZA--0.06 vs. 0.2% I D/g--6 h p.i. gave the same tumor to blood and to organ ratios as BZA at 12-18 h p.i. Based on these preclinical data we hope to obtain good tumoral images 6 h p.i. in scintigraphic studies in man.
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PMID:Synthesis, radiolabeling, and preliminary evaluation in mice of some (N-diethylaminoethyl)-4-iodobenzamide derivatives as melanoma imaging agents. 853 34

Optimal treatment for patients with localized carcinoma of prostate is controversial. Radiation therapy is an established modality; reports indicate that results are comparable to those of radical prostatectomy. A retrospective review was carried out of 963 patients with carcinoma of the prostate treated with definitive irradiation (65 to 71 Gy in 6.5 to 7 weeks). Survival, incidence of local recurrence and distant metastases, and postirradiation PSA data were analyzed. Ten-year disease-free survival with external irradiation was 100% for clinical stage A1 (T1a), 69% for stage A2 (T1b,c), 57% for clinical stage B (T2), and 41% for stage C (T3). Initial PSA level closely correlated with probability of freedom from chemical failure (PSA elevation) after definitive irradiation in 317 patients with stage T1b,c and T2 tumors (96% and 89%, respectively, with initial PSA of < 10 ng/ml and 75% and 65% with higher PSA levels). Although modern irradiation techniques produce results comparable to those of radical prostatectomy in localized prostate carcinoma, we must continue to critically assess treatment policies, develop appropriately designed prospective clinical trials, and define optimal management of these patients.
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PMID:Radiation therapy in the treatment of localized prostate cancer: an alternative to an emerging consensus. 856 72

From June 1985 to June 1993, 152 patients with advanced ovarian cancer were treated with maximum cytoreductive surgery, and six to nine cycles of platinum-based chemotherapy. Six patients had stage IIIA-B disease, 101 stage IIIC, and 45 stage IV. Twenty-two tumors were grade 1. 58, grade 2. and 72, grade 3. Eighty-four patients (55%) presented with bulky tumors (> 10 cm in diameter). Optimal cytoreductive surgery (diameter of largest residual mass < 2 cm) was performed in 138 patients (91%). Fifty patients (33%) developed postoperative complications; 38 patients (25%) required a second laparotomy within a few days. Two postoperative deaths occurred. Overall 2-year and 4-year survival rates were 56% and 28%, respectively. There was a clear relationship between residual tumor and survival: the 2-year survival rate was 80% in the absence of residual tumor vs. 22% when the residuum exceeded 2 cm in diameter. The 2-year survival rate was 49% for tumor nodules < 2 cm in diameter. In a multivariate analysis of various risk factors (grade, stage, lymph node metastases, residual tumor, and age), the one that correlated most with survival was residual tumor. Despite a high morbidity rate, this modality of treatment, with the presence of optimal and aggressive perioperative measures in terms of intensive care unit and post-operative follow-up, offers an encouraging if not promising strategy for increased chances of survival in advanced ovarian cancer.
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PMID:Extensive cytoreductive surgery in advanced ovarian carcinoma. 906 14

During the period 1994-95, 22 patients were examined with CT during arterial portography for evaluation of hepatic tumours. The majority, 20 patients, had metastases from colon cancer. All patients were candidates for liver resection. In the series of patients described here, this process detected additional lesions in four more of the patients than found with any other imaging techniques. This supports that CT during arterial portography is the most sensitive method for detecting small malignant hepatic tumours, and for localizing them in relation to liver segments and major vascular structures. Optimal results are obtained in the absence of diffuse parenchymal disease and portal hypertension. Non-tumourous perfusion defects limit the accuracy of this technique, but such defects have characteristic locations and appearance. In difficult cases the technique should be correlated with ultrasonography and MR.
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PMID:[CT combined with arterial portography. A sensitive method for evaluation of liver tumors]. 923 9

Optimal management of advanced neck metastases as part of an organ preservation treatment approach for head and neck squamous carcinoma (HNSC) is unclear. Since 1989, our management paradigm for patients on organ preservation was modified to incorporate planned early neck dissection before radiation therapy for patients who did not achieve a complete response (CR) of neck nodes after induction chemotherapy (IC). The purpose of this study was to determine if planned early neck dissection is a safe and effective approach in the management of advanced nodal disease as part of organ preservation. Fifty-eight consecutive patients with advanced HNSC who were entered in organ preservation trials using induction chemotherapy and radiation with surgical salvage were studied. Median follow-up was 26 months. Of the 58 patients, 71% were stage IV. Patients were grouped by nodal response to chemotherapy and N class, and were analyzed with respect to patterns of recurrence, complications, and survival. Overall, the rate of CR of neck nodes was 49%. Fifty-one percent had less than a complete response of neck nodes after IC and required planned early neck dissection. There were no significant differences in patterns of recurrence, complications, interval time to start of radiation, recurrence, or survival rates between the CR and less than CR groups. These data suggest that planned early neck dissection for patients with less than CR in the neck after IC is not detrimental with respect to neck relapse or overall survival. We believe that planned early neck dissection can be safely incorporated into future organ preservation treatment protocols for patients with advanced head and neck carcinoma.
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PMID:Planned early neck dissection before radiation for persistent neck nodes after induction chemotherapy. 926 Oct 21


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