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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 of the clinical findings and natural history of 140 patients with disseminated malignant melanoma treated at Wayne State University over a ten year period was done. Multiple organ metastases were diagnosed clinically in 78 per cent of all patients and seen at all autopsies. Routine roentgenograms of the chest did not diagnose metastases to the lung in 27 per cent of the patients. The concimitant elevation of alkaline phosphatase, serum glutamic-oxalacetic transaminase and serum glutamic-pyruvic transaminase enzymes is suggestive of underlying metastases to the liver even with a negative liver scan or normal liver size. Electroencephalography was found to be sensitive in predicting and confirming metastases to the central nervous system prior to clinical manifestation with a 97 per cent accuracy rate in clinically confirmed instances as compared with a 60 per cent accuracy rate with brain scan. Age, sex and primary site of melanoma did not influence the survival once the disease became disseminated. Patients with a disease-free interval of more than six months statistically have a better chance of survival from the onset of systemic metastases, p = 0.001. Patients with a poor performance status of less than or equal to 40 per cent had a median survival period of one month as compared with six months with 90 per cent performance, p = 0.001. Patients who initially presented with metastases to the skin or lymph nodes without other visceral involvement had a 14 month median survival rate as compared with eight months in patients with metastases to the central nervous system only, four months with metastases to the liver and only one month in patients with multiple organ involvement, p = 0.0001.
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PMID:Clinical presentation, natural history and prognostic factors in advanced malignant melanoma. 50 43

Four patients developed abnormal liver function tests and focal defects on liver scan while receiving cyclophosphamide, methotrexate and 5-fluorouracil as adjuvant chemotherapy following mastectomy for breast cancer. Liver biopsies showed severe focal inflammation. The biopsy findings and the subsequent clinical course of the patients strongly suggest that these abnormalities were due to hepatic toxicity of the chemotherapy and not metastic breast cancer. A review of serial liver function tests performed on 24 patients in that chemotherapy program revealed that four out of eight patients with elevated alkaline phosphatase prior to therapy developed early metastatic cancer. Elevated alkaline phosphatase occurring during chemotherapy on the other hand was quite common but more likely due to hepatic toxicity of the drugs. The development of abnormal liver function tests even in association with focal defects on liver scan is not sufficient to diagnose metastatic breast cancer in patients receiving adjuvant chemotherapy.
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PMID:Hepatic toxicity of adjuvant chemotherapy for carcinoma of the breast. 54 61

A retrospective review of the value of routine perioperative liver scanning for patients with breast cancer was performed. The liver was considered to be normal in 231 of 234 patients. The hepatoscan uncovered only one patient with unsuspected metastases. There were eight false-positive studies. Measurements of liver function, SGOT, SGPT, alkaline phosphatase, and bilirubin levels separated true positive from false-positive hepatoscans for all except one patient. Abnormal liver chemistry studies also identified liver metastases in an additional follow-up group of 192 patients. The low yield of detection of hepatic metastases during the initial work-up of breast cancer patients suggests that routine hepatoscanning be abandoned unless there is evidence of abnormal liver function.
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PMID:An assessment of routine liver scanning in patients with breast cancer. 62 72

Bone marrow acid phosphatase has been reported to be a sensitive indicator of early bony metastasis from adenocarcinoma of the prostate. In order to evaluate this hypothesis, we measured bone marrow acid and alkaline phosphatase, lactic dehydrogenase, and calcium levels in a group of 84 patients with a variety of problems, including 18 with cancer of the prostate. We found that the bone marrow acid and alkaline phosphatase and lactic dehydrogenase were elevated and calcium was depressed in most patients. Among patients with prostate cancer, bone marrow acid phosphatase was not significantly different between those with or without bone metastases. In addition, the patients with prostatic cancer did not have higher levels of bone marrow acid phosphatase than subjects with other malignant and nonmalignant conditions. The level of acid and alkaline phosphatase, lactic dehydrogenase and calcium varied predictably with the aspiration technique used and was independent of sex, disease state or method of chemical determination. Due to this variation, we believe that bone marrow enzyme and calcium levels are of no value in the detection of metastases in patients with prostate cancer.
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PMID:Lack of usefulness of bone marrow enzymes and calcium in staging patients with prostatic cancer. 63 3

We studied the metastatic pattern of 41 patients initially referred with a primary choroidal melanoma who later developed widespread disease. In the order of frequency, the most common sites of metastatic involvement were the liver (56%), subcutaneous tissue (36.5%), and bone (7%). Whereas the median interval between enucleation and the onset of metastatic disease was approximately four years, in rare cases, metastases were diagnosed concurrently with a primary choroidal melanoma. Since patients with choroidal melanomas usually survive less than one year after the development of widespread disease, a metastatic examination should be done in all patients with pigmented choroidal tumors both before and after ocular therapy. From the data obtained in this and other studies on metastatic melanoma, a reasonable basic metastatic examination for choroidal melanoma patients should include a serum lactic dehydrogenase, a serum alkaline phosphatase, a routine chest X-ray, and a general physical examination.
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PMID:Metastatic choroidal melanoma. 67 36

Patients with poorly differentiated prostatic carcinoma and skeletal metastases were randomized to treatment with 2.6-cis-diphenylhexamethylcyclotetrasiloxane (2.6-cis) and estramustine-17-phosphate (estramustine). Parallel with the clinical study a group of non-randomized patients were treated with 2.6-cis. Cytological regression of the tumor could be registered in half of the estramustine group but not in the 2.6-cis group. There were no drug-related changes in blood chemistry, kidney function tests, hematology or liver enzymes. There was in increase in acid and alkaline phosphatase in both groups but more pronounced in the 2.6-cis group. In both groups follicle-stimulating and luteinizing hormone values were depressed. Testicular and penis atrophy was observed in the 2.6-cis group. Relief of pain and marked improvement of conditions occurred in the majority of the cases in both groups. In general, no tumor regression was observed during administration of 300 mg. 2.6-cis daily for at least 3 months. Some tumor regression was noted during 600 mg. estramustine therapy daily.
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PMID:Clinical experimental randomized study of 2.6-cis-diphenylhexamethylcyclotetrasiloxane and estramustine-17-phosphate in the treatment of prostatic carcinoma. 73 10

Bone scanning with 99mTc-Sn-HEDP, radiographic skeletal survey and determination of plasma acid and alkaline phosphatase values were carried out in a consecutive series of 90 untreated patients with carcinoma of the prostate. 99mTc-Sn-HEDP provided satisfactory bone imaging and was convenient in use. The addition of bone scanning to radiographic survey increases the detection rate of skeletal metatases by 16%. Radiography increases the accuracy of bone scanning by identifying false positive scans due to benign disease and false negative scans when there are diffuse symmetrical bony metastases. The plasma phosphatases alone are less accurate staging tests. The acid phosphatase data support the validity of scan positive--X-ray negative findings. Bone scan abnormalities due to secondary deposits usually precede elevation of plasma alkaline phosphatase.
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PMID:Bone scanning and plasma phosphatases in carcinoma of the prostate. 75 55

Preoperative LDH, CPK, alkaline phosphatase and liver scan results were compared with the presence or absence of hepatic metastases at operation in 124 laparotomies in 123 patients with colorectal carcinomas during a three-year period. The overall accurcy rates for the four tests ranged from 74 to 84 per cent. The false-negative rates were acceptably low (9-13 per cent) for all but the CPK determination. The false-positive rates were unacceptably high for all four tests (38 to 60 per cent). A 'metastatic score' for reducing the high false-positive rate is described. In view of the high false-positive rates of preoperative screening tests, laparotomy is presently the most accurate method of diagnosing hepatic metastases.
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PMID:The preoperative diagnosis of hepatic metastases in cases of colorectal carcinoma. 84 94

A 48-year-old woman with severe carcinoid syndrome caused by multiple liver metastases was treated by hepatic dearterialization. After the operation, urinary 5-HIAA excretion fell transiently to normal levels and the patient was symptom-free for six months. After one year the symptoms of carcinoid syndrome had recurred and a re-dearterialization was performed. A favourable clinical effect was again achieved, but the relief of symptoms lasted only six months. The changes in urinary 5-HIAA excretion and SGOT, SGPT, bilirubin, alkaline phosphatase, cholesterol, PP activity as well as serum protein levels were uniform after both operations to an astonishing degree. Histological specimens taken at reoperation showed that the carcinoid metastases in the anterior parts of the liver were largely necrotic. The necrotic areas has peculiar features, e.g. the necrosis was partly incomplete and ghost like carcinoid structures could be seen.
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PMID:The effect of hepatic dearterialization and re-dearterialization on carcinoid liver metastases. 96 86

Prostatic acid phosphatase and alkaline phosphatase values in bone marrow were correlated with skeletal surveys and diagnoses during a six-month study. In cases of biopsy-proven adenocarcinoma of the prostate, bone marrow prostatic acid phosphatase was the most consistently abnormal value. Diagnoses other than prostatic cancer involving the bone marrow, e.g., myeloma and leukemias, were associated with elevated prostatic acid phosphatase and alkaline phosphatase values. In cases in which the bone marrow was not involved by metastasis, these values were normal. Bone marrow prostatic acid phosphatase assay was found to be a very good tool for detecting early osseous metastases from any site, including prostatic adenocarcinoma.
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PMID:New diagnostic use of bone marrow acid and alkaline phosphatase. 97 Mar 68


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