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)

From January 1980 to August 1982 the Cancer and Leukemia Group B conducted a prospective randomized trial comparing chemoendocrine therapy with T-CAF (cyclophosphamide, adriamycin, and 5-fluorouracil plus tamoxifen) to CAF alone in postmenopausal women with advanced breast cancer. The patients were stratified by estrogen receptor (ER) status into three groups: ER-negative, ER-positive, ER-unknown. They were also stratified by dominant site of metastatic disease: visceral and other (osseous and/or soft tissue). A total of 246 eligible patients were enrolled in the study; 232 were evaluable and constitute the basis for this report. The study revealed that there was no difference in overall response frequency or response duration between T-CAF and CAF; there was no difference in response between T-CAF and CAF in ER-positive or in ER-negative patients; and there was no difference in response between T-CAF and CAF by dominant site of metastatic disease. The expected advantage of T-CAF over CAF, especially for ER-positive patients, was not observed.
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PMID:Chemoendocrine therapy vs chemotherapy alone for advanced breast cancer in postmenopausal women: preliminary report of a randomized study. 636 9

Fourteen patients with advanced carcinoma of the breast were treated with CAP combination therapy. An objective therapeutic response (partial remissions with a mean duration of 6.3 months) was achieved in 6 of 13 evaluated patients. This response was observed in soft tissue metastases. Nausea and vomiting were found to be the most frequent undesirable side effects in all patients and could not be avoided by administration of antiemetics. In 2 patients mild nephrotoxicity was found without any effects on further therapy. The results of this study were considered as promising; a definitive assessment of the CAP regimen is expected to come from a randomized study which started in the CMEA countries in 1983.
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PMID:CAP (cyclophosphamide, adriamycin, cisplatinum) in the treatment of advanced breast cancer. 654 99

During the past 10 years, the Southeastern Cancer Study Group (SECSG) has been engaged in one major adjuvant study and three major advanced disease studies for patients with adenocarcinoma of the breast. The adjuvant study is demonstrating that six months of adjuvant CMF is the therapeutic equivalent of 12 months and that post-operative irradiation is of no added therapeutic benefit. In patients with advanced disease, a low dose 5 drug combination of CMFVP induces more objective responses than single agent 5FU, but improves survival only for those patients with liver metastases when compared to the sequential use of the same 5 single agents. The three drug combination, CAF, utilizing doxorubicin, induces more objective responses than low dose CMFVP, but it does not improve overall survival. The subsets of patients with bone-only metastases, with local chest wall recurrence and with nodular lung metastases benefit from CAF in terms of a longer duration of disease control and longer duration of unmaintained remission, but have only a marginal improvement in survival. The addition of a phase active combination, CAMELEON, (i.e., sequentially alternating therapy) to CAF has not improved the duration of disease control and survival for patients with liver metastases, lymphangitic and nodular lung metastases compared to CAF. Aggressive combination chemotherapeutic approaches to patients with advanced disease provide better and longer disease and tumor control but only marginal improvements in overall survival. Adding additional agents to a maximally tolerable regimen has not improved the therapeutic outcome.
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PMID:Southeastern Cancer Study Group: breast cancer studies 1972-1982. 660 45

Twenty-one patients, presenting with metastases only to bone from a primary adenocarcinoma of the breast having previously undergone mastectomy, tolerated aggressive cytotoxic chemotherapy (CAF--cyclophosphamide 500 mg/m2, Adriamycin 50 mg/m2, 5-fluorouracil 500 mg/m2 q 3 weeks) without significant clinical morbidity. Sixteen of the 21 achieved total clinical symptomatic improvement (pain, performance status). Eleven of these 16 patients tolerated and received between 75% and 100% of the original prescribed dose every 3 weeks, completing a total cumulative course dose of 450 mg/m2 of Adriamycin within 36 weeks, and remained clinically free of disease for an average of 26 months despite cessation of therapy. Their median survival is greater than 3 1/2 years. Those patients tolerating and receiving a dose of 50% or less developed early progression and had a relatively short survival. In general, patients with metastatic disease limited to bone have a relatively good prognosis and are tolerant of and benefit from aggressive cytotoxic therapy. In these patients an excellent clinical response can be achieved with a prolonged disease-free treatment-free period of life.
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PMID:Advanced breast cancer with bone-only metastases: a chemotherapeutically responsive pattern of metastases. 709 Oct 41

Ten malignant canine mammary gland tumours and five metastases from three of these tumours were studied immunohistochemically with monoclonal antibodies (MoAbs) directed against different human keratin types (K), alpha-smooth muscle actin, vimentin, and desmin. In all tumours the neoplastic epithelium was rather homogeneously labelled with the keratin MoAbs RCK 102 (K 5 and 8) and CAM 5.2 (K 8). The adenocarcinomas (n = 5), the solid carcinomas (n = 2), and the carcinosarcoma (n = 1) showed heterogeneous labelling with the MoAbs specific for luminal cell antigens in the normal canine mammary gland, i.e., K 18, K 7 and K 19 MoAbs. These cells were also immunoreactive with K 4 and K 10 MoAbs. The spindle cell carcinomas (n = 2), however, did not react with these MoAbs. All tumours except one adenocarcinoma were characterized by the absence of immunoreactive labelling with the alpha-smooth muscle actin MoAb. In the solid carcinomas this was associated with the absence of labelling with one or both basal cell specific keratin MoAbs, i.e., 8.7 (K 14 and 17) and RCK 107 (K 14), respectively. In contrast, the other malignant tumours showed marked labelling of neoplastic epithelium with these MoAbs. Another remarkable finding was the labelling of a limited to moderate number of neoplastic epithelial cells with the vimentin MoAb. The presence of such labelling patterns in canine mammary gland tumours may be indicative of malignancy. Metastatic tumour tissues had a labelling pattern largely similar to that of the primary tumour, although also loss of reactivity for some keratin MoAbs was seen.
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PMID:Immunohistochemistry with keratin, vimentin, desmin, and alpha-smooth muscle actin monoclonal antibodies in canine mammary gland: malignant mammary tumours. 750 11

A case characterized by a rare synchronous occurrence of transitional cell carcinoma (TCC) of the renal pelvis and renal cell carcinoma (RCC) in the same kidney is presented. A retrospective analysis of 23 similar cases reported in the English literature over the last 71 years demonstrated a male-to-female ratio of 2:1, an average age of 64.5 years, and a left-to-right-side ratio of 3.2:1. The three most common findings at initial examination were hematuria (90%), flank pain (19%), and flank mass (14%). Moreover, 24% of patients had tumor metastases even at initial examination. Thirty-four percent of patients had bladder neoplasms, and 24% of them had a history of cigarette smoking. There is no tendency toward higher grade of malignancy or specific histologic pattern for TCC and RCC when they occur together in the same kidney. Immunohistochemical studies were used to examine TCC and RCC, with special attention paid to the site of their collision, which displayed multifocal lymphatic permeation. Both TCC and RCC were positive for epithelial membrane antigen (EMA) and cytokeratins identified by monoclonal antibodies CAM-5.2, AE1/AE3, and MAK-6. TCC was focally positive for keratin, detectable by antibody 34 beta E12, but RCC was not. The tumor tissue infiltrating the lymphatics, which seemed to be RCC, demonstrated positive staining for EMA and keratins CAM-5.2, AE1/AE3, and MAK-6 and negative staining for keratin 34 beta E12. Interestingly, the tumor in lymphatics displayed strong staining for carcinoembryonic antigen (CEA) but both TCC and RCC in the vicinity were negative. These findings suggest that keratin 34 beta E12 may play a role in the differential diagnosis between TCC and RCC and that tumor-invading lymphatics may change phenotype, including the neoexpression of CEA.
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PMID:Collision of transitional cell carcinoma and renal cell carcinoma. An immunohistochemical study and review of the literature. 750 17

Hepatoblastoma, although rare, is the most common primary malignant neoplasm of the liver in children. In this paper we describe a case of hepatoblastoma with unusual cytologic features and present the histologic, immunocytochemical and ultrastructural features of this neoplasm. A 7-month-old girl presented with a large hepatic mass and metastatic nodules in both lungs. Intraoperative biopsy revealed a hepatoblastoma. Aspiration biopsy yielded a highly cellular aspirate with cords of pleomorphic cells embedded in a mucoid matrix. Histologic sections showed a diffusely infiltrative neoplasm composed of sheets and cords of highly pleomorphic cells. The neoplastic cells stained strongly positive for cytokeratin CAM 5.2 and AE1 and focally positive for alpha-fetoprotein, ferritin, carcinoembryonic antigen and vimentin. Ultrastructurally, the neoplastic cells had abundant intercellular junctions and intracytoplasmic aggregates of intermediate filaments. A mucoid matrix, to our knowledge, has not been reported as a finding on aspiration biopsy. This patient presented with pulmonary metastases, and thus we think the mucoid matrix may be a marker of a more aggressive variant of hepatoblastoma. This case illustrates additional cytologic features of hepatoblastoma and the usefulness of aspiration biopsy in the rapid diagnosis of this rare tumor.
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PMID:Hepatoblastoma. Report of a case with cytologic, histologic and ultrastructural findings. 751 34

In order to determine epithelial markers in malignant melanoma in routinely processed paraffin sections and to compare the staining of primary (cutaneous) malignant melanomas and their metastases, we stained formalin-fixed paraffin sections of 13 primary and 18 metastatic malignant melanomas using the streptavidin-biotin peroxidase method by antibodies to S-100, vimentin, HMB-45, polyclonal carcinoembryonic antigen (CEA), monoclonal CEA, cytokeratins (CAM 5.2 and broad-spectrum CKKES), and epithelial membrane antigen (EMA). All primary and most metastatic malignant melanomas showed positive staining with anti-S-100, HMB-45, and anti-vimentin. Reactivity with polyclonal CEA was observed in 15 (48%) of the 31 lesions; 14 of them were metastatic. No lesion was reactive with monoclonal CEA. Significant cytokeratin (CK) staining was evident in only three (9.7%) lesions (all metastatic), which also stained specifically with anti-CK 18. EMA was observed only focally in two (6.5%) lesions. There was no correlation between epithelial markers staining of the primary tumours and their metastases. All lesions with CK or EMA staining showed concomitant extensive staining for S-100, HMB-45, and vimentin. We conclude that (a) polyclonal CEA staining in malignant melanoma is not rare and is probably due to CEA-related molecules; (b) significant CK reactivity is rare and related to simple CK, such as CK 18; (c) epithelial marker reactivity is more common in metastases of malignant melanomas and is not correlated to the reactivity in their primary tumors. Considering our results and reports of positive S-100, vimentin, and HMB-45 in epithelial tumors, a wide panel of antibodies is recommended for the study of undifferentiated tumors.
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PMID:Epithelial markers in malignant melanoma. A study of primary lesions and their metastases. 752 76

We compared tumor grade and DNA content with expression of E-cadherin (E-CD), a cell adhesion molecule associated with cell-cell and cell-matrix interaction, leukocyte function, and tumor invasion and metastases, on 56 prostate carcinoma needle biopsies. The findings were correlated with final pathologic stage at subsequent prostatectomy, preoperative serum prostate-specific antigen level and further development of metastases during an initial 2.4-yr mean clinical follow-up period (range 0.5 to 5.5 yr). E-CD expression (uvomorulin, L-CAM, cell CAM 80/120, ARC-1, Sigma, St. Louis, MO) was measured by double-linked immunoalkaline phosphatase immunohistochemistry quantified with a the Roche RPW image analyzer (Roche Image Analysis Systems, Elon College, NC). DNA ploidy was determined on formalin-fixed, paraffin-embedded Feulgen-stained 5-microns tissue sections of the narrow-bore initial prostate carcinoma biopsies with the Roche RPW image analyzer. The 51% mean positive area E-CD expression in the group of 56 adenocarcinomas was significantly less than the 76% expression level for 15 normal control prostate tissues (P < 0.001). E-CD expression was also decreased in aneuploid (39%) versus diploid tumors (54%, P < 0.001); and in high-grade (44%) versus low-grade lesions (54%; P < 0.01). The 44% E-CD expression level in patients with metastases was lower than the 52% level in the nonmetastatic cases, but this finding was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:E-cadherin expression in prostatic carcinoma biopsies: correlation with tumor grade, DNA content, pathologic stage, and clinical outcome. 753 Aug 50

Four cases are described of a distinctive morphologic variant of thymic carcinoid that was characterized by abundant stromal mucin admixed with the neuroendocrine elements resulting in a histologic picture reminiscent of metastatic mucin-secreting carcinoma. The patients were three men and a woman, aged 22 to 43 years. The tumors presented with symptoms of chest discomfort, cough, and dyspnea and were described as large anterior mediastinal masses on chest radiographs and computerized scans. Histologically, all cases showed nests and strands of tumor cells embedded in an abundant lightly eosinophilic, mucinous stroma with small cellular clusters as well as scattered single tumor cells seen floating in the mucin. The mucinous matrix was negative for periodic acid Schiff's and mucicarmine stains; alcian blue stains at pH 2.5 showed strong positivity of the mucinous material; this reaction was abolished by treatment with hyaluronidase, indicating the presence of nonepithelial stromal mucosubstances. Immunohistochemical stains showed strong positivity of the tumor cells with CAM 5.2, chromogranin, synaptophysin, and neuron-specific enolase, and negative staining with carcinoembyronic antigen and epithelial membrane antigen. Electron microscopy done in one case showed abundant dense-core cytoplasmic neurosecretory granules; there was no evidence of glandular secretory activity by the tumor cells. The tumors in two patients behaved in a highly aggressive fashion, with invasion of the chest wall, recurrence, and metastases to the lungs, pleura, and axillary, retroperitoneal, and mesenteric lymph nodes. Thymic carcinoid should be considered in the differential diagnosis of mediastinal neoplasms displaying prominent mucinous features. Application of immunostains and electron microscopy will be of value for establishing the correct diagnosis in this setting.
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PMID:Thymic carcinoid with prominent mucinous stroma. Report of a distinctive morphologic variant of thymic neuroendocrine neoplasm. 757 90


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