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)

Ninety-one patients with operation history for urotheliomas were followed-up by urinary cytology for 17.5 months on the average. Cytologically, fresh urine was examined every month and vesical irrigation fluid every three months. Cystoscopy was also performed every three months, IVP every six months, and biopsy was performed when carcinoma or dysplasia was suspected. As a result, cases were classified into four groups. Group 1: All cytological examination were negative. Group 2: Cytology was positive for two or three months after TUR-Bt during which period vesical instillation therapy of anti-cancer drugs was performed, but was negative after this period. Group 3: Positive and negative cytology were diagnosed irregularly. Group 4: All cytological examinations were positive. The numbers of cases classified into these groups were 27 (29.7%), 7 (7.7%), 43 (47.3%) and 14 (15.4%), respectively. Tumor recurrence was seen in 1/27 (3.7%), 0/7, 12/43 (27.9%) and 4/14 (28.6%) cases, respectively. Metastasis was seen in only five cases of the group 4. Tumor recurrence and positive urinary cytology at the same time were seen in nine cases (20.9%) of group 3, and eight cases (57.1%) of group 4. Thirty four cases (79.1%) with discrepancy of cytological and endoscopic findings in group 3, in which cases 20 cases had only positive irrigation cytology and 11 cases had positive fresh urine and irrigation specimens, were more suspicious of temporary existence of in situ carcinomas or dysplastic urothelium. Of six cases with the discrepancy in group 4, three cases were in situ carcinoma diagnosed by random biopsies, and four cases had positive cytologies after TUR-Bt continuously.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Follow-up cytology in the management of urotheliomas]. 373 59

37 patients with recurrent Ta/T1 bladder cancer were treated with intravesical adriamycin (80 mg monthly) after complete TUR (1977-1979). Within a minimum follow-up of 5 years, 11 of them developed evidence of progression - muscle invasion or distant metastases. 8 of them have died of bladder cancer. Ten patients showed a complete response to adriamycin therapy, developing no new tumors during the period of treatment (1 year). One of them developed distant metastases. The remaining 27 patients continued to develop recurrences, despite adriamycin therapy, though the recurrence rate was reduced by at least 50% in 5 of them. The risk of progression and death remains high if the patient continues to have recurrences, even in cases in which the recurrence rate is apparently reduced. Recurrent superficial bladder cancer remains a dangerous disease. The prognosis is good if recurrences cease altogether during prophylactic intravesical adriamycin treatment.
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PMID:Short-term and long-term effect of prophylactic treatment of superficial bladder cancer with intravesical adriamycin. 408 29

Four cases of CDDP allergic reaction (CDDP reaction) are reported. CDDP was given intravenously with vinka-alkaloid and bleomycin or cyclophosphamide (CDDP combination therapy). Case 1 was a 59-year-old man with left ureteral squamous cell carcinoma. The tumor was so large and infiltrated into the retroperitoneal space, that he had conservatively undergone only left nephrectomy and tumor biopsy. Post-operative CDDP combination therapy was performed. Soon after the beginning of the 6th CDDP drip-infusion, a reaction to CDDP occurred. Case 2 was a 22-year-old man diagnosed to have left testicular embryonal carcinoma with multiple pulmonary metastases. After radical orchiectomy and retroperitoneal lymphadenectomy, CDDP combination therapy was performed. At the beginning of the 8th CDDP drip-infusion, a reaction to CDDP occurred. Case 3 was a 49-year-old man diagnosed to have non-papillary bladder carcinoma. Although his bladder was tumor free by TUR-Bt, distant lymph node metastases occurred. CDDP combination therapy was performed. At the beginning of the 6th CDDP drip-infusion, a reaction to CDDP occurred. Case 4 was a 64 year-old-man diagnosed to have bladder carcinoma which was recurrent from right renal pelvic tumor. After total cystectomy and ileal conduit, CDDP combination therapy was performed for diffuse retroperitoneal lymph nodes metastases. At the beginning of the 8th CDDP drip-infusion, a reaction to CDDP occurred. Reaction to CDDP developed at the 6th to 8th course of combination chemotherapy with CDDP, i.e., 450 to 700 mg of CDDP in total doses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Allergic reaction to CDDP: report of 4 cases]. 620 20

Fifty-seven patients with transitional cell carcinoma of the bladder, categories pT2, pT3a and pT3b, were treated by transurethral resection of the tumour mass (54 cases) or partial cystectomy (3 cases) followed by 8 doses of methotrexate 2 g i.v. every 3 weeks with appropriate Leucovorin rescue. At completion of chemotherapy 6 months after TUR 33/57 patients were tumour-free; 5/57 had new superficial tumours; 13/57 had persistent tumour invading muscle, 3 showed tumour progression and 3 had died from treatment complications. One-year survival was 45/57 (82%); 2-year survival was 23/39. Although some patients developed metastases and others have grown new superficial tumours, of those surviving, the bladder was free of the original invasive tumour in 38/45 (84%) at 1 year and in 19/24 (79%) at 2 years. It is concluded that transurethral resection plus high dose methotrexate may offer an effective alternative to radiotherapy or cystectomy for a significant proportion of patients with invasive bladder cancer.
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PMID:Treatment of invasive bladder cancer by local resection and high dose methotrexate. 653 87

Of 99 patients who had carcinoma-in situ (TIS) at least once between 1970 and 1980, 84 were subjected to detailed analysis and pathologic review. They may be classified into four groups: (Group 1) 14 patients, who presented with invasive bladder carcinoma (TCC) associated with TIS; (Group 2) 15 patients who, subsequent to the diagnosis of TIS with or without another superficial TCC developed muscle invasion (12 patients) or metastases without muscle invasion (three patients); (Group 3) 29 patients who underwent cystectomy for superficial TCC (Ta or T1, or TIS alone). Twenty (69%) had extravesical superficial extension. Two patients developed metastases subsequent to undergoing cystectomy; and (Group 4) 26 patients with TIS proven at least once who have not developed muscle invasion, metastases nor have undergone cystectomy. Nineteen had previous non-TIS superficial TCC. All patients in Groups 2 and 4 were treated conservatively (TUR +/- intravesical chemotherapy) when the initial diagnosis of TIS was made. Twelve patients in Group 3 underwent cystectomy within a month of the diagnosis of TIS. When 38 patients found to have TIS in association with the first diagnosis of superficial transitional cell carcinoma of the bladder were compared with 32 patients who had TIS diagnosed subsequent to their initial diagnosis of transitional cell carcinoma, the former group fared significantly worse (P less than 0.01) in regard to muscle invasion, metastases, or clinical indications for cystectomy.
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PMID:Carcinoma in situ of the urinary bladder with and without associated vesical neoplasms. 686 Oct 89

We described the clinical results and efficacy of laparoscopic pelvic lymphadenectomy for localized prostate cancer. This procedure was followed by radical prostatectomy, if metastasis was not found in frozen section. In the presence of positive nodes, optional treatment, such as TUR or castration, other than radical prostatectomy was performed. We performed laparoscopic lymphadenectomy on twenty seven patients between April 1992 and September 1993. They range from 52 to 78 years in age and consist of 4 patients with stage A2, 17 with stage B, and 6 with stage C. We dissected the obturator lymph nodes on bilateral sides. The average operating time was 162 minutes (range 86 to 320 minutes). The average number of nodes removed from the right side was 7.1 +/- 5.9 and 6.1 +/- 4.5 from the left side, which was comparable to the number of lymph nodes obtained by open dissection. Colon injury occurred in one patient, which was managed by laparotomy procedure. Nodal metastases were found in 6 patients by frozen section, and in 10 patients by permanent section. This discrepancy suggested that two-staged operation might be preferable for the localized prostate cancer. Six patients were given suitable therapies besides radical prostatectomy. Laparoscopic pelvic lymphadenectomy is a safe and useful procedure for prostate cancer, especially for the patients who are likely to have nodal metastasis.
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PMID:[Laparoscopic pelvic lymphadenectomy in prostate cancer]. 786 46

Between January 1974 and December 1988, 46 patients with cancer of the urinary bladder, stages T1 or T2, and one patient with stage T3, were treated with an interstitial implant at the radiotherapy department of the Catharina Ziekenhuis at Eindhoven, The Netherlands. Prior to implantation, one patient received no external radiotherapy, all other 46 patients were treated by either a low dose (40 patients: 12 Gy median) or an intermediate dose (six patients: 38-40 Gy) of external radiotherapy. Loco-regional relapse was observed in 14/47 (30%) of the patients (1/14 also had distant metastases). The site of loco-regional relapse was the bladder in 11 patients and the immediate vicinity of the bladder in three patients. Only four patients died due to uncontrolled locoregional disease. A salvage cystectomy was performed in five patients. Distant metastases alone were observed in 3/47 (6.4%) of patients. The intercurrent death corrected actuarial 5 and 10-year survival was 79.5% (72.2% for T1; 85.7% for T2). The difference between T1 and T2 tumors was not significant (P = 0.55). During follow-up, 17/47 (36%) patients died. Cause of death was intercurrent disease in eight patients, bladder cancer in eight patients and unknown cause in one patient. For the whole group, seven patients developed second or third malignancies. Multivariate analyses using survival as the endpoint showed no significant prognostic variables, while using relapse-free survival (RFS) as the endpoint (calculated from the date of interstitial implant and with censoring for death from intercurrent disease) the number of TUR before implant (P = 0.01) and the dose of external radiation before interstitial implant (P = 0.045) were of prognostic significance, both being negatively correlated with RFS. As six patients had received an intermediate dose of interstitial radiotherapy, separate multivariate analyses were performed on the subgroup of 41 patients who had received a high dose of interstitial radiation. Using survival as the endpoint, again no prognostic significant factors were found, but in the analyses using local relapse-free period (LRFP) as the endpoint, dose rate (P = 0.026) and duration of implant (P = 0.021) were inversely correlated with LRFP. The higher the dose rate, the better the LRFP, while a long duration of implantation had a negative impact on the LRFP. Information concerning radiotherapy-related complications was not available in one patient, ulceration of the bladder mucosa was observed in 9/46 (19.6%) and bladder stone formation in 3/46 (6.5%) patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Carcinoma of the urinary bladder: long-term results of interstitial radiotherapy. 789 21

A female patient is presented who had a large carcinosarcoma of the urinary bladder that became clinically manifest only 2 months before treatment. The initial treatment by transurethral resection was followed by radical cystectomy; 7 months postoperatively the patient died of local tumour recurrence with widespread metastases. Carcinosarcoma of the urinary bladder is a rare tumour with a poor prognosis. The majority of such tumours are not diagnosed until tumour growth is already far advanced. Owing to the small number of cases there is no clinically proven form of management. In contrast with superficial transitional cell carcinoma of the bladder, superficial carcinosarcoma of the bladder has always invaded the lamina propria, since in addition to the carcinomatous degeneration of the mucosa, sarcomatous degeneration of the underlying submucosal stroma is also present. Any local surgical treatment, such as TUR or partial cystectomy, involves the risk of incomplete tumor removal, because the sarcomatous elements typically invade the submucosa while the overlying mucosa remains intact. Therefore, radical cystectomy appears to be the treatment of choice for both superficial and invasive carcinosarcoma of the urinary bladder.
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PMID:[Carcinosarcoma of the urinary bladder]. 844 47

Non-familial human adrenocortical adenomas and carcinomas were screened for mutations in exons 5-8 of the p53 tumor suppressor gene by single-strand-conformation-polymorphism (SSCP) analysis, followed by direct sequencing of PCR-amplified DNA. Point mutations in codons 12, 13 and 61 in H-ras, K-ras and N-ras proto-oncogenes were similarly assessed by direct DNA sequencing. Three out of 15 primary adrenocortical carcinomas (20%) contained a mis-sense point mutation in the conserved regions (exons 5 and 8) of the p53 gene. Mutations were located in codon 157 (GTC-->TTC; Val-->Phe), codon 163 (TAC-->AAC; Tyr-->Asn), and codon 273 (CGT-->TGT; Arg-->Cys). The mutation in codon 157 was detected in the primary tumor as well as in brain and lymph-node metastases. Among 18 adrenocortical adenomas, there was only a single non-miscoding mutation in codon 295 (CCT-->CCC; Pro-->Pro). These data suggest that mutational inactivation of the p53 gene occurs in a minority (20%) of sporadic adrenocortical carcinomas and that these mutations constitute a late event in the multi-step process of malignant transformation. No ras mutations were detected in any of these tumors, suggesting that these genes are not involved in the development of tumors originating from the adrenal cortex.
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PMID:p53 mutations in sporadic adrenocortical tumors. 850 16

The prognosis of intrahepatic bile duct carcinoma (cholangiocellular carcinoma: CCC) is extremely poor unless detected at an early and curable stage. However, little is known about the clinico-pathological features of CCC resected at a symptom-free stage. We herein report the clinico-pathological findings in two asymptomatic patients who underwent resection. Their liver function tests showed elevated levels of gamma-glutamyl transpeptidase. An intrahepatic mass was first detected by ultrasonography, and subsequent direct cholangiography and cytological examination revealed the presence of carcinoma in both patients. Left or right hepatic lobectomy with caudate lobectomy and lymph node dissection with or without resection of the extrahepatic bile duct was carried out. The lesions were 2.5 and 2.8 cm in maximal size, originating from the intrahepatic bile duct of segment IV and I, respectively. Both were free from extrahepatic bile duct involvement, intrahepatic and lymph node metastases. However, even in a symptom-free stage, perineural invasion, vascular or lymphatic involvements were histologically proved in both cases, which may be an indication of poor prognosis after surgery alone.
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PMID:Clinico-pathological findings of asymptomatic intrahepatic cholangiocellular carcinoma: report of two cases and review of the literature. 860 39


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