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)

Over the past 10 years there has been significant progress made in the recognition and treatment of soft tissue sarcomas. With the advent of CAT scans and MRI, preoperative delineation of soft tissue tumors has become readily available. The diagnostic use of these modalities in patients presenting with an ill-defined asymptomatic mass has been extremely helpful in terms of screening patients to decide whether or not a biopsy is indicated. These techniques have also provided a much clearer delineation of the anatomic extent of the primary tumor, which has been of great assistance both in radiation therapy treatment calculations as well as in preoperative surgical planning. The recognition that tumor grade is the dominant prognostic variable has resulted in the more common use of a grading system, and a more uniform reporting and stratification of end results. Recent studies with immunohistochemical staining have proven of value in determining the histogenesis of many tumors that in the past were difficult to classify accurately. Most recently the use of flow cytometry suggests that this will also be a valuable adjunct in determining tumor grade and thereby prognosis. The most recent investigations of molecular biologic evaluation of genetic DNA and RNA sequences, as well as of oncogenes are extremely interesting from a diagnostic standpoint and in demonstrating the potential of molecular biologic evaluation for understanding the origin of these tumors. Multimodality therapy with surgery, radiation, chemotherapy, or all three has resulted in a marked improvement in local tumor control for patients with soft tissue sarcomas. The combination of modalities has allowed smaller surgical excisions of the tumor and thereby preservation of the extremity and much of its function. There are currently several different methods of multimodality therapy used including neoadjuvant therapy and postoperative therapy, both of which have been proven efficacious. Chemotherapy is now playing an increased role in clinical investigation and treatment. The availability of Adriamycin, DTIC, cisplatin, and most recently ifosfamide has added several chemotherapeutic agents for use by the clinician. Combination chemotherapy and radiation is of value in the neoadjuvant setting, and several studies are now underway to determine whether postoperative adjuvant chemotherapy is of similar value in reducing systemic spread of disease. Finally, surgical resection of pulmonary metastases has been proven of value in 20% to 25% of patients who subsequently develop metastatic disease. As a result of these advances in several different treatment disciplines, the overall survival rate and quality of life of patients with soft tissue sarcoma have improved markedly over the past 10 years.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Progress in the recognition and treatment of soft tissue sarcomas. 240 92

In patients undergoing radiotherapy (RT) for malignant neoplasies of the head and neck the availability of a diagnostic method permitting frequent, easy checkups of the latero-cervical lymph nodes would be extremely useful. This is especially so because clinical examination is often hindered by the post-actinic fibrosis of the tissues. Among the methods presently available for this purpose (CAT, NMR, lymphoscintigraphy, xerography, ultrasound) echotomography appears to be the most indicated as it is least invasive, can easily be repeated and is not difficult to perform. The refining of ultrasound techniques would, as reported in the literature, make it possible today to evaluate the effects of RT on latero-cervical metastases both during and some time after treatment. The authors, therefore evaluated the advantages and limitations of the method examining 33 patients undergoing RT for latero-cervical metastases due to head and neck carcinoma. Each patient underwent ultrasound examination prior to, during and at the end of the RT treatment cycle. Once treatment had been terminated 18 underwent latero-cervical neck dissection. Upon termination of the radiation treatment three distinct types of ultrasound behaviour were identified: complete response; partial response; minimal or negligible response. For those patients undergoing surgery this response was compared to lymph node chain histology while, for the others, it was compared to the ultrasound findings of subsequent examinations. The results obtained appear to indicate that a systematic scheduling of ultrasound checkups offers a reliable evaluation of how metastatic adenopathies respond to RT. At times such response can only be completed several months after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Role fo ultrasound in the study of latero-cervical metastases]. 265 70

Chordomas are bone tumors of the axial skeleton. They arise from notochordal remnants. In children these tumors are extremely rare and are predominantly located in the skull base. The authors report on a clivus chordoma in a 9 7/12-year-old girl. It presented as a nasopharyngeal mass with destruction of the clivus and paralyses of the ninth, tenth, and eleventh cranial nerves on the right side. After incomplete resection by a transoral transclival route, high-dose radiotherapy was added. This treatment was effective as demonstrated by follow-up CAT scans. A short review of the current literature is given. The local recurrence rate is extremely high, and distant metastases may occur. Complete resection is rarely possible, and combined management with postoperative radiotherapy is propagated. Permanent cure is rare, and at the present time, chemotherapy appears to be of no value in the primary treatment of chordomas.
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PMID:Clivus chordoma in a 9-year-old child: case report and review of the literature. 315 25

Murine monoclonal antibody (MAb) B72.3 was prepared using a membrane-enriched fraction of breast carcinoma as the immunogen. MAb B72.3 has been previously shown, by in vitro assay, to have a high degree of specificity for carcinomas of the colon, ovary, breast and stomach versus normal adult tissues. The reactive antigen (termed TAG-72) has been purified and characterized. B72.3 IgG was radiolabeled with 131I and utilized for the in situ detection of colorectal cancer metastases. The radiolocalization of MAb B72.3 administered intravenously (i.v.) into colorectal cancer patients was sufficient to allow detection of more than 50% of the lesions by gamma-scanning. Radiolocalization indices (RI) (i.e., cpm 131I-labeled MAb/g of tumor versus cpm/g of normal tissue) were obtained by direct analyses of biopsy materials. Using an RI of greater than 3 to indicate positive localization, tumor lesions at various sites from 17/20 patients were positive. Seventy percent (99/142) of the tumor lesions had RIs of greater than 3, while only 12 of 210 normal tissues had RIs of greater than 3. 131I-B72.3 IgG was also intraperitoneally (i.p.) administered to 10 patients with colorectal cancer. Specific tumor localization via gamma-scanning (confirmed at surgery) was observed in 7/10 patients. Three of the 7 patients were negative for tumor detection by both CAT scan and X-ray but were positive for tumor localization via gamma-scanning of i.p.-administered MAb B72.3. Direct analyses of biopsy specimens of carcinoma and normal tissues demonstrated ratios greater than 70:1 for tumor MAb localization versus normal tissues. No clinical toxicity or adverse reactions were observed with the MAb when administered i.v. and i.p. These results thus demonstrate the efficacy of i.v. and i.p.-administered MAb B72.3 for the radiolocalization as well as potential use of MAb B72.3 in protocols aimed at tumor targeting and in MAb-guided therapy for human epithelial malignancies.
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PMID:[In vivo application of monoclonal antibodies in the management of human carcinomas]. 329 70

I 131-metaiodobenzylguanidine (MIBG) is an aralkylguanidine with certain structural similarities to norepinephrine (NE). It is concentrated, stored, and released from chromaffin granules in a manner almost identical with that of NE. It will image the enlarged adrenal medullae of adrenal medullary hyperplasia when the CAT and NMR scans are normal. It is more sensitive in detecting extra-adrenal pheochromocytomas than CAT and NMR imaging. Because 46% of our 176 patients with histopathologically proved "benign" pheochromocytomas (pheos) have developed demonstrable metastases, with or without elevated plasma and urinary catecholamines, we now image all patients with "benign" pheos yearly. As of January 22, 1986 we had treated 28 patients with malignant pheos 71 times with MIBG. As of July 24, 1986, we had given 34 neuroblastoma patients 55 tracer doses. In some cases MIBG demonstrates more neuroblastoma than all other imaging modalities and this is helpful in staging. We have had 30-50% objective regressions in neuroblastoma tumor mass in 3 out of the first 12 patients treated. These three patients had slower-growing tumors and a lower body burden than the nonresponders. We also record the sensitivity of MIBG imaging of neuroendocrine tumors other than pheos and neuroblastomas.
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PMID:Update on basic research and clinical experience with metaiodobenzylguanidine. 330 1

The authors report on two cases of sacrococcygeal chordoma, with complications involving visceral organ metastases and distal bony metastases. Chordomas are malignant tumors which develop in adult subjects which originate from remnants of the embryonic notochord. Sacrococcygeal localization is found in 50% of the 1,300 cases reported in the medical literature, which represents 20% of sacrococcygeal tumors observed. The difficulty and the delay in diagnosing these tumors should decrease by routine CAT scan examination. Diagnostic certainty is based on histological examination, often suggestive of the diagnosis (physaliphore-like cells), possibly combined with ultrastructure and immunohistological study. The clinical course involves local recurrences, but there is a real risk of metastatic development, notably in the case of sacrococcygeal chordomas, with their incidence estimated at 17.5% of cases. Sometimes developing in later stages of their course, histological findings are similar to those of the initial lesion. Organs which are frequently the sites of metastases are the lung (48% of cases) and bone (26%), then the lymphatic organs, the liver, and subcutaneous tissue... Therapeutic management is unsatisfactory, with ideally, complete surgical excision of the initial tumor of its size permits and hence early diagnosis of this condition is a prerequisite for good results.
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PMID:[Metastatic chordoma. General review apropos of 2 cases]. 331 68

In a prospective study the preoperative ultrasonography of 54 cases of carcinoma of the breast was able to predict the pTNM staging precisely in 83.3% for tumor size and in 72.3% for lymphnode metastases. Multicentric-multifocal carcinomas were diagnosed by ultrasonography in 10 of 13 patients, better than by mammography (6 of 13). The CAT scan is indicated only in advanced tumor stages. The preoperative staging by ultrasonography enables with more precision planning and differentiated therapy of the carcinoma of the breast, especially in view of breast-preserving therapy.
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PMID:[Decision aids in determining therapy of breast cancer by preoperative staging using sonography and computerized tomography]. 354 76

Monoclonal antibody (MAb) B72.3 has been shown to have selective reactivity for a wide range of carcinomas (colorectal, ovarian, breast, lung, gastric, and endometrial) versus normal adult tissues. 131I-Labeled B72.3 IgG has recently been shown to selectively bind carcinoma lesions when administered i.v. in patients with metastatic colorectal cancer. We report here the first direct comparison of i.p. administered [131I]B72.3 IgG to specifically localize metastatic carcinoma. Three of 10 patients studied were negative for tumor detection by both CAT scan and X-ray but were positive for tumor localization via gamma scanning i.p. administered 131I-labeled MAb B72.3 IgG. Direct analyses of biopsy specimens of carcinoma and normal tissues demonstrated ratios of greater than 70:1 (based on percentage of injected dose/mg) for tumor MAb localization versus normal tissues. Specificity of [131I]B72.3 tumor targeting was demonstrated by the concomitant administration of an equal dose of an 125I-labeled isotype identical (IgG1) control MAb. Simultaneous i.p. administration of [131I]B72.3, and i.v. administration of [125I]B72.3 in individual patients demonstrated: peritoneal implants are targeted more efficiently via i.p. MAb administration, and hematogenously spread and lymph node metastases as well as local recurrences are targeted more efficiently by i.v. administered MAb. No antibody toxicity was observed in any patients. Pharmacokinetics of MAb clearance demonstrated that only 10 to 30% of the i.p. administered MAb was found in plasma. These studies thus demonstrate the efficacy of intracavitary MAb administration as well as the advantage of the concomitant use of intracavitary and i.v. administered MAbs for tumor targeting and for potential MAb guided therapy of metastatic carcinoma.
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PMID:Complementation of intracavitary and intravenous administration of a monoclonal antibody (B72.3) in patients with carcinoma. 360 61

The clinical TNM classification system allows improved exchange of information, is an aid in tumor staging and establishing treatment schedules, assists in assessing prognosis and forms the basis of cancer registration. New elements in the last edition of classifications are stage T4, which means a tumor invading the mediastinum, the heart, the great vessels, the trachea, the esophagus, vertebral bodies, the carina or the pleural space, and stage N3, which includes mediastinal, contralateral hilar, scalene and supraclavicular lymph node metastases. Both stages rule out surgical treatment. Mediastinoscopy is advised in the case of lymph nodes in thoracic CAT of greater than or equal to 1.5 cm diameter. There is evidence that most peritumoral infiltrations consist in T lymphocytes, presenting the host's immunological reaction against tumor tissue. In the context of tumor staging such phenomena may be of prognostic significance.
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PMID:[Justification of the TNM classification system in lung carcinoma]. 367 82

Selection modes for surgery were studied in a group of lung cancer patients. Selection is based: on the certain diagnosis of the disease, its histological classification and stage respiratory function tests and the assessment of any surgical indications. A total of 714 lung cancer cases were examined. Of these, 28.4% were at stage 1, 19.8% at stage 2 and 51.8% at stage 3. Only 141 patients or 19.8% of all cases examined were judged fit for radical exeresis. In the absence of metastasis all three stages of epidermoid carcinomas and adenocarcinomas were judged operable. In the case of microcytomas indication to surgery was limited to very few cases and only those in the first two stages. In the presence of metastasis to the hilar lymph nodes, surgery was only indicated where the metastasis was small. Exeresis was also indicated in the presence of single metastases to mediastinal lymph nodes on the same side as the neoplasia especially if these were considered intranodal. The difficulty of precise assessment of metastases to the hilar and mediastinal lymph nodes even with the aid of modern techniques like CAT scanning and mediastinoscopy was also noted. In 87 of 141 patients operated it was possible to check the result which was radical in 84 cases. In all, 19 pneumonectomies, 49 lobectomies and 16 bilobectomies were performed. The operative mortality rate was 3.4%. The various surgical indications were also examined in relation to the diverse clinical situations presented by lung cancers. In conclusion the modalities to be followed in order to enhance the value of radical resections in lung cancer are outlined. Above all diagnostic means must be refined to a point where the disease can be staged with maximum precision, patients for surgery must be selected with the utmost care and diagnosis must be as early as possible.
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PMID:[Indications for surgical intervention in patients with pulmonary cancer. Observations on 714 cases]. 370 28


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