Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This retrospective analysis aims to report results of patients with cancer of uterine cervix treated with external-beam radiotherapy (EBR) and high-dose rate (HDR) brachytherapy, using manual treatment planning. From 1975 to 1995, 237 patients with FIGO stages IIB-IVA and mean age of 54.31 years were treated. EBR dose to the whole pelvis was 50 Gy in 25 fractions. Brachytherapy with HDR after-loading cobalt source (Cathetron) was performed following EBR completion with a dose of 30 Gy in three weekly fractions of 10 Gy to point A. Survival, local control, and genitourinary and gastrointestinal complications were assessed. In a median follow-up of 60.2 months, the 10-year overall and disease-free survival rate was 62.4%. Local recurrence was seen in 12.2% of patients. Distant metastases to the lymph nodes, peritoneum, lung, liver, and bone occurred in 25.3% of patients. Less than 6% of patients experienced severe genitourinary and/or gastrointestinal toxicity that were relieved by surgical intervention. No treatment-related mortality was seen. This series suggests that 50 Gy to the whole pelvis together with three fractions of 10 Gy to point A with HDR brachytherapy is an effective fractionation schedule in the treatment of locally advanced cancer of cervix. To decrease the complications, newer devices and treatment planning may be beneficial.
 ...
PMID:High-dose rate brachytherapy in the treatment of carcinoma of uterine cervix: twenty-year experience with cobalt after-loading system. 1680 92

The incidence of thyroid microcarcinoma is rising due to the frequent use and improvement of fine-needle aspiration biopsy and ultrasonography. Since the recent update of the TNM (Tumor, Node, Metastasis) staging system for thyroid cancer, the importance of lymph node metastasis became more prominent. In the present study, we evaluated the prognostic factors and extension of thyroid microcarcinomas in Korean patients. The clinical and pathological findings in patients with thyroid microcarcinomas in a Korean hospital from January through December 2004 were evaluated. A total of 302 (50.2%) out of 601 cases of thyroid cancers were microcarcinomas. Evaluation of the histology revealed that nearly all of the cases (300 of 302) were of the papillary type. Analyzing patients of papillary thyroid microcarcinomas, 273 (91.0%) out of 300 patients of papillary microcarcinomas were women. Seventy-eight (26.0%) cases contained multiple tumor masses (> or =2), including 49 (16.3%) cases that were bilateral. There were 84 (28.0%) cases of extrathyroidal extensions and 89 cases (29.7%) of lymph node metastasis, but no cases of distant metastases. Application of the new staging system revealed 7 (2.3%) cases that changed from stage III to stage IVA. Thyroid microcarcinomas were also associated with poor prognostic factors and appear to exist at relatively higher cancer stages. Therefore, it is important to treat them as early and as vigorously as possible with extensive surgery, radioactive iodine therapy, and thyroxine suppression.
 ...
PMID:Frequent, aggressive behaviors of thyroid microcarcinomas in korean patients. 1689 63

Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. In uterine cervical cancer, the FIGO staging system is determined preoperatively by limited conventional procedures. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement. CT and MR imaging are widely used as comprehensive imaging modalities to evaluate tumor size and extent, and nodal involvement. MR imaging is an excellent modality for depicting invasive cervical carcinoma and can provide objective measurement of tumor volume, and provides high negative predictive value for parametrial invasion and stage IVA disease. In contrast, endometrial cancer is surgically staged. Beside recognition of the important prognostic factors, including histologic subtype and grade, accurate assessment of the tumor extent on preoperative MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy. Contrast-enhanced MR imaging can offer "one stop" examination for evaluating the depth of myometrial invasion cervical invasion and nodal metastases. Evaluation of myometrial invasion on MR imaging may be an alternative to gross inspection of the uterus during the surgery.
 ...
PMID:Staging of carcinoma of the uterine cervix and endometrium. 1721 42

Globally, cervical cancer is the second most common cause of cancer-related mortality among women causing approximately 234,000 deaths annually among developing countries and killing 40,000 in developed nations. Most of these deaths occur in women with bulky or locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stages IIB through IVA, when lesions are not amenable to high cure rates with surgery or radiation (RT). The standard prescription for RT used to treat locally advanced cervical cancer has been dictated by common practice and patterns of care studies. In contrast, the addition of concomitant chemotherapy to RT has been studied in a number of randomized prospective trials, which are discussed in detail. When added to RT, cisplatin reduces the relative risk of death from cervical carcinoma by approximately 50% by decreasing local/pelvic failure and distant metastases. In 1999, weekly intravenous cisplatin at 40 mg/m2 for 6 weeks in combination with RT was established as a new standard for the treatment of locally advanced cervical carcinoma. More recently, this recommendation has been expanded to include women with FIGO stage IB2 lesions as well as those with bulky stage IIA cancers. This monograph reviews the state of the art in treating locally advanced cervical cancer with combined chemotherapy and RT and discusses clinical and pathologic prognostic factors that impact cure. Quality of life during and after multimodality therapy is considered as well as ongoing clinical trials and future directions.
 ...
PMID:Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions. 1761 27

The patient was a 63-year-old Japanese male who came to the hospital with a chief complaint of a sore throat. Hypopharyngeal carcinoma (T4N2bM0, stage IVA) was diagnosed, and at the strong request of the patient he was treated by chemoradiotherapy. The tumor markedly decreased in size, but atrial fibrillation was detected when an ECG was performed in preparation for planned a scheduled re-biopsy of the hypopharynx. The echocardiography findings and result of a myocardial biopsy led to a diagnosis of cardiac metastasis by the hypopharyngeal carcinoma. Metastasis by head and neck malignancies is rare, and it is extremely rare for a confirmed diagnosis to be made while the patient is still alive. The case is described together with some discussion of the published literature.
 ...
PMID:[Cardiac metastasis by hypopharyngeal carcinoma. Case report]. 1763 16

Rhabdomyosarcoma is the most common sarcoma of childhood. Fortunately, the goal of cure is realistic for the majority of patients with localized tumors. However, management of these patients remains challenging. The fact that the tumor arises in a wide variety of primary sites, some of which are associated with specific patterns of local invasion, regional lymph node spread, and therapeutic response, requires physicians to be familiar with site-specific staging and treatment details. In addition, rhabdomyosarcoma requires multimodality therapy that can be associated with significant acute toxicities and long-term effects, particularly when administered to young children. These factors sometimes present a dilemma as to the best approach to optimize the chance of cure, minimize toxicity, and respect quality of life. The purpose of this review is to discuss 'optimal' management of this complicated tumor. Since the tumor is relatively rare, requires highly specialized care, and important management questions remain to be answered, optimal management of rhabdomyosarcoma includes enrollment in clinical trials whenever possible. Appropriate management begins with establishing the correct pathologic diagnosis, histologic subtype, primary site, extent of disease (International Society of Pediatric Oncology [SIOP]-TNM-Union Internationale Contre le Cancer stage or Intergroup Rhabdomyosarcoma Study Group [IRSG] stage), and extent of resection (IRSG group). Cooperative groups throughout North America and Europe have defined risk-adapted treatment based on these factors; this treatment requires a coordinated management plan that includes surgery, chemotherapy, and usually radiotherapy. The surgical approach for rhabdomyosarcoma is to excise the primary tumor whenever possible without causing major functional or cosmetic deficits. Wide excision is difficult in some primary sites and can be complicated by the fact that the tumor grows in a locally infiltrative manner so that complete resection is often neither possible nor medically indicated. Incompletely resected tumors are generally treated with radiotherapy. The cooperative groups reduce the dose of radiation based on the response of the tumor to chemotherapy and delayed primary resection to differing degrees. Response-adjusted radiation administration may reduce the long-term effects of radiotherapy, such as bone growth arrest, muscle atrophy, bladder dysfunction, and induction of second malignant neoplasms; however, it may also be associated with an increased risk of tumor recurrence. All patients with rhabdomyosarcoma require chemotherapy. A backbone of vincristine and dactinomycin with either cyclophosphamide (VAC) or ifosfamide (IVA) has been established. Risk-adapted treatment involves reducing or eliminating the alklyating agent for patients with the most favorable disease characteristics. Clinical trials are ongoing to improve outcomes for higher risk patients; newer agents, such as topotecan or irinotecan, in combination with VAC or use of agents in novel ways are being investigated. Acute and long-term toxicities associated with these chemotherapy regimens include myelosuppression, febrile neutropenia, hepatopathy, infertility, and second malignant neoplasms. A 5-year survival rate >70% has been achieved in recent trials for patients with localized rhabdomyosarcoma. However, the outcome for patients who present with metastatic disease remains poor. In the future, risk-adapted classification of rhabdomyosarcoma will likely be based on biologic features, such as the presence of chromosomal translocations or specific gene expression profiles. It is hoped that newer therapies directed at specific molecular genetic defects will benefit all patients with rhabdomyosarcoma.
 ...
PMID:Optimal management strategies for rhabdomyosarcoma in children. 1805 9

Results of surgical treatment of 240 patients with thyroid differentiated microcarcinoma (less 1 cm in diameter) are analyzed. Papillary and follicular tumor was diagnosed at 212 (88.3%) and 28 (11.7%) respectively. Microcarcinoma had no clinical symptoms in majority cases. In some cases microcarcinoma had aggressive clinical course: at 10.8% patients the tumor was extended beyond the bounds of thyroid capsule (T3), at 2.1% patients the primary symptoms of disease were metastases into cervical nodes. Long-term results of surgical treatment were followed-up until 25 years after surgery, 5-year survival rate and recurrence-free period were 99.5 and 99% respectively. Recurrence of tumor occurred at 2 (0.8%) patients with initial III and IVA stages of disease despite previous radical operation, one of them died in 4 years after surgery. Microcarcinoma is regarded as early stage of thyroid gland cancer. Ultrasonic examination and fine-needle biopsy permit to diagnose timely this malignant tumor.
 ...
PMID:[Clinical value, diagnosis and treatment of thyroid differentiated microcarcinoma]. 1816 6

We evaluated the additional diagnostic value of magnetic resonance/positron emission tomography (MR/PET) fusion in the detection of metastatic lymph nodes in cervical cancer patients. Seventy nine patients with FIGO stage IB-IVA cervical cancer who had undergone both magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) before lymphadenectomy were included in this study. Image analysis was first performed with PET/CT images only. A second analysis was then performed with MR/PET fused images that focused on the additional information obtained from the MR images. Lymphadenectomy involved removing all visible lymph nodes in the surgical field. To enable nodal group-specific comparisons, para-aortic and pelvic lymph nodes were divided into seven nodal groups: para-aortic, both common iliac, both external iliac and both internal iliac/obturator areas. Histopathological evaluation of lymph nodes has been the diagnostic standard. The value of the additional information from the MR images was evaluated by means of receiver operating characteristic (ROC) analysis. Fused MR/PET rendered readers to detect six more metastatic lymph node groups. The sensitivity and specificity of PET/CT and fused MR/PET were 44.1%, 93.9% and 54.2%, 92.7% respectively. The ROC analysis demonstrated a higher diagnostic performance of fused MR/PET compared to PET/CT alone for detecting lymph node metastases (p=0.0259). The findings of this study demonstrate the additional diagnostic value of fused MR/PET images compared with PET/CT in the detection of metastatic lymph nodes in patients with uterine cervical cancer.
 ...
PMID:Additional value of MR/PET fusion compared with PET/CT in the detection of lymph node metastases in cervical cancer patients. 1940 3

Worldwide, cervical cancer is the second most common malignancy in women, and is a major cause of morbidity and mortality. Accurate tumor staging is essential for optimal treatment planning and prognosis. Cervical cancer is staged by clinical examination according to the International Federation of Gynecology and Obstetrics staging system. However, clinical staging has inherent deficiencies in evaluating several parameters that are critical for treatment planning. It is now widely accepted that cross-sectional imaging, and in particular MRI, has an important role to play in the staging of these tumors. MRI is an excellent modality for depicting invasive cervical cancer: it can provide objective measurement of tumor size and provides a high negative predictive value for parametrial invasion and stage IVA disease. MRI and positron emission tomography (PET)/computed tomography (CT) play key roles in identifying recurrent disease. PET/CT is also useful in detecting nodal and distant metastases and in radiotherapy planning. Diffusion-weighted MRI is an emerging imaging technique that is currently being evaluated for the detection of primary and recurrent disease and in the assessment of treatment response.
 ...
PMID:MRI and PET scans for primary staging and detection of cervical cancer recurrence. 2018 30

The presentation of intracranial metastases from Hodgkin's lymphoma is an infrequent event that worsens clinical outcome. A case of Hodgkin's lymphoma relapse in the cerebellum is described in a 70-year-old woman with a previously treated stage IVA Hodgkin's lymphoma. Diagnostic workup and treatment strategies for central nervous system relapses are reviewed and discussed. A combination of surgery, radiotherapy and occasionally chemotherapy remains the most appropriate approach to intracranial Hodgkin's lymphoma.
 ...
PMID:Cerebellar involvement in Hodgkin's lymphoma: an atypical site of relapse. 2053 2


<< Previous 1 2 3 4 5 6 7 8 9 Next >>