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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Wedge resection for pulmonary metastases was performed on 18 children suffering from a variety of malignant tumors. The overall survival rate was 39%. However, tumor recurred at or near the site of resection in half the patients. A more extensive resection, such as lobectomy, should be considered for most patients. Wedge resection should be reserved for tumor involving many lobes or for neoplasms having a demonstrated sensitivity to chemotherapy and irradiation.
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PMID:Assessment of pulmonary wedge resection for the treatment of lung metastases. 118 53

A retrospective study to determine the value of bone and brain scans was performed in preoperative patients with melanoma, sarcoma, cancer of the head and neck and carcinoma of the pelvis. No occult metastases were identified in 170 patients in whom brain scan was performed. On late follow-up data, eight patients had neurologic symptoms develop and had brain metastases identified on scan. Of 223 bone scans performed, only one distant metastatic lesion was identified. It is, therefore, suggested that, in these types of patients, bone and brain scans be reserved for those with symptoms referable to the neurologic or skeletal systems.
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PMID:The use of bone and brain scans as screening procedures in patients with malignant lesions. 118 62

At the Symposium in Teheran two aspects of radiotherapy in mammary cancer came up for discussion: post-operative radiotherapy and the possibilities of conservative treatment, combining tumorectomy ("lumpectomy", "tylectomy ") for stage 1 cases. The place of post-operative irradiation was discussed in relationship to the appearance of local recurrences, metastases and the survival rates available from published data (therapeutic trials and retrospective studies) and in relationship with a population of 206 cases treated at the Gustave Roussy Institute between 1963 and 1966. The possible relationship between post-operative irradiation and immunity were mentioned. With identical wide surgical excision the essential role of post-operative irradiation consists of diminishing in a significant fashion the level of local recurrences. With more restricted surgery of the simple mastectomy type one asks whether irradiation could not replace radical node dissections. It should be reserved for the bad N+ cases. A retrospective study of 44 cases coded T1 NO/N1 MO/PevO treated by tumorectomy and cobalt 60 was compared with 44 matching cases which differed only in their local treatment which consisted of wide surgical excision. The survival actuarial rate at 8 years is 88.6% for the more conservatively treated group compared with 73% for the radical group. In order to provide a quite impartial result a WHO therapeutic trial was begun in 1972.
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PMID:[Current data on radiotherapy of breast cancer]. 121 24

An analysis of twenty-six cases of epidermoid carcinoma of the anus from the University of Virginia Medical Center and 1,060 cases from the surgical literature has been presented. We believe this review justifies the following conclusions. (1) Considerable delay in diagnosis frequently occurs, adversely affecting the prognosis of patients with this disease. (2) Abdominoperineal resection remains the treatment of choice. Wide local excision is inadequate for most lesions, and should be reserved for lesions of the anal verge less than 2 cm in diameter with favorable histology, that is, low grade of malignancy. (3) Large lesions and those with a high grade of malignancy are associated with a poor prognosis, but even these patients may sometimes be cured with aggressive surgical excision. (4) Synchronous inguinal node metastases are associated with a poor prognosis, but an occasional patient may be cured by iliofemoral node dissection. (5) Iliofemoral node dissection is indicated for metachronous inguinal node metastases in the absence of distant spread. (6) Iliofemoral node dissection should not be performed if these nodes are not clinically involved with metastases. Approximately 70 per cent of these patients will not need this procedure and would therefore have this resection and its attendant morbidity unnecessarily.
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PMID:Surgical management of epidermoid carcinoma of the anus. 125 98

Five hundred six consecutive cases of ductal infiltrating carcinoma of the breast (T1-T2,N0,M0) were evaluated to define the frequency of peritumoral lymphatic invasion (PLI) and verify its possible prognostic significance. Histologically, PLI was characterized by the presence of neoplastic emboli within vascular lumina lined by recognizable endothelial cells, adjacent to but outside the margins of the carcinoma. In routine histopathologic assessment the frequency of PLI was 68% whereas in a randomly selected group of 234 reviewed cases the frequency rose to 20%. Patients with routinely evaluated PLI had a worse prognosis than those without PLI with reference both to disease-free survival (P = 0.0001) and total survival rates (P = 0.0001). The difference for local recurrences was prognostically highly significant (P = 0.0001) and also significant for the development of metastases (P = 0.0576). In the reviewed material the difference in prognosis between PLI-positive and PLI-negative cases was not confirmed for total survival whereas the significance for the disease-free interval persisted. The assessment of PLI, carried out following strict histopathologic criteria, appears to select a group of node-negative breast cancer patients who have an increased risk of recurrences and might benefit from a treatment different from that reserved for node-negative and PLI-negative patients.
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PMID:Peritumoral lymphatic invasion in patients with node-negative mammary duct carcinoma. 131 23

Seventeen cases of gastric metastases are reported; some of them appeared after a long latency period. Two cancers prevail from an aetiological standpoint: melanoma (7 cases) and breast cancer (4 cases). Endoscopic appearance is often typical in melanoma, but suggests a primary carcinoma or radiation-induced lesions in breast cancer. Surgery is reserved to located lesions, but seems to have no incidence on prognosis. Overall mean survival is 11 months with a range of 3 months to 5 years.
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PMID:[Gastric metastases. Apropos of 17 cases]. 141 55

Endoscopic ultrasound is a new technology that improves the local staging of esophageal, gastric, and rectal carcinomas. In addition, EUS may provide useful information which will affect management in individual patients with subepithelial masses (e.g., varices, leiomyomas) and pancreatic diseases. Other imaging studies such as transcutaneous ultrasonography and CT are still necessary to detect distant metastatic disease. At present, EUS may be best reserved for use by individuals who have sufficient patient materials to provide broad experience with the technique. Physicians at centers where large numbers of patients with gastrointestinal cancer are evaluated may find this technology most useful. Even in patients with malignancy, however, studies are needed to show that the improved local staging by EUS will translate into changes in patient management and improved outcome.
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PMID:Status evaluation: endoscopic ultrasonography. American Society for Gastroenterology Endoscopy. Technology Assessment Committee. 147 98

The impact of para-aortic field radiation therapy upon survival was studied among 26 patients with para-aortic nodal metastases from carcinoma of the endometrium. Seventeen of these 26 patients received postoperative radiation therapy to the para-aortic field as a part of their primary therapy. Sixteen of the 17 also received adjuvant hormonal therapy. Nine of 17 patients (53%) are alive without evidence of disease (18-55 months) with a median survival time of 27 months. Of the remaining eight patients, six (35%) died of endometrial cancer at 6-38 months, with a median survival time of 14.5 months. Five of these patients had distant disease. Two of the 17 patients (12%) died of intestinal obstruction felt to be secondary to radiation enteritis, one of whom was disease free. No difference in survival was detected in patients treated with radiation therapy with microscopic versus macroscopic nodal involvement. Of the nine patients who did not receive para-aortic radiation, eight were treated with hormonal therapy (n = 6) or chemotherapy (n = 2). Seven patients died of disease from 5-28 months, with a median survival time of 13 months. One patient is alive at 12 months. Survival in the 17 patients treated with para-aortic radiation was better than the eight patients not treated with para-aortic radiation (p = 0.004). This survival difference remained significant for patients with microscopic but not macroscopic nodal disease. Para-aortic field radiation appears to improve survival, but has a significant complication rate, and should be reserved for patients with histologic evidence of para-aortic metastases.
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PMID:Radiation therapy for surgically proven para-aortic node metastasis in endometrial carcinoma. 152 60

A case of adenoid cystic carcinoma of the ear in a 67-year-old man is presented along with a review of the literature. Adenoid cystic carcinoma most commonly arises in the salivary glands. Primary cutaneous adenoid cystic carcinoma occurs principally in the scalp and chest. Perineural invasion is seen in at least half the cases and is associated with an increased recurrence rate. Treatment consists of wide local resection with tumor-free margins. Just over half the patients will develop recurrence, with long tumor-free intervals necessitating long-term follow-up. Distant metastases are rarely seen. Radiation therapy is not curative and should be reserved for palliation.
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PMID:Primary cutaneous adenoid cystic carcinoma: a case report and review of the literature. 164 38

With the increasing availability of curative surgical techniques for primary and secondary hepatic neoplasms, the tasks for clinical imaging of liver cancer suspects have become more exacting. Detection of tumor, differential diagnosis of individual nodules, and mapping the anatomic extensions of malignant disease are now routinely required. Related and unrelated liver substrate abnormalities such as cavernous hemangioma and focal fatty deposits are often discovered in liver cancer suspects and must be differentiated from metastatic deposits. Moreover, modern imaging methods frequently display tiny subcentimeter nodules which often prove difficult to adequately characterize (micrometastases vs other). The most sensitive imaging techniques are CT after arterial portography and intraoperative ultrasound, but because of their invasiveness, these are reserved exclusively for staging. For primary screening MR imaging is increasingly preferred over CT because of its superiority in discriminating hemangiomas and cysts from metastases without the need for iodinated contrast material.
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PMID:Liver tumor imaging: current concepts. 166 23


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