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

An autopsy study was performed on 190 cases with Hodgkin's disease and on 134 cases with reticulum cell sarcomas. It was found that a cascade spread of metastases, as opposed to a random spread, was detectable in patients with Hodgkin's disease, but not in patients with reticulum cell sarcoma. Metastatic key-sites for both lymphomas are defined as those organs whose chance of being seeded by the primary tumor is the highest; these sites are the spleen, liver, bone marrow and lungs. This study could not demonstrate in Hodgkin's cases that metastases in the liver and bone marrow were spleen dependent, but rather it showed that the spleen, liver and bone marrow acted as three independent sources of generalized metastases. Explanations proposed to account for the different metastatic spread in Hodgkin's disease and reticulum cell sarcomas, included different intrinsic cellular characteristics of the two lymphomas. the different location of the primary tumor either because of nodal, or of extra nodal origin, or because the primary tumor was located either in the upper or in the lower torso or in both areas. Malignant cells in the kidney, central nervous system and endocrine system were either released by the spleen via the lungs, or released by the liver and the lungs, or they were bone marrow dependent. The cascade spread of metastases hold true only for Hodgkin's disease. In cases with reticulum cell sarcomas, metastases appeared to spread at random from the primary tumor throughout the body, with rare exceptions such as metastases in the central nervous system, which originated either in the liver or in the spleen, lungs, kidney and bones.
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PMID:The spread of blood-borne metastases in malignant lymphomas of man. 79 73

The preliminary results are presented of a multicentre, co-operative randomised trial, sponsored by the Institute of Urology, London, in which radical irradiation (6,000 rads in 6 weeks) is compared with preoperative irradiation (4,000 rads in 4 weeks) plus radical cystectomy for deeply infiltrating carcinoma of the bladder (Stage T3 or B2C). 189 of the 199 cases entered into the trial between 1966 and 1975 were eligible for study. The overall 3- and 5-year survival rates for combined treatment were 41% and 33%, respectively, compared with 28% and 21% for radical radiotherapy. The operative mortality was 7.8%. The difference between the two treatments in favour of the combined treatment has not yet reached the generally accepted level of significance (P less than 0.05), the p factors for the 3- and 5-year results being 0.064 and 0.077, respectively. Of patients receiving the protocol combined treatment, reduction in tumour stage was found in the surgical specimen in 47% of cases. The overall incidence of nodal metastases was 23% (against the usual figure of 40-50%), and in the presence of a good response of the primary tumour to irradiation, only 8%. The 3- and 5-year survival rates for the down-staged cases were 66% and 55%, respectively, compared with 29% and 22% for patients showing no stage reduction in the surgical specimen. The aim of our future studies is to find effective radiosensitising and cytotoxic agents with which to try and increase the incidence and degree of tumour response to pre-operative irradiation in the combined modality treatment of T3 bladder cancers.
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PMID:The management of deeply infiltrating (T3) bladder carcinoma: controlled trial of radical radiotherapy versus preoperative radiotherapy and radical cystectomy (first report). 79 27

Forty patients with disseminated malignant melanoma were treated with triple combination chemotherapy consisting of Imidazole Carboxamide, BCNU and Vincristine. Seventeen of 40 patients (42.5%) showed significant responses including three complete responses. Responses were seen in cutaneous, lymph node and pulmonary metastases. Nine instances of hepatic metastases were unaffected by therapy but 68% of the skin and nodal patients responded. The median response duration was only 4 months and the median survival of responders was 9.5 months compared to a 2 month median survival of non-responders. Half of the responders died of CNS metastases. The short duration of response, the resistance of hepatic metastasis and the high incidence of cerebral recurrence necessitate additional therapeutic approaches to this disease.
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PMID:Combination chemotherapy of malignant melanoma with imidazole carboxamide, BCNU and vincristine. 83 50

Staging pelvic lymphadenectomy has been done on 87 patients with clinically localized prostatic carcinoma. With this method nodal metastases can be discovered, although they are undetectable by any other means. There were 44 patients with negative pelvic lymph nodes by surgical staging subjected to radical prostatectomy. Only 6 patients (14 per cent) had microscopic invasion of the prostatic capsule and there was just 1 instance of microscopic seminal vesicle invasion in those with negative pelvic lymph nodes.
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PMID:Pelvic lymphadenectomy for the staging of apparently localized prostatic cancer. 83 67

In the past, neck dissections have been recommended only when nodes were clinically palpable or when they became so. A retrospective ten year study of thirty-seven patients with carcinoma of the lip and with an unusually high mortality has allowed reevaluation of indications for neck dissection. (1) Ten of thirty-seven patients died of this disease and nearly all of the ten died with and because of regional metastases. (2) Seven patients with nonpalpable nodes initally had nodal metastases later which, despite neck dissection at that later time, proved lethal. (3) Two patients who, despite nonpalpable nodes, had undergone neck dissections and were found to have occult bilateral nodal metastases were effectively cured with early neck dissection. This suggests that early bilateral supramohyoid neck dissections for small carcinomas of the lip and ipsilateral radical neck dissections for large primaries may yield higher cure rates than currently achieved.
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PMID:Indications for neck dissection in carcinoma of the lip. 83 95

To stage accurately the extent of the disease comprehensive investigations were done on 75 patients with histologically documented carcinoma of the prostate. Estimation of bone marrow acid phosphatase appears to be the most sensitive test to detect blood-borne metastases. Serum acid phosphatase appears to be of little value in the detection of early blood spread and may have a role only in monitoring the effect of treatment on advanced disease. Bone scanning with technetium compounds has the disadvantage of non-specificity but has far greater sensitivity than a skeletal survey. Bone marrow cytology was not rewarding in the detection of early metastatic disease. Pedal lymphangiography is a highly inaccurate method to detect lymphatic spread of carcinoma of the prostate and pelvic lymphadenectomy, when indicated, remains the only truly adequate method to assess lymph node involvement. There was a 37 per cent incidence of metastatic lymph node pathology in 30 patients undergoing this procedure before either radical prostatectomy or deep x-ray therapy. A close correlation was found between stage and grade of disease and incidence of nodal pathology. There was some correlation between degree of nodal involvement and evidence of blood spread as detected by elevated bone marrow acid phosphatase levels. The significance of this finding remains unclear.
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PMID:Carcinoma of the prostate: a critical look at staging. 83 93

The accuracy of bipedal lymphangiography to evaluate nodal metastases in patients with testicular malignancies is discussed. A total of 108 patients were evaluated. Histologic correlation was available in 45 cases. The over-all accuracy was 89% which compares favorably with other large series.
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PMID:Accuracy of bipedal lymphangiography in testicular tumors. 84 93

During the ten year period of this retrospective study, 66 of 1,451 patients with carcinoma of the colon and rectum had carcinoma of the cecum. The most frequent symptoms were nonspecific and caused by anemia which, in some instances, were treated without adequate investigation. The standard and most appropriate treatment for carcinoma of the cecum is a right hemicolectomy with ileotranversostomy and, when necessary and feasible, en bloc resection of involved parts of the abdominal wall. In the absence of nodal disease or distant metastases, extension to the abdominal wall does not adversely influence the prognosis. The surgeon must remain aware of the possibility of coexisting carcinoma of the cecum and appendicitis. Any patient with a mass or a persistent draining sinus after an appendectomy or drainage of an appendical abscess should be suspected of having carcinoma of the cecum. The over-all five year survival rate in this series is 33%, and if curative resections alone are considered, it is 44%, with an operative mortality of 3%. More recent evidence indicates that there has been a shortening of the delay in treatment, and we believe future studies will show an improvement in these figures.
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PMID:Carcinoma of the cecum. 84 3

One hundred twenty-five patients with a history of prior irradiation to the head and neck region for benign disease underwent thyroidectomies between 1967 and 1976 at Evanston Hospital. One hundred twenty-four had a palpable abnormality. Forty-two had carcinoma, and nine of these had nodal metastases. Palpation was found to be more accurate than thyroid isotope scan in finding carcinoma within an abnormal gland. Some form of irradiation thyroiditis was found in one half of the resected specimens.
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PMID:Thyroid disease following irradiation for benign conditions. 84 45

A retrospective review from 1935 to 1962 of 772 melanomas involving the head and neck seen at the Pack Medical Foundation (PMF) is presented with the main emphasis of 660 cutaneous and mucosal melanomas. Clark's levels for pathologic invasion are presented and correlated to 289 cases with 19 percent in Level II and 81 percent deeply invasive at Level III, IV, and V. The face was the most commom location with the cheek alone accounting for 22.3 percent of all the cases. The male to female ratio was 1.5 to 1 with 76 percent of the cases being equally distributed among the fourth through the seventh decades. 55.9 percent were local disease, Stage I, with 33.5 percent, Stage II, and 10.6 percent, Stage III or distal disease. The five-year or greater absolute cure rate in positive nodal disease was 12.6 percent. Elective versus no elective neck dissection in Stage IA disease demonstrated a five-year or greater absolute cure rate of 55 percent as compared to 38.5 percent. Distal metastases occurred in 30 percent of cases with elective neck dissection but in 70 percent of those cases with therapeutic neck dissection. The absolute five-year or greater cure rate was able to be analyzed in 556 cases. The rate was 25.6 percent for the mucosal and cutaneous lesions combined; an 8 percent rate for mucosal alone and 27.8 percent for cutaneous melanoma. The five-year or greater absolute cure rate for those cases treated totally at PMF was 35.4 percent.
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PMID:Melanoma of the head and neck. 85 Apr 50


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