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)

This study presents a retrospective look at 115 patients evaluated here from 1957 to 1974. In this series, 57 percent were males and 43 percent females, 84 percent were Caucasian and 16 percent Negro. Lesions confined to or originating in the antrum made up 67 percent while nonantral lesions were 33 percent. Mean age at diagnosis was 59.1 years. Smoking and drinking history did not appear to be contributory. Antral lesions were retrospectively staged according to Sisson's TNM classification. Sixteen tumor types were involved, with the most common being epidermoid. Diagnosis was most often made by intranasal or Caldwell-Luc biopsy. Most frequent symptoms, as well as earliest symptoms, were nasal obstruction, localized pain, and epistaxis. Average duration of symptoms was 6.4 months. Therapy was generally in the form of radiotherapy alone, preoperative radiotherapy and surgery, surgery and postoperative radiotherapy, or surgery alone. Local recurrences occurred in 44 percent of antral lesions and 50 percent of non-antral lesions. Regional (cervical) nodal metastases developed in 25 percent of antral lesions and 11 percent of non-antral lesions. Distant metastases developed in 30 percent of antral cases and 35 percent of non-antral cases. Five-year survival was 32 percent (35 percent determinate) for the total group. The more advanced the staging of the antral lesions, the worse the prognosis. Best survival figures were in the areas of preoperative radiotherapy and surgery at 38 percent (43 percent) and surgery alone at 56 percent (59 percent).
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PMID:Malignant neoplasms of the nasal cavities and paranasal sinuses: (a retrospective study). 85 Apr 51

Pelvic lymph nodes from 80 patients with primary invasive cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were evaluated morphologically. Six to 25 (mean 14) lymph nodes from each patient were examined histologically and classified as follows: lymphocyte preominant, germinal center predominant, unstimulated, or lymphocyte depleted. Tumors were classified according to their primary cell type: large cell non-keratinizing, keratinizing squamous cell, small cell, and adenocarcinoma. There was no direct relationship between lymph node morphology and patient age, lesion size, or tumor cell type. A lymphocyte predominant nodal pattern was associated with a statistically significant decrease in lymph node metastases, and tumor recurrence, and an increase in patient survival. In contrast, patients with a lymphocyte depleted nodal pattern had a high incidence of metastatic disease and tumor recurrence, and a decreased survival. Patients with lymph nodes showing an unstimulated or germinal center predominant pattern had an intermediate incidence of nodal metastases and tumor recurrence. These findings suggest that regional lymph nodal morphology may be of prognostic significance in patients with invasive carcinoma of the uterine cervix.
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PMID:The prognostic significance of pelvic lymph node morphology in carcinoma of the uterine cervix. 87 61

Four consecutive patients with measurable recurrent squamous cell carcinoma of the vulva were treated with Adriamycin, in small doses approximately 45 mg/square meter of body surface area every 3 weeks. Three patients achieved objective regression of nodal metastases and residual tumor with clinical subjective benefit. Tumor control was maintained for 32, 31+, and 28+ weeks.
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PMID:Adriamycin treatment of advanced vulvar carcinoma. 87 32

Carcinoembryonic antigen (CEA) levels were followed in 18 patients with a history of breast cancer to determine the prognostic value of serial determinations in predicting either the development of clinically evident metastatic disease or the progression of previously stable metastatic disease. In patients with local disease, values were in the normal range initially and tended to remain so for the duration of the study, correlating with clinical quiescence. Patients with nodal or extranodal involvement tended to have higher values, but changes could not be consistently correlated with clinical deterioration. Exceptions to these general trends were found in each group. This study suggests that the assay of CEA is of limited predictive value in an individual patient with a history of breast cancer.
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PMID:Prognostic value of carcinoembryonic antigen in patients with breast cancer. 87 24

During the years 1954 through 1964, 259 individuals with primary malignant melanoma had an elective node dissection. Microscopic metastases were found in 15% of these patients. The presence of only a microscopic focus of involvement gave a 10-year cure rate of 67%; metastasis larger than a microscopic focus in a single node, 50%; and more than one node, 15%. One hundred forty-five individuals were treated by wide excision alone with 18% subsequently requiring a therapeutic lymphadenectomy with a ten-year cure of only 6%. A prospective study was then initiated which was concerned with efficacy of selection of patients for elective node dissection. Clark's level of invasion was determined for 258 patients treated since January 1972. The depth of invasion of the primary lesion was found to correlate directly with the absence of lymph node metastases, extent of nodal involvement, and rate of recurrence. It is concluded that the concept of elective node dissection is valid.
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PMID:Biostatistical basis of elective node dissection for malignant melanoma. 87 70

Sixteen women, twelve with stage 2 and four with stage 3 mammary cancers, were given autografts of irradiated cancer cells immediately after simple mastectomy and before postoperative radiotherapy, as a pilot trial with entry limited for ethical and operational reasons. Entry was based upon the presence of the poor prognostic features of tumor diameter exceeding 4 cm, fixation to skin or fascia or presence of axillary lymph nodal metastases. Actuarial survival curves for a period of six years show significant (p less than 0.01) prolongation of survival of the small autografted group (63% at six years) compared to that (30% at six years) of 139 ungrafted stage 2 mammary cancer patients treated by mastectomy and postoperative radiotherapy. The concept of deficiency of a treatment based upon person-years lived is introduced and used to analyze the data. The observations and analyses support the theoretical concept that irradiated autografts of cancers may sensitise residual cancer to subsequent conventional radiotherapy and in the process can activate systemic immunological restraints.
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PMID:Prolonged survival after immunotherapy (irradiated cancer autografts) or mammary cancers, assessed by a measure of therapeutic deficiency. 88 May 58

Histologic features of the primary tumor and their effects on the incidence of unsuspected pelvic lymph node metastases have been studied in a prospective series of 62 patients with clinical stage B1, B2, or C prostatic adenocarcinoma who underwent pelvic lymph node removal. Twenty-one patients (34%) proved to have unsuspected nodal metastases. Differentiation of the primary tumor and extent of involvement of the prostate by carcinoma were the only two features that correlated significantly with the incidence of pelvic nodal metastases, 56% of those with undifferentiated tumors had metastases. Thirty-one of these patients underwent total prostatectomy; an average of only 46% of the sections of prostate contained tumor in the patients without metastases but an average of 65% of the sections were involved by carcinoma in those patients who did have nodal metastases.
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PMID:Clinicopathologic features of unsuspected regional lymph node metastases in prostatic adenocarcinoma. 90 39

Ten boys with paratesticular embryonal rhabdomyosarcoma were treated in a 44-year period. Two prognostically distinct stages of the disease and appropriate treatments are described. Children with non-infiltrating tumors (stage IA) are curable (3 patients are alive and free of tumor after 8 to 44 years) and radical orchiectomy with adjunctive radiation or, preferably, chemotherapy is adequate for these patients. Conversely, in those children with infiltrative tumors retroperitoneal nodal metastases invariably develop. Early retroperitoneal lymphadenectomy with adjuvant radiation and multidrug cyclic chemotherapy is life-saving (3 are alive and free of tumor after 2 1/2 to 4 years). However, delayed recognition and treatment of retroperitoneal disease, despite agressive therapy, is frequently disappointing--2 of 4 patients died after 2 and 6 years; another, who had advanced disease, is lost to followup and also is presumed dead and 1 is alive and free of tumor after 6 1/2 years.
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PMID:Paratesticular rhabdomyosarcoma in childhood. 90 55

The surgical tissues and clinical records of 54 surgically treated patients with microinvasive carcinoma of the cervix were retrospectively analyzed. Utilizing a definition that limited microinvasion to a depth of 3 mm, and excluded lymphatic and blood vascular involvement, the incidence of regional metastases in 37 patients for whom lymph nodes were available for study was 0%. Confluence of microinvasion did not imply a greater potential for metastatic spread or a worse prognosis. Lymphatic and blood vascular permeations were associated with nodal metastasis in one of four lesions which otherwise were microinvasive. Random cervical biopsy alone was inadequate for the diagnosis of microinvasion. Cone biopsy demonstrated an accuracy of 83% in diagnoses, but failed to eliminate intraepithelial or microinvasive carcinoma in 78% of the hysterectomy specimens. It is concluded that microinvasive carcinoma, as defined in this study, can be effectively treated by conservative rather than radical means.
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PMID:Microinvasive squamous carcinoma of the cervix: definition, histologic analysis, late results of treatment. 90 2

One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rad per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category. Three-year determinate survival rates were as follows: radiation therapy --10%, surgery--56%, and combined therapy--40%. Evaluation of the local recurrence rate revealed it to be: radiation therapy--19/33 (58%), surgery--1/19 (5%), and combined therapy--9/32 (28%). We interpret this data to suggest that preoperative irradiation impaired the determination of adequate resection margins, despite the use of frozen sections from those margins at the time of surgery. The incidence of late contralateral palpable nodes was greatest in the surgery group--5/19 (26%), compared with radiation therapy--0/33, and combined therapy--1/32 (3%). This supports other studies which indicate that radiation therapy is very effective in controlling subclinical nodal metastases.
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PMID:Carcinoma of the pyriform sinus a comparison of treatment modalities. 91 86


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