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)

A three-stage study of 177 patients in Puerto Rico who had esophageal carcinoma is presented. Those surviving five or more years over a twenty-one-year period were located. Next, the experience at the San Juan City Hospital from 1968 to 1973 was examined. The information obtained from those two groups led to the last stage, a prospective study in which treatment was based on objective staging of the extent of the disease. Only 27% of these patients are really potentially curable upon admission to the hospital, and they should have aggressive therapy. Adequate palliation can be obtained with radiotherapy and chemotherapy in the remainder. The findings that nearly half of the five-year survivors had metastases or tumor extension and that some patients survived for prolonged periods without treatment emphasize the need for individualized treatment and research in tumor immunology.
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PMID:Esophageal carcinoma. The value of staging in long-term survival. 4 79

Ebryonal nephroma was diagnosed in a young, free-ranging female wapiti (Cervus canadensis) from the San Juan National Forest in southwestern Colorado. Metastases were found in the lung.
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PMID:Embryonal nephroma in a wapiti. 22 74

Seventy patients received primary surgical or radiotherapeutic treatment for osteosarcoma at the University of California-San Francisco between 1950 and 1974. Twenty-two received surgery alone and 27 received preoperative irradiation followed at varying intervals by surgery. Twenty-one patients received irradiation alone because of tumor location, refusal of recommended surgery, or development of metastatic disease. The results are analyzed and the role of radiation therapy in the primary management of osteosarcoma is discussed. The authors believe that irradiation without chemotherapy offers little in terms of palliation or enhanced survival in patients who are able to undergo radical surgery.
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PMID:The role of radiation therapy in the treatment of osteosarcoma. 106 87

Temporary implants of high-activity 125iodine sources have been used in the treatment of brain tumors since December 1979 at the University of California, San Francisco. For previously untreated patients who underwent external beam radiation therapy followed by implant boost, median survival from the date of diagnosis was 88 weeks for 34 patients with glioblastoma multiforme (GM) and 157 weeks for 29 patients with nonglioblastoma gliomas (NGM). For recurrent tumors treated with brachytherapy only, median survival from the date of the implant was 54 weeks for 45 patients with GM and 81 weeks for 50 patients with NGM. Finally, in 48 patients with recurrent tumors treated with combined hyperthermia and brachytherapy, median survival from the date of the implant was 46 weeks for 25 patients with GM and 44 weeks for 7 patients with metastases; 18-month survival was 65% for 16 patients with NGM. Brachytherapy appears to be a useful technique for the treatment of selected recurrent brain tumors and selected primary glioblastomas.
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PMID:Brachytherapy of brain tumors. 133 31

This study examines whether primary laser excision results in augmentation of the systemic host anti-tumor response to tumor rechallenge. Single R3230AC mammary tumor implants, (0.5 x 0.5 x 1.0 mm), were grown in 112 female Fisher 344 rats. The animals were randomized. Group S tumors were excised by scalpel. Group E was excised with a Surgistat electrocautery (Valley Labs, Boulder, CO). Group CS was excised with a Sharplan 1100 CO2 laser (Sharplan, Allendale, NJ) at 25 watts (W) continuous wave (CW) (0.2 mm spot size) and the wound was "sterilized" with a 5-mm spot size by gently heating the tissue without blanching. Group K was excised with a KTP/532 laser (Laserscope, San Jose, CA) at 17 W CW using a 400 microns fiber. Group Y was excised with a Sharplan 2100 Nd:YAG laser set at 15W CW using a 0.2 mm clear sapphire tip. A second tumor implant, (0.5 x 0.5 x 1.0 mm), was placed at a remote site 14 days postoperatively. An unoperated control group was implanted. Secondary tumor volumes were measured for 36 days and the mean tumor volumes (MTV) were statistically compared. The MTV in groups CS, K, Y, and E was less than control (P less than 0.01). The MTV in groups CS, K, Y, and E was less than group S, although this was not statistically different. Lasers and cautery appear to increase the host response against subsequent tumor challenge. This study corroborates earlier studies of other modalities. Further studies to determine whether this host sensitization is an immune response and to elucidate the mechanisms of this effect are warranted.
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PMID:Augmentation of the systemic host anti-tumor response through laser excision. 150 27

We undertook a retrospective study of all lung cancer patients diagnosed between 1978 to 1982 and seen at the University of California San Diego affiliated hospitals. There were 390 evaluable patients; the vast majority were men. Overall median survival was 8 months and was similar for all histologic types. Completely asymptomatic patients had a median survival of 20.1 months while symptomatic patients had a median survival of 5-8 months. Retrospective application of the new clinical staging system for lung cancer increased the survival distinction between clinical Stage I and Stage II disease. Median survival for small cell carcinoma of the lung was 10 months: 16.6 months for disease limited to the chest, and 5.8 months for metastatic disease. Median survival for Stage III nonsmall cell lung cancer patients was only 5 months. Only those asymptomatic patients with small lesions which were detected incidentally or by screening chest x-ray had any likelihood of long-term, disease-free survival with more than 60% alive two years after diagnosis. This study suggests that screening and early detection programs in existence during the period of observation were not effective in detecting early disease, and that no therapy of advanced diseases [Stages II through IV] was sufficiently efficacious to be considered standard.
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PMID:Recent outcomes for patients with carcinoma of the lung. 184 43

We retrospectively reviewed eight patients with biopsy-proven anorectal Kaposi's sarcoma (KS) treated between 1984 and 1989 at San Francisco General Hospital. All patients were homosexual men with the acquired immunodeficiency syndrome (AIDS). The average age was 34 years. Three patients had primary rectal KS without metastases. Five patients had disseminated KS with lesions throughout the alimentary tract, viscera, skin, or local lymph nodes. Three patients were treated with radiation or chemotherapy. Five patients had disseminated KS with lesions throughout the alimentary tract, viscera, skin, or local lymph nodes. Three patients were treated with radiation or chemotherapy. Five patients with advanced AIDS received no specific treatment for anorectal KS. Follow-up ranged from 1 month to 5 years. Three of the untreated patients and the three patients treated with chemotherapy or radiotherapy were alive 1 month to 5 years after diagnosis. Aggressive surgical treatment of anorectal KS is not indicated.
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PMID:Kaposi's sarcoma of the rectum in patients with the acquired immunodeficiency syndrome. 225 36

Eighteen patients with poorly differentiated gliomas of the cerebellum were treated by the University of California San Francisco Neuro-Oncology Service between January 1977 and January 1987. Within this group pathologic diagnosis included five glioblastoma multiforme (28%), nine anaplastic astrocytomas (50%), and four mixed malignant gliomas (22%). The group included 13 male and five female patients with a median age at diagnosis of 23 years (range, 4-46 years). All patients underwent surgical resection, 16 of 18 received radiation therapy (12 limited-field irradiation and four whole-brain with or without a posterior fossa boost), and 16 of 18 received chemotherapy. Overall median survival was 31.5 months (range, 5-366 months). Ten patients (55%) died of recurrent disease with a median survival of 32 months (range, 5-128 months), two of whom manifested metastatic disease within the central nervous system (one parietal lobe and one cervical cord). Of the two extracerebellar metastatic recurrences, one patient failed at the junction of whole-brain irradiation and the cervical cord and one patient failed after inadequate posterior fossa irradiation. Eight patients (45%) are alive with a median follow-up of 27.5 months (range, 14-366 months). In this series recurrences of primary cerebellar anaplastic gliomas were locoregional failures. As a consequence, the authors suggest high-dose limited-field irradiation directed at the primary tumor as in their current strategy utilized for supratentorial gliomas.
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PMID:Poorly differentiated gliomas of the cerebellum. A study of 18 patients. 229 56

During the 30 year period from 1957 to 1986, 42 patients with primary tumors arising from the spinal cord or cauda equina received postoperative irradiation at the University of California, San Francisco. Twenty-one patients had ependymomas: 18 were localized to one site, and 3 diffusely involved the cord. There were 12 patients with low grade astrocytomas and 3 with highly anaplastic astrocytoma or glioblastoma multiforme. All astrocytomas were localized at presentation. In 6 cases tissue was insufficient to permit a histologic diagnosis. Thirty-nine patients (93%) received total radiation doses ranging between 45.0-54.7 Gy using standard fractionation. The 10-year actuarial disease-specific survival rate for patients with localized ependymoma was 93%; 33% of these tumors recurred locally. The corresponding rate for diffuse ependymomas was 50%; the spinal disease was controlled in all 3 patients, but one developed a cerebral metastasis despite prophylactic cranial irradiation. Low-grade astrocytoma patients had a 10-year actuarial disease-specific survival rate of 91%, with 33% of these tumors recurring locally. No patient with highly anaplastic astrocytoma or glioblastoma multiforme survived longer than 8 months; all of these tumors recurred locally, and two of the three also developed diffuse craniospinal axis metastases. Local recurrence for ependymoma was delayed as long as 12 years following treatment, while all but one astrocytoma failure occurred within 3 years of treatment. No significant dose-response relationship with respect to local control was noted for either localized ependymomas or low grade astrocytomas. One patient developed radiation myelitis after receiving 50.4 Gy with standard fractionation. These results indicate that patients who undergo postoperative irradiation for low grade spinal astrocytomas and localized spinal ependymomas achieve excellent survival. However, despite treatment with total radiation doses taken to the practical limit of spinal cord tolerance, local failure remains common.
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PMID:Postoperative radiotherapy of primary spinal cord tumors. 254 94

Between 1965 and 1984, 20 patients with chemodectomas of the temporal bone were seen at The Methodist Hospital in Houston, Texas and at the Cancer Therapy and Research Center in San Antonio, Texas, Ten patients were treated with radiation therapy alone, seven with surgery and post-operative radiation, one with pre-operative radiation, and two with radiation therapy following surgical recurrence. Most patients had advanced tumors at presentation. Radiation doses ranged from 22.5 Gy to 50.0 Gy. The most frequent dose was 45.0 Gy, given in 225 cGy fractions, 9.0 Gy per week. The most common radiation portal arrangement was oblique fields with paired wedges. There were no local failures or significant radiation induced complications among the patients with benign chemodectomas. The follow-up period ranged from 3 to 23 years (mean 11 years). Only one patient developed systemic metastases and progression of the primary temporal bone chemodectoma. These results and a review of the literature demonstrate that radiation therapy alone is a safe and effective treatment modality for chemodectomas of the temporal bone.
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PMID:Twenty year experience with radiation therapy for temporal bone chemodectomas. 255 9


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