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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic dissemination of differentiated cancer was studied in a personal group with the following results. Invasion of cancer to adjacent structures can be encountered even in children with typical increase with age. The lymphatic spread to regional lymph nodes is typical of papillary cancers and in young patients. The same type of spread without the age-dependent decrease can also be proved, with lower incidence, in follicular cancers. Pulmonary metastases are frequently the only type of distant metastases and may originate from previous spread to lymph nodes. The isolated bone metastases a;e probably brought about through the vertebral venous system. Patients having multiple bone metastases or both bone and lung lesions are probably the only typical examples of metastasizing through the systemic blood flow. As the above types of distant metastases carry different prognosis they should also be recognized by the TNM system.
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PMID:Mode of spread of thyroid cancer. 48 44

In a group of 840 patients with thyroid carcinoma the authors found pulmonary metastases in 123 patients, i. e. in 14.6%. In 78 pulmonary metastases were the only remote ones, in the remainder they were combined also with other remote metastates, almost always bone metastases. Cases of "pure" pulmonary metastases were found in the whole group without a proved relationship to age and histology, with a slight prdominance of men, while in patients with a combination of pulmonary and bone metastases follicular carcinoma predominates and it is found mainly in patients of more advanced age. The biological behaviour of these two groups differs completely, and this should be taken into account in the international TNM classification. When investigating the biological properties of thyroid carcinoma, we evaluated in detail in a recent publication (15) bone metastases. As all remote metastases of thyroid carcinoma are included according to the classification of WHO under the common sign M1 (9), we wanted to compare some factors in the incidence of pulmonary and bone metastases.
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PMID:Pulmonary metastases of thyroid carcinoma. 52 23

A total of 110 consecutive females who presented in 1987 with primary carcinoma of the breast were staged according to the UICC TNM staging system. Of these, 90 patients had bone scans at presentation, of which seven were positive. The rate of positive initial scans for Stages I-II was 3.5%. Of these only one patient subsequently had bone metastases confirmed, to diagnose which by bone scan, the estimated cost was pounds 1300. Follow-up information was obtained for 95 patients, repeat scans being performed in 22 who had symptoms suggestive of bone metastases. Ten patients with negative initial scans converted to scan-positive within a mean time of 15 months. Only four of these had radiological confirmation of bone metastases. The cost of detecting bone metastases by follow-up scan was approximately pounds 80 per patient. The false-positive rate and the false-negative rate were both calculated as 10%. The specificity of the test was calculated as 90%. It is recommended that bone scanning should be reserved for patients with Stages III and IV disease and to evaluate symptoms suggesting bone metastases.
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PMID:Cost efficiency of bone scans in breast cancer. 203 84

The aim of the study was to assess the value of routine bone scintigrams, independent of the primary tumor stage or the presence of symptoms, in the postsurgical follow-up of breast cancer patients for the early detection of bone metastases. For this purpose 1,000 patients with postsurgical breast cancer without previous documentation of metastatic disease, who were admitted to the special oncology hospital, Onkologische Klinik Bad Trissl, entered a prospective study in 1987-1988. The parameters followed were the TNM stage of the primary tumor, the presence of pain, bone pain as revealed by a thorough physical examination, and the patient's history for the assessment of risk factors. In addition, a whole-body skeletal scintigram, supplementary X-rays, and additional diagnostic measures were performed, if necessary, to detect bone metastases. It was shown that in 856 of 894 patients (groups 1-6) without clinical symptoms, the clinical examination and radiological and scintigraphic diagnostic measurements, demonstrating the absence of bone metastases, gave matching results, but in 12 of the 894 patients the results of all examinations remained questionable. In another 12 of the 894 patients (groups 1-3) radiological and/or scintigraphical evidence for the presence of bone metastases was found. In 14 of 79 cases (groups 7-10) with clinically suspicious symptoms these were proven to be signs of metastases by subsequent scintigrams, supplementary X-rays, and additional diagnostic measures. In 65 of the 79 patients with clinically suspicious symptoms, bone metastases could not be confirmed by obtaining bone scintigrams or X-rays while in the other 14 patients (groups 9 and 10) evidence for the presence of bone metastases was found in the scintigrams and/or X-rays. However, 10 of these 14 patients were high-risk patients for developing bone metastases as they had axillary lymph node infiltration. The other 4 patients were of the low-risk group as they had positive receptor status or no axillary lymph node infiltration at the time of primary diagnosis. In 13 of 27 patients (groups 11-14) with clinical symptoms indicating the presence of bone metastases this diagnosis was confirmed by scintigrams and/or X-rays (groups 11 and 12), while it was possible to exclude the presence of bone metastases in spite of the symptoms in 11 of the 27 patients. In the other 3 patients the results of the additional examinations remained questionable.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Value of bone scanning in the follow-up of breast cancer patients. A study of 1000 cases. 222 39

From June 1, 1981 to December 31, 1985, 122 patients aged 54 to 83 years, with locally advanced prostatic carcinoma, were treated with buserelin. Nineteen of the patients received combined therapy with buserelin and androcur for the first 3 months. To control the response of the primary tumor to therapy, fine-needle aspiration biopsy of the prostate was made in all patients at 3-month intervals. Fifty-eight (76.3%) of 76 patients with locally advanced prostatic carcinoma, with or without bone metastases, who underwent buserelin therapy for periods of 12-54 months showed good to satisfactory regression grades in the primary tumor. Eighteen patients (23.7%) showed poor regression or none, established by cytological findings and the measure of DNA by means of single cell-scanning cytophotometry. In three of the 58 patients, tumor progression or bone metastases occurred despite favorable regression grade; these were the only cases in which there was a discrepancy between the clinical course of the disease and the grade of regression in the primary tumor. According to TNM classification, 68 of the 78 patients treated for 12-54 months were in stage T3 NX M0; eight were in stage T3/T4 NX M1. On the basis of our long-term studies, it can be stated that buserelin therapy induces positive therapy response in more than 75% of locally advanced, inoperable, primary prostatic carcinoma. The clinical castration caused by buserelin through selective suppression of gonadotrophic secretion in the pituitary gland is, as the term implies, no more effective than surgical castration. However, the gonadotrophin suppression induced by buserelin is reversible and spares the patient the psychic stress of orchiectomy. This is a decisive advantage in light of the fact that in 20-40% of patients with locally advanced primary prostatic carcinoma, the primary tumor is hormone-refractory, and surgical castration would prove unnecessary after all.
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PMID:Treatment of locally advanced prostatic carcinoma with LHRH analogues: cytological, DNA-cytophotometrical, and clinical results. 296 59

Variations in the serum level of alpha-HS-glycoprotein may be observed in all pathological conditions which induce changes in bone turn-over, as well as in inflammatory and neoplastic diseases. This study includes 162 patients divided into four groups according to the TNM classification (tumour, lymph node metastasis). The first consisted of patients with neoplasms at TNM stages 1 and 2 with no bone metastases; the second of similar patients at TNM stages 3 and 4. The third group were patients with primary or secondary neoplasms of bone, and the fourth were patients with viral or bacterial diseases. The levels of alpha-2-HS-glycoprotein serum were determined for all the groups and these were compared with AAG (alpha-1-glycoprotein) and CEA (carcinoembryonic antigen). There were no significant differences in the levels of alpha-2-HS-glycoprotein for the first group as compared with normal controls, while in the other groups the differences were significant. The levels of alpha-2-HS-glycoprotein were diminished when the levels of CEA and AAG were both high, but increased when only one of these other parameters was high.
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PMID:Variations in alpha-2-HS glycoprotein level in neoplastic disease with and without involvement of bone. 350 81

The rapid and widespread development of imaging techniques during the last decade has markedly modified the previous algorithms used in the staging of pulmonary carcinoma, particularly M0/M1 in the TNM classification and the directives of the American Thoracic Society. Sensitivity and specificity of each method are reviewed according to the most frequent metastatic sites of bronchopulmonary carcinoma. Presently, CT is the most efficient technique for detection and display of metastases of the contralateral lung, brain, adrenal glands and retroperitoneal lymph nodes. Ultrasound is equal or even slightly superior to CT for the detection of liver metastases. The superiority of magnetic resonance imaging (MRI) over CT in the detection of brain metastases has already been demonstrated. The results of MRI using fast sequences have recently been demonstrated for imaging of thoracic, abdominal and bone metastases, but confirmation of these first results by prospective studies is needed. Skeletal survey is still obtained by radioisotope scanning.
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PMID:[Staging of pulmonary cancer, establishment of M1]. 367 84

Response criteria for phase II and phase II trials of prostate carcinoma patients of the EORTC Genito Urinary-Group are described. These criteria, initially closely related to National Prostatic Cancer Project criteria, have gone through a development into the direction of more stringency. Admission of patients to phase II trials is now restricted to those showing objectively measurable lesions, excluding bone metastases. World Health Organization criteria are applied to these patients. For phase III trials, progression to Metastatic TNM system status, time to progression, and duration of survival are recommended as end points. Measurable marker lesions, as for phase II trials and subjective and nonspecific response criteria, are accepted as parameters for progression. Response usually is not evaluated in these studies. Based on recent literature and personal experiences, the author suggests that serum acid phosphatase (SPAP) and volume changes of the primary tumor can be used as indicators for response under certain conditions. There is obviously a great need for further development of objective response criteria for prostatic cancer patients.
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PMID:Treatment response criteria for prostatic cancer. 636 78

The observation that the proteins encoded by ras genes play a central role in the signalling pathways used by cells to respond to growth factors and the fact that mutated ras proteins are constantly promoting cell division have led to a PCR-based hunt for additional clinical information. In the present study, K-ras analysis draws the following conclusions: (1) K-ras point mutation frequency was higher in the surgery group (10 of 24 patients) than in the chemotherapy-surgery group (3 of 20 patients). (2) Mutated K-ras was predominantly observed at codon 12 but five mutations appeared at codon 61. (3) Mutations were identified in the squamous cell carcinoma histological NSCLC subtype except in four cases corresponding to adenocarcinoma. (4) A multifarious pattern of substitutions, especially at codon 12, were noted with aspartic K 12 substitutions more prone to develop bone metastases. (5) Although a genotypic K-ras classification of NSCLC may not yet be formulated, our accumulated data (unpublished) suggest a trend toward it. (6) Patients with mutated K-ras tumors in the surgery group had no different survival than those with normal K-ras. However our pooled data as well as other authors' results assert that mutated K-ras constitute an additional prognostic datum that deserves to be included together with TNM classification. In the design of new preoperative (neoadjuvant) chemotherapy trials, stratification of tumors by K-ras status deserves to be further investigated in order to correlate with response, relapse and survival. Mutated K-ras genotype merits further research. Finally, the paradigm of uneven histological distribution and mutated K-ras spectra among researchers should serve as a stimulus to search for further contributions in this field.
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PMID:Mutated K-ras gene analysis in a randomized trial of preoperative chemotherapy plus surgery versus surgery in stage IIIA non-small cell lung cancer. 755 35

Two-hundred and sixty patients with T2-T3a, pN1, M0 (TNM classification) breast cancer underwent clinical and instrumental follow-up (mean 122 months) including periodic bone scintigraphy. A total of 1971 scintigraphic examinations were performed (range 3 to 15 scintigraphies/patient, mean 8). The results of scintigraphy were compared to standard radiographs and to the clinical history of the patients. Bone metastases occurred in 71% of 122 patients who suffered from tumor recurrence during the study. Bone lesions (alone or associated with other tumor lesions) represented the most common site (42%) of first tumor relapse and occurred as first site of distant metastases in 11% of 29 patients with locoregional relapse. Bone metastases were symptomatic in 41% of cases. The sensitivity and specificity of bone scintigraphy were 98% and 95%, respectively; the positive and negative predictive values were 73% and 100%; the accuracy was 96%. Scintigraphic false positive results occurred particularly in the skull and in the ribs and generally when the examination detected less than three focal abnormalities. This study demonstrates that the number of positive scintigraphies during follow-up increases over the years, reaching a plateau only at approximately 8-10 years. It is therefore not advisable to stop performing bone scintigraphies after the first years of follow-up as this may lead to the loss of important information.
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PMID:Bone scintigraphy in breast cancer: a ten-year follow-up study. 837 34


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