Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Progression after radical prostatectomy, evaluated by a rise in plasma PSA and/or the appearance of a pelvic nodule positive on biopsy and/or the presence of bone metastases confirmed by bone scan, was studied in a series of patients with prostatic cancer with a follow-up of between 6 months and 5 years. The progression-free survival rate was 86% at 1 year and 60% at 5 years. A progression-free survival rate and the relative risk of progression were established on the basis of the morphological characteristics (anatomical stage, tumour volume, seminal vesicle invasion, condition of the prostatic capsule and lymph nodes, positive resection margins at the apex) and histological features (Gleason's score) of the cancer, allowing determination of the influence of prognostic criteria on the outcome. The positive resection margins at the apex were due to preservation of the nervi erigentes. The preservation of the neurovascular pedicles may not be justified in the case of a tumour confined to the prostatic apex.
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PMID:[Progression after radical prostatectomy of cancer of the prostate: prognostic criteria and the role of PSA in monitoring]. 128 86

Activity and side-effects of clodronate (Ostac), an inhibitor of osteoclastic bone resorption, were recorded in an open prospective uncontrolled study on 35 patients with metastatic prostatic cancer. All patients had progressive symptomatic bone metastases despite prior hormone therapy. Clodronate was initially administered i.v. for 8 days with 300 mg/day. This was followed by a daily oral administration of 1600 mg. The analgesic effect was evaluated by using a visual analogue scale and by recording the daily consumption of analgesic drugs. Karnofsky index and routine blood examinations, including PSA, were assessed. Repeated bone scans and radiological evaluations were performed. An improvement in pain was observed in 71% of the patients. The mean duration of improvement was 4 weeks. Average survival time was 12 weeks. There were no side-effects after i.v. administration. Slight gastrointestinal discomfort was observed in 3 patients after oral administration. No effect was observed on the extent or biology of the metastases. Clodronate is an effective drug for palliative treatment of symptomatic bone metastases of prostatic carcinoma. It causes fewer and less pronounced side effects than other palliative drug therapies.
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PMID:[Clodronate in the palliative therapy of bone-metastasized prostatic carcinoma]. 137 55

Serum activities of bone alkaline phosphatase (b-ALP) and of tartrate resistant acid phosphatase (tr-ACP) were evaluated in 271 cancer patients; 120 of them had bone metastases (BM) and 151 had none. Correlation coefficients, specificities, sensitivities, negative and positive predicting values were computed. They showed the important contribution that these isoenzymes can bring to the diagnosis of BM in 80 patients with prostate cancer, and to the followup of 191 patients with breast cancer. The assay results were analysed in parallel with bone scan and radiography. They were also compared to those of serum antigens: PSA and PAP for prostate cancer, and CEA and CA15.3 for breast cancer. These results clearly indicate that both isoenzymes are better correlated with BM than antigens, these antigens being markers of the whole tumor burden--primary tumor, metastases, recurrence--whereas b-ALP and tr-ACP are specific markers of bone metabolism.
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PMID:[Evaluation of two serum isoenzyme phosphatases as bone metastasis markers]. 208 Dec 81

In the presence of prevalent bone metastases, the precise histo-pathological diagnosis of the primary tumor is often difficult. The authors study the diagnostic value of systematic serum assay of a series of tumoral tracers (ACE, AFP, PAP and PSA, SCC, CA 19:9, CA 15:3, CA 125) which until now were used in evolutive and therapeutic monitoring. 34 patients were selected for this preliminary retrospective study (including 20 with a demonstrated histopathological diagnosis). 70 p. cent of prevalent bone metastases express a target tracer corresponding to the initial location. In some cases, an elevated tracer, because of its specificity, may bring about a diagnostic or therapeutic decision (always according to the context). No conclusion may currently be drawn in case of discordance between the anatomo-clinical context and the "profile" of the markers (1 case in our series).
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PMID:[Systematic study of various tumoral markers in prevalent bone metastasis]. 275 18

An 89-year-old man with bilateral leg edema and a huge abdominal mass was admitted for further evaluation. CT scan showed a hugh prostatic mass which occupied the whole pelvis cavity accompanying multiple pelvic bone metastases. Suprapubic needle biopsy revealed that the mass was well differentiated adenocarcinoma of prostate origin. The treatment was initiated by 500 mg per day of estramustine phosphate combined with injectable LH-RH analogue 2 months later. The serum levels of tumor markers were markedly elevated at the first visit; PSA 210ng/ml, PAP 110ng/ml, gamma-Sm 800ng/ml. They became normalized 3 months after the initiation of the treatment, and the mass was reduced to 11.5% of the initial size, which lead to removal of indwelling urethral catheter. The patient and his family, however, refused further treatment and the patient died of disseminated disease 8 months later.
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PMID:[A case of huge prostate cancer]. 748 33

The asymptomatic patient who has been treated with a curative intent by surgery or irradiation for cancer of the prostate needs only a PSA and a baseline bone scan for his initial (post-treatment) follow-up. Rising serum PSA levels which still remain in the moderate range may signal a local recurrence, but this must be documented histologically. The therapeutic options to consider for a documented local recurrence include pelvic irradiation for the previously operated patient, or surgery for a post-irradiation recurrence. A serum PSA which rises to high levels following treatment will often be associated with distant metastases, and this is more certain if the original tumor was locally advanced and/or the histology was poorly differentiated or aneuploid. A newly elevated serum acid phosphatase in a treated patient with prostate cancer will usually signify disseminated disease also. Whether to wait until a patient becomes symptomatic from a recurrence or to initiate endocrine treatment solely on the basis of a rising serum marker still remains a point of controversy. The overall survival of Stage D2 patients has not been prolonged by endocrine manipulations which were instituted before symptoms of widespread dissemination appeared. The routine use of periodic imaging studies to follow asymptomatic patients with prostate cancer after they have received treatment cannot be justified for clinical decision-making purposes. On the other hand, in treated patients who develop new symptoms suggesting bone metastases, radionuclide scans which are correlated carefully with the patient's symptoms and with radiographs of "hot" areas on the scans are indicated. When a suspected diagnosis of metastatic disease still remains in doubt, elevated serum tumor markers may provide additional evidence. Imaging studies can also be used to guide percutaneous biopsies of suspected metastases in bones (radionuclide scans and radiographs), or of persistent tumor in an irradiated prostate gland or at the urethro-vesical junction after surgery (TRUS). Since cancer of the prostate often progresses slowly and disseminated disease remains incurable at this time, some degree of uncertainty about the presence of metastases or of recurrent local disease might be safer and less costly than the use of multiple diagnostic studies and aggressive treatment (including endocrine manipulations) in nonsymptomatic patients.
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PMID:Surveillance of patients with prostate cancer after treatment: the roles of serologic and imaging studies. 768 12

A 58-year-old male complaining of pollakisuria, miction pain and back pain visited us Dec. 26, 1979. Rectal examination revealed the prostate enlarged by 5 digital width, stony hard and irregular. Transrectal needle biopsy revealed moderately differentiated adenocarcinoma of the prostate. Bladder neck invasion, pelvic and mediastinal lymph node metastases and multiple bone metastases were found. The case was diagnosed with prostatic adenocarcinoma T3N2M1 (OSS, LYM) stage D2. Three courses of chemotherapy using ifosfamide applied from Feb. 2, 1980 showed no marked effect except for partial pain relief. Hormonal treatment with diethylstilbestrol diphosphate was started from May 28 and arterial infusion chemotherapy using CDDP and 5-FU was performed 2 months later, resulting in size reduction of the prostate and pelvic lymph node metastases and disappearance of mediastinal lymph node metastases. Needle biopsy of the prostate was negative for cancer cells. After 8 months, Tegafur was started, and 12 months later radiotherapy was added to the prostate and pelvic lymph nodes. The abnormal accumulation in bone scan began to decrease after 14 months and achieved complete remission 28 months after the initial therapy. We discontinued the hormonal therapy 31 months later because of his complaint of chest discomfort and palpitation. At the present time, 14 years after the initial therapy, the prostate was 35 x 29 x 19 mm in size on transrectal ultrasonography with undetectable serum PSA level and no tumor cells but only mass fibrosis has been seen by pathological examinations. We considered this patient to be with no evidence of disease.
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PMID:[A case of completely responding stage D2 prostatic cancer with no evidence of disease 14 years after diagnosis]. 780 48

Based on a retrospective study of 52 patients with prostatic adenocarcinoma and bone metastases (stage M1b), the authors analysed the following prognostic factors at the time of diagnosis: age, general status, bone pain, haemoglobin, local tumour volume, ureteric repercussions, pre and post-treatment PAP and PSA levels, Gleason score, and metastatic spread on bone scan. This study demonstrated two predominant prognostic factors for the appearance of early or late therapeutic escape: tumour differentiation established by the Gleason score (P = 0.003), stage of the disease, i.e. local tumour volume (p = 0.001) and bone mass invaded on bone scan (p = 0.0002). The other prognostic factors can be deduced from these two parameters. Qualitative analysis of the initial bone scan allowed patients with peripheral bone metastases to be distinguished from those with exclusively axial involvement. The two-year survival was 50% in patients with peripheral metastases versus 93% in patients without peripheral metastases (p < 0.05). Although bone metastasis constitutes a decisive prognostic factor, the detection of peripheral bone metastases appears to be a factor of poor prognosis.
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PMID:[Stage M1b prostatic adenocarcinoma: prognostic factors, value of bone scintigraphy]. 787 87

Three new collagen markers deriving from the collagenous matrix, e.g. carboxyterminal propeptide of type I procollagen (PICP), carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP), and aminoterminal propeptide of type III procollagen (PIIINP) were used for the diagnose of prostatic bone metastases. Blood samples were obtained prior to biopsy or TURP. Serum PICP, PIIINP and ICTP were measured with commercial available RIAs and PSA by IRMA. Serum PSA was increased in patients with local prostatic cancer compared with patients with hyperplasia (p < 0.05). The level of PIIINP, ICTP, and PICP did not differ between these two groups. In patients with metastatic prostatic cancer all five markers were increased compared to the level measured in patients with localized cancer (p < 0.0001). All variables showed a significant positive relationship with alkaline phosphatase. The sensitivity ranged from 0.53 to 0.62 and specificity from 0.91 to 0.95. The sensitivity for alkaline phosphatase and PSA was 0.69 and 0.66 and specificity 0.91 and 0.68, respectively.
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PMID:Collagen derived serum markers in carcinoma of the prostate. 857 75

Procollagen 1 carboxyterminal peptide (P1CP) is thought to be an indicator of new bone formation. The present report demonstrates that effective endocrine therapy induced an initial increase followed by a delayed decrease in serum levels of P1CP and alkaline phosphatase in spite of an immediate decrease in serum PSA and PAP and improvement of clinical symptoms in prostate cancer patients with bone metastases. The transient increase in P1CP and alkaline phosphatase is a healing reaction and is followed by apparent improvement. Short-term effects of endocrine therapy on prostate cancer patients with bone metastases should be comprehensively evaluated based upon the entire spectrum of clinical and laboratory findings including serial changes of serum prostate markers and bone markers as well.
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PMID:A transient increase in serum procollagen 1 carboxyterminal peptide following effective treatment in prostate cancer patients with bone metastases. 925 25


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