Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study, 63 patients with histopathologically proved Stage III nonseminomatous testicular cancer (NSTC) were analyzed to predict the need for surgical resection of residual masses after cis-platinum-based chemotherapy. Of these 63 patients, 23 (37%) had residual masses after cis-platinum-based chemotherapy requiring surgical resection. Of the 23 patients undergoing surgical resections for their residual masses, 18 patients (78%) had matured teratoma, 3 (13%) had fibrosis with necrosis, and 2 (9%) had residual tumors. Twenty of the 23 (91%) patients with residual disease had either teratomatous elements in primary tumor or bulky metastatic disease at the time of initial chemotherapy. Two patients had incomplete resection of the metastatic disease containing teratoma and required additional resection of recurrent growing matured teratomas. We conclude that teratomatous elements in primary tumor having also bulky metastatic disease are strong predictors of residual disease after initial chemotherapy requiring surgery (21 of 23 or 91%).
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PMID:Predictors of residual mass requiring surgical resection after chemotherapy of stage III testicular cancer. A prospective study. 132 Mar 3

Forty-nine patients with assumed extragonadal germ-cell tumors (retroperitoneum: 39, mediastinum: 8, CNS: 2) were included in the present study. The patients were treated with 'high' (40 mg cisplatin/m2 and 200 mg etoposide/m2 daily x 5) or 'conventional' (20 mg cisplatin/m2 and 100 mg etoposide/m2 daily x 5) doses of cisplatin and etoposide together with bleomycin, depending on the presence or absence of poor prognosis factors. Forty-six patients were evaluable for response and 3 patients were classified as non-responders (1 early death, 2 toxic deaths). Eighty percent obtained complete remission and 76% are alive without evidence of disease after a median observation time of 41 months (88% of patients with primary tumor in the mediastinum, 72% with tumor in the retroperitoneal area, 87% of patients with seminoma and 71% with non-seminoma, respectively). In 48 patients testicular biopsies were performed. In 42% of patients with primary retroperitoneal tumors, carcinoma in situ testis (CIS) was diagnosed. None of the patients with tumors in mediastinum or CNS had CIS in the testicles. The therapeutic outcome for patients with extragonadal germ-cell tumors is now similar to that of patients with very advanced testicular cancer when considered in relation to the presence of prognostic factors. The coexistence of CIS and retroperitoneal tumor could indicate that these tumors are not truly extragonadal or that these lesions have a common malignant progenitor.
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PMID:Management of extragonadal germ-cell tumors and the significance of bilateral testicular biopsies. 132 76

Detection of serum and cellular AFP and hCG has made a significant contribution in understanding and management of testicular cancer. It is essential to remember the following events in utilizing these markers: (1) Histologic diagnosis of seminoma, but AFP is elevated. There is usually an element of choriocarcinoma. (2) Histologic diagnosis of seminoma and highly elevated hCG greater than 100 ng/ml has usually an element of choriocarcinoma. (3) Histologic diagnosis of choriocarcinoma with an elevated serum AFP. There is usually an element of embryonal carcinoma. (4) Pathologic stage I nonseminomatous testicular cancer with elevated serum markers is either stage II or stage III. (5) In a recent study of 23 patients undergoing resection of residual nonseminomatous testicular cancer after intensive chemotherapy, 21 had either teratoma in primary tumor or bulky metastatic disease. The markers were normalized after chemotherapy and prior to resection. (6) Although normalization of these markers after chemotherapy indicates effective therapeutic response, one should look of residual tumor utilizing radiologic investigations.
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PMID:Current status of tumor markers in testicular cancer. A practical review. 138 31

The paper discusses the results of an epidemiologic case-control study dealing with the risk of development of acute nonlymphoblastic leukemia in patients treated with radio- or chemotherapy. Out of 165 patients with primary multiple metachronous tumors, primary Hodgkin's disease, lymphosarcoma and breast, ovarian and testicular cancer, 18 developed secondary acute nonlymphoblastic leukemia; in 13, the primary tumor had been Hodgkin's disease, in 4--breast cancer and in one--testicular cancer. Relative risk (RR) of acute nonlymphoblastic leukemia proved higher in patients who had undergone radiation (RR = 6.4) or chemotherapy (RR = 1.9). Combination of those two procedures carried a higher risk, too (RR = 5.9). Relative risk of acute nonlymphoblastic leukemia proved the highest in patients treated with adriamycin (11.3) and nitrogen mustard (9.9) and much lower for cyclophosphamide (RR = 1.5).
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PMID:[The risk of the occurrence of acute nonlymphoblastic leukemia in patients with malignant neoplasms undergoing radio- and chemotherapy]. 166 2

Between 1981 and 1986, 279 consecutive patients with clinical stage I (CS1) nonseminomatous germ cell tumors (NSGCT) of the testis underwent pathological staging (PS) with retroperitoneal lymphadenectomy (RPLND). Patients with retroperitoneal metastases (PS2) received adjuvant chemotherapy. The median follow-up time after RPLND was 50 months (range, 30 to 90). Clinical and histopathologic features were registered prospectively and analyzed for association with risk of having PS2, relapse despite pathological stage 1 (PS1) or the combined risk of either event, metastatic disease (MET). Seventy-five (26.9%) of the patients had PS2 disease, and 30 (14.7%) of the 204 PS1 patients relapsed, indicating that at least 105 (37.6%) of this CS1 population had subclinical MET at the time of orchiectomy. Four (1.4%) of the 279 CS1 patients died of testicular cancer. Multivariate analyses showed several variables to be significantly associated with outcome for the CS1 patients; vascular invasion in primary tumor and normal preorchiectomy serum alpha-fetoprotein (Pre-AFP) level indicated PS2 disease. If Pre-AFP was excluded from the model, the absence of teratoma or yolk sac elements in the primary tumor became significant predictors of PS2. Vascular invasion, absence of teratoma, and a short interval between orchiectomy and RPLND indicated increased risk of relapse in PS1 patients. Vascular invasion, normal Pre-AFP, absence of teratoma elements, and a short orchiectomy to RPLND interval were predictive of MET. Our results indicate that prognostic factors useful for stratification of CS1 patients with NSGCT to different treatment options may be established.
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PMID:Prognostic factors in clinical stage I nonseminomatous germ cell tumors of the testis: multivariate analysis of a prospective multicenter study. Swedish-Norwegian Testicular Cancer Group. 168 73

Disseminated germ cell testicular cancer proved to be highly sensitive to platinum-containing chemotherapy regimens. We present data concerning the treatment of advanced seminoma and nonseminomatous tumors in a developing country. We treated 30 patients with advanced germ cell testis tumors with 3 or 4 cycles of vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum. Surgical resection of residual masses was done 30 days after completion of chemotherapy in 18 patients. The histology of the primary tumor was seminoma in 13 patients and nonseminomatous tumors in 17. Toxicity was mild and no treatment-related deaths occurred. All 13 patients (100 per cent) with seminoma and 12 of 17 patients (71 per cent) with nonseminomatous tumors had a complete response to chemotherapy, and 1 of 17 patients was free of disease after a debulking operation and additional chemotherapy. A total of 3 patients with seminoma and 2 with nonseminomatous tumors had recurrences 5 to 8 months after an initial complete response and received additional chemotherapy (VP-16 regimen) with or without radiotherapy. Complete clinical response was achieved in 4 of 5 patients. Median followup was 24 months (range 8 to 38 months) in the 13 patients with seminoma and 28 months (range 9 to 58 months) in those with nonseminomatous tumors, and 13 (100 per cent) and 12 (71 per cent), respectively, are alive without evidence of disease. These data suggest that the protocol of vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum is highly effective and minimally toxic in the treatment of disseminated germ cell testicular cancer, inducing an 83 per cent long-lasting clinical remission. Seminomas seem to be equally or even more sensitive than nonseminomatous tumors to this platinum-containing chemotherapy regimen. Recurrence after initial complete response can be treated successfully with regimens containing VP-16.
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PMID:Vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum for advanced germ cell testis tumors: Brazilian experience. 240

A phase II trial of 6 months of alternating etoposide plus cisplatin (EP) and cyclophosphamide, vinblastine, actinomycin D, bleomycin, cisplatin (VAB-6) was conducted in 41 evaluable patients in an attempt to improve the treatment results in those patients considered to have "poor-risk" germ cell tumors (GCT). Eight of 14 (57%) patients with mediastinal and retroperitoneal GCTs achieved complete remission (CR), and five (36%) remain alive and free of disease. Fourteen of 27 patients (52%) with poor-risk testicular cancer achieved CR, and ten (37%) remain alive and free of disease. Two patients with seminoma, one each with a testicular and extragonadal primary tumor, achieved durable CRs. Toxicity was tolerable, but greater than that of VAB-6 alone. The response and survival of the 39 patients with nonseminomatous tumors were found to be identical to the results of 29 patients with nonseminomatous GCTs and poor-risk characteristics who were treated with VAB-6 alone. Thus, this 6-month schedule of alternating months of chemotherapy is not recommended for patients with poor-risk GCTs. Patients with such tumors should be referred to centers conducting prospective trials, so that research seeking better therapy may continue.
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PMID:Alternating cycles of etoposide plus cisplatin and VAB-6 in the treatment of poor-risk patients with germ cell tumors. 243 27

Between 1983 and 1985, six patients with advanced testicular cancer were treated with 3 cycles of vinblastine, actinomycin D, bleomycin, cyclophosphamide and cisplatinum (VAB-6 combination chemotherapy without maintenance). The histology of the primary tumor was seminoma in one patient and nonseminomatous germ cell testicular tumor (NSGCTT) in 5. Five men with stage III or bulky stage II diseases received no prior chemotherapy but one had received another chemotherapy without cisplatinum. Two patients showed a complete response to chemotherapy. Three were partial responders free of disease after a debulking operation and additional chemotherapy. The other patient who had NSGCTT had recurrence 5 months after the last induction chemotherapy and received additional chemotherapy (PVeBV regimen). Median follow-up was 16 months (range 2 to 28 months) and all patients are alive with no evidence of disease. Severe myelosuppression and serious renal toxicity were not experienced. Marked, but transient elevation of serum transaminase were observed in all patients. These data suggest that this protocol is highly effective and minimally toxic in the treatment of disseminated testicular tumor.
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PMID:[VAB-6 combination chemotherapy in patients with stage II, III testicular tumor]. 243 34

Univariate and multivariate linear logistic regression analyses of potential prognostic variables have been performed for 163 patients with disseminated nonseminomatous testicular cancer, treated with cisplatin, vinblastine, and bleomycin in a multicenter study of the European Organization for Research on Treatment of Cancer Genito-Urinary Tract Cancer Cooperative Group. With a multivariate analysis, four prognostic groups with complete responder rates of 100, 89, 41, and 18%, respectively, were identified based on three prognostic factors: trophoblastic elements in the primary tumor, serum concentration of alpha-fetoprotein, and lung metastases by size and number. However, with a univariate analysis the logarithm of the beta subunit of human chorionic gonadotrophin (BHCG) was the single most important factor. This model aids the physician in selecting prospectively good risk patients who are candidates for low toxicity chemotherapy and poor risk patients with whom innovative treatment should be attempted.
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PMID:Multivariate analysis of prognostic factors in patients with disseminated nonseminomatous testicular cancer: results from a European Organization for Research on Treatment of Cancer Multiinstitutional Phase III Study. 243 56

Cancers of unknown origin represent approximately 5% of all cancers and are therefore as frequent as some solid tumors such as gastric or pancreatic cancers. The diagnosis of cancer of unknown origin should be based on a detailed pathological examination including immunohistochemical techniques and electron microscopy; hormonal receptors should also be measured. Besides detailed medical history and physical examination, only a few additional tests should be carried out: routine chemistry including the assay of HCG, alphafoetoprotein and specific antigen of the prostate, chest X-ray, thyroid scan, mammography and abdominal CT scan. Other tests are generally not of sufficient specificity and sensitivity. Unknown primary tumors arising in the cervical area are frequently squamous cell carcinomas corresponding to occult primary tumors of the upper aerodigestive mucosae and are efficiently treated by cervicofacial radiotherapy or lymph node dissection. Women presenting with axillary lymph nodes with no obvious primary tumor should be treated according to the guidelines used for breast cancer. The patients with inguinal lymph nodes of unknown origin are usually treated with radiation therapy. The syndrome of germinal tumors of extragonadic origin corresponds to cases of undifferentiated or poorly differentiated carcinomas in patients under 50 years of age and with one of the following characteristics: involvement of the median organs, lung involvement, lymph node involvement or increase of alphafoetoprotein or HCG. The therapeutic approach recommended for these patients consists of the chemotherapeutic combination used for testicular cancer. For all other patients, the prognosis remains poor. Patients with local symptoms may be treated by radiation therapy; others may receive a combination of fluorouracil, doxorubicin and mitomycin.
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PMID:[Diagnosis and treatment of unknown primary tumors]. 269 83


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