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)

The accumulating data show that endoscopic ultrasonography (EUS) is highly compatible with the UICC/AJCC staging classification for esophageal and gastric cancer, based on the TNM system expressing anatomical extent of disease. The great strength of EUS in staging these cancers is its ability to image the gut wall and adjacent structures in unique detail. EUS is more accurate than computed tomography in staging the depth of primary tumor invasion (T) and regional lymph node metastases (N). High frequency EUS is not useful in staging for distant metastases (M) due to limited depth of the field. EUS also has limitations in reliably distinguishing between neoplastic and inflammatory tissue. Thus, the major use of EUS is in staging rather than in diagnosis. However, initial reports indicate that EUS may be helpful in the detection of malignancy in Barrett's esophagus, in diagnosing post-operative recurrent cancer, and in evaluating the response to non-operative therapy. EUS appears to represent an important advance in the staging and follow-up of patients with esophageal and gastric cancer. Instruments and techniques will continue to evolve, but the next level of research should be designed to show that the improved staging provided by EUS has clinical utility and can affect patient outcome.
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PMID:Endoscopic ultrasonography in the diagnosis, staging and follow-up of esophageal and gastric cancer. 163 69

Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4 x 10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure.
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PMID:Radioimmunoguided surgery using iodine 125 B72.3 in patients with colorectal cancer. 199 77

Between 1982 and 1989, 19 patients with gynecologic carcinoma, paraneoplastic cerebellar degeneration, and seropositivity for anti-Purkinje cell cytoplasmic antibodies were identified at our institution. Seven of the patients had no clinical, computed tomographic, or magnetic resonance imaging evidence of cancer but had undergone laparotomy solely because anti-Purkinje cell antibodies were found in their serum; all had high-grade adenocarcinoma. Cerebellar symptoms preceded or coincided with the initial cancer diagnosis in 15 patients and preceded the diagnosis of recurrent cancer in 4 patients. The cancers were 14 ovarian, 2 fallopian tube, 2 surface papillary, and 1 poorly differentiated metastatic adenocarcinoma in a periaortic lymph node. Two remarkable surgical observations in patients with high-grade ovarian and tubal cancers were the conspicuous lack of peritoneal implants and the small metastatic volume. A comparison of the 8 patients who had primary stage III cancer with 24 matched control patients without paraneoplastic cerebellar degeneration revealed no difference in primary tumor volume but a significantly smaller volume of metastatic tumor in the seropositive group (P = 0.05). Anti-Purkinje cell antibodies were not detected in 111 neurologically normal patients with advanced ovarian cancer. The small metastatic volume in the face of high-grade and advanced stage malignancy in seropositive patients with paraneoplastic cerebellar degeneration suggests that an immune response to the tumor (presumably cross-reactive with cerebellar cells) may impair the metastatic process. Earlier diagnosis and treatment of cancer, based on prompt serologic testing, may offer an improved neurologic and oncologic prognosis.
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PMID:Gynecologic cancer in patients with subacute cerebellar degeneration predicted by anti-Purkinje cell antibodies and limited in metastatic volume. 225 17

Gastrointestinal malignancies frequently recur with metastatic disease limited to the abdominal cavity. Due to full thickness penetration of tumor through bowel wall and spillage of tumor from lymphatic channels by surgical trauma, tumor cells are disseminated throughout the peritoneal surfaces either prior to at the time of surgical removal of the primary tumor. Diagnosis of recurrent cancer is difficult because no sensitive diagnostic test is available by which to image a small tumor volume present on peritoneal surfaces. Computerized tomography can not demonstrate small to moderate nodules. Intraperitoneal instillation of 131-1 labeled monoclonal antibody has allowed visualization of mucinous tumor on peritoneal surfaces not seen by any other radiologic test. Intraperitoneal chemotherapy has been shown to provide palliation in patients with small volume disease confined to peritoneal surfaces. Because of limited penetration of chemotherapy into large tumor nodules this treatment strategy has not been effective for bulky intraabdominal recurrent cancer. Cytoreductive surgery can make patients relatively disease free. New surgical technologies combined with postoperative intraperitoneal chemotherapy have been shown to be curative for selected patients with recurrent cystadenocarcinoma. The wider application of immediate postoperative intraperitoneal chemotherapy treatments for gastrointestinal patients in an adjuvant setting may be of value in preventing the occurrence of peritoneal carcinomatosis and in improving survival.
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PMID:Management of peritoneal carcinomatosis. 251 51

A 70-year-old woman was treated with a simple mastectomy followed by a course of 5000 rad to the breast and chemotherapy with 5-fluorouracil for breast cancer. About 15 months later, the patient died of widespread metastases. An autopsy revealed no recurrent cancer in the breast. The metastases were seen in bones (sternum, ribs and spine), pleura, spleen, uterus, ovaries, small intestine, adrenal glands, and lymph nodes (hilar, periaortic and mesenteric). Histologically, the resected tumor was a solid-tubular carcinoma with an infiltrative growth pattern. At autopsy, the tumor cells in the metastatic foci contained an abundance of lipids in the cytoplasm, while the tumor cells in the primary tumor contained small amounts of lipids.
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PMID:An autopsy case of breast carcinoma with prominent lipid-secretions in the metastatic foci. 258 75

Gastrointestinal and ovarian malignancies frequently recur with metastatic disease limited to the abdominal cavity. Due to full thickness penetration of tumor through bowel wall, spillage of tumor from lymphatic channels by surgical trauma or perforation of the tumor through the ovarian capsule, tumor cells are disseminated throughout the peritoneal surfaces either prior to or at the time of surgical removal of the primary tumor. In the past, diagnosis of recurrent cancer was difficult because no sensitive diagnostic test was available by which to image a small tumor volume present on peritoneal surfaces. Computerized tomography with intraperitoneal infusion of contrast can demonstrate tumor nodules not otherwise detectable. Intraperitoneal installation of I-131 labeled monoclonal antibody has allowed visualization of mucinous tumor on peritoneal surfaces not seen by any other radiologic test. Intraperitoneal chemotherapy has been shown to provide palliation in patients with small volume disease confined to peritoneal surfaces. Because of limited penetration of chemotherapy into large tumor nodules this treatment strategy has not been effective for bulky intraabdominal recurrent cancer. Cytoreductive surgery utilizing high voltage electrocautery and CO2 laser evaporation of tumor can make patients relatively disease free. These surgical technologies combined with postoperative intraperitoneal chemotherapy have been shown to be of benefit for selected patients with recurrent intraabdominal cancer. The wider application of these intraperitoneal chemotherapy treatments for patients in an adjuvant setting may be of value in preventing the occurrence of peritoneal carcinosis and in improving survival.
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PMID:Surgical management of peritoneal carcinosis: diagnosis, prevention and treatment. 328 30

Various modalities of treatment for recurrent cancers of the head and neck were studied and discussed, focusing especially on radical excision followed by reconstruction. Thirty-two patients with recurrent cancer of the head and neck were given this treatment over a 12-year period. Pectoralis major myocutaneous flap was most commonly used for reconstruction, while free latissimus dorsi myocutaneous flap with microneurovascular anastomosis was used for total cheek defect after surgery for cancer of the maxillary sinus. Five-year survival was 62% in cases of radical excision followed by reconstruction. Simple resection of recurrent lesions was conducted in 36 cases and the 5-year survival was also 62%. Radical neck dissection was performed in 22 cases in which cervical node metastases developed after control of the primary tumor, and the 5-year survival was 52%. On the other hand, the 5-year survival was not obtained in cases treated with radiotherapy alone in this series, while the 5-year survival was only 1% in cases treated with chemotherapy alone. It was concluded that surgery was the most reliable treatment for recurrent cancers of the head and neck, and that radical excision followed by reconstruction played an important role as salvage surgery.
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PMID:[Radical excision followed by reconstruction of recurrent cancers of the head and neck]. 338 99

Thirty patients have undergone multiple resections for non-small cell lung cancer from 1973 to July 1994, constituting 2.6% of 1,153 who had undergone pulmonary resection for such tumor. In the 22 patients for recurrent cancer, 15 resections of the ipsilateral lung and 9 of the contralateral lung were performed with no operative death. The survival rate following second resection in 22 patients was 33.8% at 3 years and 13.5% at 5 years. Survival rate was poor in patients with DNA aneuploid primary tumor and there was not a patients of 5 years survival. Three out of the 5 patients which had a diploid pattern in the primary tumor, showed an aneuploid pattern in the recurrent tumor. Long survival patients were founded only in the patients which had a diploid primary tumor. In the 8 patients for second primary lung cancer, 4 resections of the ipsilateral lung and 4 of the contralateral lung were performed, including two bronchoplastic surgery for early hilar squamous cell carcinoma. The survival rate following second resection in 8 patients was 64.2% at 5 years with good result. We concluded that an aggressive surgical approach is safe and warranted in patients with second primary lung cancer.
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PMID:[Reoperation for recurrent and second primary lung cancer]. 786 32

After polypectomy, the cut end of the polyp is usually examined by light microscopy to assess the risk of recurrent cancer. Here, we report a recurrent tumor that appeared in the colon 6 years after polypectomy, although cancer cells were not observed in hematoxylin and eosin-stained sections of the cut end of the primary polyp. Retrospectively, the primary polyp and the recurrent tumor were analyzed for mutations of the p53 gene. We detected p53 mutations in the primary polyp, even in the cut end of the polyp. The same set of two p53 mutations was detected in the recurrent tumor. These observations indicate a common origin of the primary tumor and the recurrent tumor. We conclude that it is important to analyze p53 mutations in colonic polyps, especially when the cut end of the polyp is difficult to evaluate histologically, in order to predict recurrence.
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PMID:Genetic analysis of a local recurrent tumor after colonic polypectomy. 1148 Jul 96

The clonal development of colorectal carcinoma resulting from specific mutations in certain oncogenes and/or tumor suppressor genes is a well-accepted model. It is increasingly recognized that a majority of colorectal cancers are polyclonal on the basis of molecular analysis that demonstrates cells with different mutations within a given oncogene or tumor suppressor gene in the same tumor. This polyclonal pattern may occur as a result of either clonal convergence or divergence during the many steps of oncogenesis. Further complicating this picture is the fact that metastatic lesions may arise from only one of the clonal populations within a tumor and thereby present only a partial molecular make-up of the whole tumor. There are few data available that define clonal selection or specificity of circulating tumor cells in patients undergoing curative resection of colorectal carcinoma. The purpose of this paper is to describe the clonal distribution of circulating tumor cells in four patients with multiple K-ras mutations present in the primary lesion. Patients were selected who were known to have polyclonal primary colorectal cancers resected for cure. All patients had multiple mutations present in exon one, codon 12 and/or 13, of the K-ras gene. Blood samples were drawn immediately before surgery and at 2-week to 6-month intervals postoperatively. Epithelial cells were isolated from peripheral blood mononuclear cells using Dynal Immunobeads coated with antiepithelial antibodies. DNA was extracted from these cells and analyzed for all K-ras mutations present in codons 12 and 13 of the patient's primary tumor using allele-specific polymerase chain reaction followed by Microwell Array Diagonal Gel Electrophoresis. Circulating tumor cells were identified in all four patients. However, in each case of positive circulating cells the only mutation identified was an aspartic acid mutation at codon 13. Once positive the circulating tumor cells persisted in subsequent multiple blood samples. These results provide further strength for the theory of polyclonal progression in primary colorectal cancers, although there may be specific mutational patterns that confer the ability to metastasize. The significance of this persistence of the glycine-to-aspartic acid mutation at codon 13 remains to be defined given that none of these patients has clinical evidence of recurrent cancer at the time of this report.
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PMID:K-ras mutational analysis of polyclonal colorectal cancers identifies uniclonal circulating tumor cells. 1151 May 88


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