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)

Allelic loss of chromosome 17p with a mutated p53 gene on the remaining allele has been observed in various kinds of human cancers. To examine the significance of allelic loss of chromosome 17p in human urothelial cancer with special attention to the clinicopathological features, 49 tumors with various stages and grades from 43 cases (35 bladder cancers and 8 renal pelvic or ureteral cancers) were examined for loss of heterozygosity using 5 polymorphic probes on chromosome 17p. Thirty-seven cases were informative, and allelic loss of chromosome 17p was observed in 15 (41%) of them. In bladder cancers, the loss of 17p was observed with significantly higher frequency (p < 0.01) in cases with invasive (> or = pT2) tumors (7/10, 70%) than in cases with superficial (pTa or pT1) tumors (4/21, 19%). In renal pelvic or ureteral cancers, none of 2 superficial tumors and all of 4 invasive tumors showed the allelic loss. As to tumor grade, the allelic loss was observed in 1/9 (11%) for grade 1 cases, 6/18 (33%) for grade 2 cases, and 8/10 (80%) grade 3 cases (grade 1 versus 3, p < 0.01; grade 2 versus 3, p < 0.05). On the other hand, examination of clinical features, such as primary tumor site, tumor multiplicity or previous history of urothelial cancer did not significantly influence the frequency of the allelic loss. Our results suggest that the allelic loss of chromosome 17p is strongly associated with invasive phenotype in urothelial cancer. The results further indicate that the 17p deletion may represent a new genetic marker of malignant potentials in urothelial cancers.
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PMID:Allelic loss of chromosome 17p in urothelial cancer: strong association with invasive phenotype. 143 75

353 patients with stages pTis, pT1-2, pN0-1, cM0 breast cancer have been treated consecutively by breast conserving therapy in a prospective, nonrandomized study at the University Hospital Basel and the Women's Clinic Rheinfelden/Baden/Germany. The median age was 47 years, the median follow-up time 67 months, and 4% only of this collective were lost to follow-up after a median time of 42 months. In 79% of the cases the tumor was excised totally, while in 19% the resection margins were positive and in 2% only the margins were not available for histological judgement. The rate of local failure reached 8% with a median time interval of 53 months. 116 patients showed postactinic induration in the primary tumor region. 73 of these were given additional diagnostic examination: The postactinic induration was judget clinically suspicious in 51 cases and clinically nonsuspicious of local failure in 22 cases. All 73 patients received additional examination by mammography and biopsy. By comparison with the histological results the clinical results were correct in 59% and false in 41%, while the mammographic results were correct in 82% and false in 18% of the cases.
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PMID:[Diagnostic problems in local recurrence after breast saving treatment]. 152 25

To ascertain the risk of lymph node metastasis (LNM) from early rectal cancer, the authors retrospectively analyzed 154 patients with pT1 or pT2 rectal cancer treated by radical resection. Gross and microscopic pathologic characteristics of the primary tumor were examined as predictors of LNM. Comparisons were done by Fisher's test; significance was defined as a P value of less than 0.05. The incidence of LNM for T1 and T2 tumors was 3 of 26 (12%) and 28 of 128 (22%), respectively. LNM occurred significantly less often in well-differentiated cancers (0 of 12.0%). The incidence of LNM for T1/T2 tumors without lymphatic vessel invasion (LVI) or blood vessel invasion (BVI) (20 of 119, 17%) was significantly less than that for T1/T2 tumors with LVI or BVI (10 of 32, 31%). None of the T1 tumors without LVI or BVI had LNM. There was a trend toward decreased LNM for sessile nonulcerated tumors compared with nonpolypoid, exophytic, or ulcerated lesions (P = 0.06). Tumor size and colloid histologic characteristics were not significant predictive features for LNM. The data suggest that local excision alone is adequate for well-differentiated or moderately differentiated T1 rectal cancer in the absence of LVI or BVI and for well-differentiated T2 tumors. Radical resection or local excision combined with pelvic radiation therapy may be more appropriate for the remainder of early cancers.
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PMID:Variables correlated with the risk of lymph node metastasis in early rectal cancer. 172 63

Prognosis of 141 women with pT1 breast cancer from a defined urban area was investigated. Only one of the 47 women with a primary tumor diameter less than or equal to 10 mm in diameter (pT1a or pT1b) died from breast cancer within 5 years after the diagnosis. The 5-year survival rate corrected for intercurrent deaths of the women with pT1c cancer (from 11 to 20 mm in diameter, n = 94) was 83%; 96% in pT1cN0 and 62% in pT1cN+ cancer respectively (p less than 0.0001). In a multivariate analysis axillary nodal status and S-phase fraction determined by flow cytometry were independent prognostic factors. The excellent survival of women with pT1a or pT1b breast cancer, and women with pT1cN0 breast cancer with no axillary nodal metastases, does not support the policy of giving adjuvant treatment to all women with breast cancer.
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PMID:Prognosis of breast cancer with small primary tumor (pT1). 176 68

For the optimisation of the therapy for small cell bronchial carcinomas (SCLC), surgery is used to eliminate the primary tumor and its regional lymph nodes and chemo- and radiotherapy for the general treatment of micrometastasis. After patho-histological examination of the operation specimen, randomization for two arms is performed for a standard chemotherapy (CAV) or a sequential chemotherapy using three different drug combinations. Thereafter all disease-free patients receive prophylactic cranial irradiation (PCI). Preliminary evaluations in December 1987, of 112 patients from 19 cooperating departments show that the survival rate projected for 2 yr of 43 patients at stage pT1-3 N0 M0 is 76%, of 43 patients at stage pT1-3 N1 M0 it is 63% and of 26 patients at stage pT1-3 N2 M0 it is 38%.
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PMID:The role of ifosfamide and cyclophosphamide in the multi-modality treatment after surgery for cure for small-cell bronchial carcinomas (SCLC). 254 79

Since the initiation of a 'surveillance' therapy the role of retroperitoneal lymph node dissection as standard treatment in the management of patients with clinical stage I nonseminomatous germ cell testicular tumor (NSGCTT) continues to be debated. Noninvasive staging techniques (CT scans, lymphography, ultrasound and serologic tumor markers) help to identify more accurately patients with distant metastases. 'Surveillance' alone as a possible treatment modality following orchidectomy in selected patients with clinical stage I NSGCTT requires cooperative and reliable patients. In our urological clinic surveillance alone is not justified any longer because of a noncompliance rate of 10% and a relapse rate of 30%, although the early detection of small-volume metastatic disease, lymphadenectomy and polychemotherapy result in a high rate of cure. Any patient should be excluded from 'wait and see' protocols if metastatic prognostic factors such as vascular infiltration of the primary tumor or local tumor stage greater than pT1 are identified.
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PMID:[Position of surveillance therapy in clinical stage I testicular non-seminoma]. 283 54

A retrospective analysis of 252 patients with renal cell carcinoma was performed with the tumor, nodes and metastasis system of cancer staging. Each patient received a clinical and a pathological classification. Patient survival was calculated for each pT stage. All patients with stage pT1 disease (100 per cent) were alive at 5 years, as were 91 per cent of those with stage pT2 tumors. Higher T stages showed poorer survival; 58 per cent of the patients with stage pT3 and only 25 per cent with stage pT4 tumors were alive at 5 years. Invasion into the inferior vena cava (pT3c) had an adverse effect on survival, which was statistically significant compared to patients in the pT3a and pT3b subgroups. The type of surgical procedure performed had no influence on ultimate survival, nor did the use of adjuvant radiation therapy. The tumor, nodes and metastasis system clearly documents that the survival of patients with renal cell carcinoma depends on the local extent of the primary tumor, determined at the time of surgical exploration.
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PMID:Validation of the tumor, nodes and metastasis classification of renal cell carcinoma. 403 39

Between 1979 and 1986, 74 patients with hypopharyngeal carcinomas were operated using transoral laser microsurgery by the first author. 32 of the patients were subdivided into 5 subgroups and considered separately because of pretreatment for head and neck tumors, simultaneous multiple tumors etc. (excluding criterias). Survival times were not significantly prolonged and lasted 1-27 months (median, 11 months), but the quality of life was improved due to preservation or restoration of natural laryngopharyngeal functions. Forty-two patients were operated with curative intention. This group primarily underwent transoral laser microsurgery, aiming at complete locoregional tumor resection with function preservation (pT1, 5; pT2, 31; pT3, 4; pT4, 2). In 29 patients 31 necks were operated, mostly as a regionally limited functional neck dissection (or "selective" neck dissection). In 90% of the cases neck metastases (pN+) were found, mostly in levels II and III; pN1, 6; pN2a, 1; pN2b, 18; pN2c, 1. Altogether, stages III and IV were found in 71.4% of the patients. A temporary tracheotomy was required in four patients. There was no secondary laryngectomy, even though it was indicated in one case. Post-treatment oncological followup (median observation time, 104 months) demonstrated loco-regional recurrences (n = 1), late or recurrent metastases (n = 4), persisting metastases in the neck with cerebral metastasis (n = 1), distant metastases (n = 4), secondary tumors (n = 9, 5 of which occurred in the head and neck). Through March 1993, 24 patients (57%) have died. Causes were TNM-related (7), second primary tumor with or without distant metastases (8) and intercurrent disease with no evidence of disease (9). Within 5 years 17% of the patients died of TNM-related tumors, 9.5% due to a second primary with or without distant metastases, as well as 9.5% with intercurrent disease. The 5-year overall survival rate was 64% and was 83% (adjusted survival rate) if only TNM-related deaths were considered.
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PMID:[Therapy of hypopharyngeal cancer. Part IV: Long-term results of transoral laser microsurgery of hypopharyngeal cancer]. 775 93

The aim of this study was to evaluate the expression of E-cadherin as a potential marker for the prognosis of thyroid carcinomas. In normal thyroid (n = 8), the expression of E-cadherin messenger ribonucleic acid levels was uniformly high and seemed to be restricted to thyrocytes. Steady-state messenger ribonucleic acid levels and immunostaining were both completely lost in undifferentiated thyroid carcinomas (n = 7) and were variably reduced in differentiated thyroid carcinomas (n = 44). In a follow-up study during a mean of 4.5 +/- 1.4 yr, E-cadherin messenger ribonucleic acid and immunohistochemical expression were compared with the initial clinicopathological parameters and with locoregional recurrence and the development of nodal or distant metastases in differentiated thyroid carcinomas. Immunohistochemical expression of E-cadherin was greatly reduced with the progression to primary tumor stage 4 (pT4) tumors. In parallel, patients with pT4 tumors had a higher rate of locoregional tumor recurrence and distant metastasis than did the group of patients with pT1-3 tumors. In 5 of 29 patients with pT4 tumors, positive E-cadherin staining of more than 30% of the cells was detected. None of these patients showed signs of a regional recurrence or distant metastases during an observation period of 4.3 +/- 1.1 yr. In 13 patients with E-cadherin-positive tumors, none developed new distant metastases which was in contrast to 7 of the group of 31 patients with less than 30% E-cadherin-positive cells. Thus, E-cadherin expression seems to be associated with the dedifferentiation, progression, and metastatic spread of thyroid carcinomas and may be a useful marker for the prognosis of these tumors.
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PMID:Clinical significance of E-cadherin as a prognostic marker in thyroid carcinomas. 760 73

From November 1984 to April 1989, 122 patients with clinical T2-4a Nx-2 M0 transitional cell carcinoma of the bladder were entered in a prospective randomized trial to compare survival between a control group of 60 patients treated only with radical cystectomy (arm A) and a group of 62 patients treated with 3 cycles of 100 mg./m.2 neoadjuvant cisplatin before radical cystectomy (arm B). Secondary objectives of the trial were comparison of the disease-free interval and time to death, significance of response of the primary tumor to cisplatin, pattern of relapse and toxicity. As of April 1993 after a median followup of 78.2 months (range 48 to 101) no difference in survival between the control patients and those who received neoadjuvant cisplatin has been observed. The overall direct survival is 37.3% for arm A and 35.5% for arm B. The survival rate of the 109 patients who complied with the protocol is 38.2% for 55 patients of the control group and 40.7% for 54 patients of the cisplatin group. Survival rates of patients theoretically rendered free of disease by radical cystectomy (complete response pT0-4a, pN0-2, M0) is 43.7% for 40 control patients and 47.8% for 41 cisplatin treated patients. The time to relapse in complete response patients was significantly longer (p = 0.0298) for those who received cisplatin (arm A 13.1 months versus arm B 30.3 months). The time to death (cause specific) did not differ significantly between both groups overall (p = 0.1349) but it was significantly different between controls and responders (p = 0.0501). Preoperative cisplatin downstaged the primary tumor in 19 patients (33.9%), of whom 11 (19.6%) had no tumor in the cystectomy specimen (pT0) and 8 (14.3%) had superficial tumor (pTis pTa pT1). In 6 patients (9.7%) disease progressed during chemotherapy. The survival of the responders was significantly better than that of nonresponders (p = 0.0142), with specific death rate of 26.3% and 62.5%, respectively, and a median time to death of 43 months for responders and 30.5 months for nonresponders. Patients without nodal involvement (pN0) or with only 1 micrometastasis (pN1) fared significantly better (p = 0.0001) than those with major node invasion (pN2-4), irrespective of the treatment received. The survival rate is 48.6% for patients with pN0 disease, 37.5% for pN1 and 5% for pN2-4. Toxicity of cisplatin was minimal and there were no differences in perioperative morbidity between the arms.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Neoadjuvant cisplatin chemotherapy before radical cystectomy in invasive transitional cell carcinoma of the bladder: a prospective randomized phase III study. 785 84


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