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)

Metastatic tumor to the lungs is one of the most important factors in the poor prognosis of primary osteosarcoma of bone. Until recently, pulmonary resection alone was the only therapeutic method available to salvage these patients. Previous investigators have reviewed a number of clinical and pathologic parameters which may possibly relate to the prognosis of osteosarcoma and the occurrence of pulmonary metastases. The pathologic features of these latter lesions have received little attention other than to state that they generally are less differentiated than the primary tumor. A review of multiple pulmonary nodules resected from 15 patients has demonstrated that 66% of all lesions were essentially identical to the primary tumor. The 5-year survival from the original amputation was 33% in this series; however, it was not possible to prognosticate a favorable outcome from the metastasis, a similar type of observation which has been made by others in relation to the primary osteosarcoma.
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PMID:Metastatic osteosarcoma to lung: a clinicopathologic study of surgical biopsies and resections. 27 Oct 38

Metastases of osteosarcomas do not grow according to a simple exponential function, but rather according to a type of Gompertz' function where flattening with a tendency toward plateau formation sets in after a certain time. This deviation from an exponential growth type corresponds to a substantial increase in the initial tumor size--doubling time. The metastasis doubles in the period after its transfer faster than when it first becomes visible in an x-ray. Another important conclusion resulting from the use of the Gompertz model is the assumption of a tumor-specific maximum volume which cannot be exceeded over a period of infinite growth. For lung metastases of osteosarcoma this volume amounts to approximately 120 cm3. The critical volume which kills the host is, at 70 to 80 cm3, relatively close to this theoretical growth limit (only approximately one cell division below this limit). If a metastasis develops from a single cell, the number of divisions up to this point is approximately 46. Of these, 38 lie within the growth zone which is not visible via x-ray. Since cell-cycle specific agents (for example Vincristin and Methotrexate) have the greatest effect against rapidly proliferating tumors, these drugs (for example alkylantic drugs) are especially effective in the case of slowly proliferating neoplasms. Therefore, use of these drugs should be favored when the metastasis is visible in the x-ray. Since occasionally, particular when the primary tumor is still relatively small, metastasization may not necessarily have already taken place, radical operation of the primary tumor should be carried out as soon as possible. A preliminary irradiation of the primary tumor cannot prevent metastasization with certainty. Therefore delayed amputation should be avoided.
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PMID:[On the growth characteristics of human osseous sarcoma metastases: mathematical calculations and clinical consequences (author's transl)]. 27 86

Levels of alkaline phosphatase were measured in the primary tumor of 26 patients with osteosarcoma. One of seven patients with a tissue alkaline phosphatase level less than 0.6 microM/min/mg developed pulmonary metastases. In contrast, 16 or 17 patients with a tissue alkaline phosphatase level greater than 0.6 microM/min/mg developed pulmonary metastases. It thus appears that tissue alkaline phosphatase levels of primary osteosarcomas are strongly correlated with prognosis (p less than .01).
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PMID:Alkaline phosphatase levels in osteosarcoma tissue are related to prognosis. 29 11

In conclusion, then, we would answer the seven questions raised earlier concerning transfer factor as follows: Certianly, as shown by clinical results, it does exist. It does have a definite immunologic effect in humans, boosting cell-mediated immunity, as shown by a rise in the level of active T cells. Its clinical effects have been demonstrated repeatedly, and it should become useful in still other clinical situations as further research provides more effective therapeutic modalities. Transfer factor from selected donors appears to provide prophylaxis against metastasis when administered to osteosarcoma patients with no clinically evident metastases at the time of surgical removal of the primary tumor; whether this treatment is superior to chemotherapeutic prophylaxis is conjectural and controversial. Its mechanism of action has not been demonstrated as yet, although many theories exist. The best evidence is that the effects are both specific and nonspecific. It appears to be produced by T lymphocytes. The exact nature of the substance we call "transfer factor" remains to be elucidated. Further research should provide more conclusive answers to these questions.
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PMID:Dialyzable transfer factor in the treatment of human osteosarcoma: an analytic review. 79 87

The role of radiotherapy and adjuvant chemotherapy in the primary treatment of osteogenic sarcomas and of Ewing's sarcoma is reviewed. In osteosarcoma radiotherapy can take the form of prophylactic total irradiation of the lung, but preoperative irradiation of the primary tumor has not proved successful. On the other hand, in Ewing's sarcoma primary and local irradiation is the therapy of choice, and is followed by adjuvant polychemotherapy over a long period.
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PMID:[The role of radiotherapy in the treatment of malignant bone tumors (author's transl)]. 106 Sep 7

A transplantable murine osteosarcoma is described. Following transplantation into a syngeneic mouse the tumor grows rapidly and kills the mouse with pulmonary metastases simulating human osteosarcoma. A cell-mediated antibody response is evoked in the host mouse as demonstrated by in vivo and in vitro tests. The number of pulmonary metastases may be decreased with adjunctive immunotherapy following excision of the primary tumor. Immunotherapeutic materials include BCG and isologous cells treated with Vibrio cholerae neuraminidase.
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PMID:Immunological studies in murine osteosarcoma. Immunogenicity, growth kinetics, and immunotherapy. 106 29

The aim of this study was to evaluate the effect of chemotherapy on osteosarcoma by comparing the histologic pattern of primary tumors with that of their metastases. Therefore the primary tumors and metastases in 11 patients were macroscopically and histologically classified according to the Enneking and Broder systems as well as our own method. Three of 11 patients developed metastases with a less malignant pattern, 8 patients developed metastases which were as malignant as the primary tumor. The chemotherapeutics used had either an insubstantial effect or none at all on the differentiation of immature tumorous structures in the metastases and treatment did not lead to the expected improvement. Only the patients in whom, according to our own system, the primary tumors were classified as less malignant, are still alive.
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PMID:The effect of chemotherapy on osteosarcoma. 130 83

A malignant stromal tumor of the testis with an osteosarcoma component and five of its metastases mainly containing osteosarcoma have been analyzed for RB1 and TP53 abnormalities. Whereas in the primary tumor and in some of the metastases loss of heterozygosity could not be detected for RB1 or for the 17p13 region in which TP53 is located, other metastases showed such losses of heterozygosity. By polymerase chain reaction analysis an 18-base pair deletion from exon 5 of the TP53 gene was found in a small proportion of primary tumor cells and in one of the metastases, but not in the other metastases. Therefore, in this case neither RB1 nor TP53 seems to play an essential role in the initiation of osteosarcoma.
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PMID:Analysis of a metastasizing testicular mixed gonadal stromal tumor with osteosarcoma components suggests that a malignant tumor with the histology of osteosarcoma may develop without primary involvement of RB1 and TP53. 142 18

From September 1986 to December 1989, 26 selected patients with high-grade osteosarcoma of the extremities metastatic at presentation were treated with primary chemotherapy (high doses of methotrexate, -cisplatinum and adriamycin) followed by surgery. Twenty-one cases underwent resections of the primary and metastatic tumor at the same time; owing to the disappearance of lung metastases after preoperative chemotherapy in 3 cases, only the primary tumor was operated on. Due to progression of the disease in 2 patients, no surgery was performed. Histologic examination of the resected specimen was performed to evaluate the percentage of necrosis produced by chemotherapy on the primary and metastatic tumor. After surgery, the patients received further chemotherapy with the same drugs used preoperatively plus ifosfamide and VP-16. The histologic response of the primary tumor was good (> 90% tumor necrosis) in 25% of the cases; in the resected metastatic nodules, 23% had good responses. A discrepancy between the histologic response of the primary and secondary tumor was observed in only 15% of the cases. These results seem to confirm the validity of the strategy (widely used today in the neoadjuvant treatment of non-metastatic osteosarcoma) of changing the postoperative treatment when the histologic response of the primary tumor is poor. At an average follow-up of 3.5 years, only 6 patients remained disease-free; 19 patients relapsed and 1 patient died for adriamycin cardiotoxicity. Of the 19 relapsed patients, 16 died and 3 are still alive but with uncontrolled disease. These results are much worse than those obtained in 144 cases of non-metastatic osteosarcoma of the extremities treated in the same period with the same preoperative chemotherapy (77% with good response in the primary tumor and 78% with continuous disease-free survival). The data suggest that a very effective neoadjuvant chemotherapy for nonmetastatic osteosarcoma of the extremities gives disappointing results in osteosarcoma of the extremities which is metastatic at presentation.
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PMID:Osteosarcoma of the extremity metastatic at presentation: results achieved in 26 patients treated with combined therapy (primary chemotherapy followed by simultaneous resection of the primary and metastatic lesions). 144 Sep 45

Surgical and chemotherapeutic effects on pulmonary metastatic disease were evaluated in the MGH-OGS murine osteosarcoma. The tumor responded to three sequential injections of doxorubicin with prolonged growth delay but cisplatin administration (although given in doses sufficient to cause weight loss and significant mortality) was not effective in controlling local disease progression. Using a protocol with three injections of doxorubicin (0.006 mg/g of body weight), it was observed that disease-free survival was enhanced when one of the three doses of doxorubicin was given at the time of surgery (perioperatively). By marginally resecting the primary tumor and permitting its regrowth, a model was developed with recurrent primary and metastatic disease present simultaneously. It was observed in this model that amputation or resection of the recurrent primary lesion resulted in pulmonary metastatic growth acceleration. Using this recurrent primary tumor model, doxorubicin's effect on pulmonary metastatic lesions was enhanced when the drug was given at the time of amputation.
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PMID:Chemotherapy and surgery in a murine osteosarcoma. 150 Sep 84


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