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Metastatic Involvement (metastatic + involvement)
Selected AbstractsRole of sonographically guided fine-needle aspiration biopsy of adrenal masses in patients with lung cancerJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2004Ksenija Kocijan Abstract Purpose The aims of this retrospective study were to determine the accuracy and safety of sonographically guided fine-needle aspiration biopsy (FNAB) in evaluating enlarged adrenal glands in patients with lung cancer and to correlate the metastatic involvement of the adrenal glands with the surgical stage of the primary lung tumor. Methods During an 11-year period, 64 patients with cytologically proven lung cancer had undergone sonographically guided FNABs of an adrenal mass. The accuracy of this method was assessed on the basis of cytologic findings and the safety, on the number of complications reported after FNAB. The location of the adrenal metastasis relative to the primary tumor (ipsilateral, contralateral, or bilateral) was correlated with the surgical stage of the disease. Results FNAB results were accurate in 58 of the 64 cases (91%), and the procedure was associated with no serious complications. In 6 (9%) of the 64 patients, the FNAB specimen had been inadequate. Cytologic analysis of the aspirates revealed malignancy in 52 (90%) of the 58 patients in whom the FNAB specimen had been adequate for an accurate diagnosis. The adrenal metastases were ipsilateral in 21 patients, contralateral in 15, and bilateral in 16, for an ipsilateral-to-contralateral ratio of 1.4:1. Among patients with operable disease, an ipsilateral pattern of metastasis was present in 65%, whereas among those with inoperable disease, the ipsilateral pattern was present in only 31%. The difference between these 2 groups was statistically significant (p < 0.05). Conclusions Sonographically guided FNAB is accurate and safe for evaluating enlarged adrenal glands in patients with lung cancer. Our results also suggest that a solitary ipsilateral adrenal metastasis in a patient with resectable primary lung cancer may represent a regional extension of the disease rather than systemic spread. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 32:12,16, 2004 [source] Presence of prostate cancer metastasis correlates with lower lymph node reactivity,THE PROSTATE, Issue 16 2006Gannon Philippe Olivier Abstract BACKGROUND Several reports suggest that the dissemination of neoplastic cells and cancer progression are associated with the generation of an immunosuppressive environment. METHODS In this report, we investigated immunological effects of prostate cancer by comparing metastastic and non-metastatic pelvic lymph nodes (LNs) from 25 patients with carcinomatous involvement of LNs to the non-metastatic LNs from 26 control patients with no metastatic involvement by immunohistochemistry and histological analyses. RESULTS Our results showed a decreased abundance of CD20+ B lymphocytes (P,=,0.031), CD38+ activated lymphocytes (P,=,0.038), and CD68+ macrophages (P,<,0.001), and less evidence of follicular hyperplasia (P,=,0.014), sinus hyperplasia (P,<,0.001), and fibrosis (P=0.028) in metastatic LNs comparatively to control LNs. Finally, we observed that metastatic LNs were significantly smaller than control LNs (P,=,0.005). CONCLUSIONS Our results suggest that the development of prostate cancer LN metastasis is accompanied with smaller LN size and decreased LN reactivity suggesting the development of an immununosuppressive microenvironment. © 2006 Wiley-Liss, Inc. [source] Retrospective review of mitomycin C use as third-line chemotherapy in metastatic colorectal cancerASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2008Wei CHUA Abstract The aim of this review was to determine the therapeutic value of the combination of mitomycin C with either infusional 5-fluorouracil or oral capecitabine in metastatic colorectal cancer when used as third-line treatment or beyond in the setting of routine clinical practice. We retrospectively reviewed 18 patients with advanced colorectal cancer who received this combination at our institution after the failure of two lines of prior treatment. All the patients were assessable for toxicity and survival and 14 for tumor response. The median age of the patients was 61 (range 39,78). Of these, 72% were male and 78% had Eastern Cooperative Oncology Group performance status 0 or 1. Eighty nine percent of the patients had metastatic involvement of the liver and five patients had at least three sites of metastatic involvement. All patients had received at least two lines of chemotherapy and had progressed on an oxaliplatin-containing regimen. Most of the patients had previously received an irinotecan-containing regimen, and a third had received prior biological agents. Overall, none of the patients achieved either complete or partial responses. Two patients (11%) achieved stable disease and 12 patients (67%) had progressive disease. The median progression-free survival was 2.7 months (range 0.5,8.8) and the median overall survival was 5.4 months (range 1.3,31.2). This chemotherapy regimen was well tolerated with an acceptable toxicity profile. The results of our review confirm the low efficacy of combination mitomycin C in heavily pretreated Australian patients with advanced colorectal cancer. This review confirms that it has no role after two lines of modern combination chemotherapy regimens and recommends that focus should be placed on investigating newer agents for good performance status patients progressing after these treatments. [source] Characteristics of sentinel lymph nodes' metastatic involvement in early stage of vulvar cancerAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009Jaroslav KLÁT Background:, Nodal involvement is one of the most significant prognostic factors in early-stage vulvar cancer. Aims:, To determine the diagnostic accuracy of sentinel lymph node (SLN) detection in early-stage vulvar cancer and to describe the characteristics of metastatic lymph node involvement. Methods:, Of 23 women with early-stage squamous cell vulvar cancer included in the study, five had lateral lesions and 18 had midline lesions. SLN detection was performed by using a radioactive tracer and blue dye, followed by radical vulvectomy or radical wide excision with uni/bilateral inguinofemoral lymphadenectomy, depending on tumour size and localization. SLNs were subsequently examined with haematoxylin,eosin and immunohistochemistry. Results:, The SLN detection was successful in all 23 women (100%) and in 38 of 41 groins (92.3%) tested. The total number of SLNs was 67, with an average of 1.76 per groin. In total, 20 positive SLNs were detected in 14 of 23 patients. From a total of 20 positive SLNs, micrometastases were found in five SLNs and isolated tumour cells in one SLN. We experienced one case with a false negativity of SLN. Sensitivity, negative predictive value, accuracy and false negativity of SLN detection were 93.3%, 88.8%, 95.6% and 7.1% respectively. Conclusion:, The SLN biopsy performed by an experienced team is a feasible method, with high accuracy in patients with early-stage vulvar cancer. Prognostic value of micrometastases should be confirmed in further studies. [source] Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2006Y. Kanemitsu Background: The aim of this study was to assess the impact of inferior mesenteric artery (IMA) root nodal dissection before high ligation of the artery on survival in patients with sigmoid colon or rectal cancer. Methods: Data on 1188 consecutive patients who underwent resection for sigmoid colon or rectal cancer, with high ligation of the IMA, were identified from a prospective database (April 1965 to December 1999). Survival of patients with involvement of nodes along the IMA proximal to the origin of the left colic artery (root nodes, station 253) through the bifurcation of the superior rectal artery (trunk nodes, station 252) was determined. Results: Twenty patients (1·7 per cent) had metastatic involvement of station 253 lymph nodes and 99 (8·3 per cent) had metastases to station 252. The 5- and 10-year survival rates of patients with metastases to station 253 were 40 and 21 per cent, and those for patients with metastases to station 252 were 50 and 35 per cent, respectively. Conclusion: High ligation of the IMA allows curative resection and long-term survival in patients with cancer of the sigmoid colon or rectum and nodal metastases at the origin of the IMA. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seedingBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2004S. González-Moreno Background: Traditionally epithelial malignancies of the appendix with or without carcinomatosis have been treated by right hemicolectomy. Recent accumulation of a large number of patients with this disease has enabled a re-evaluation of this surgical judgement. Methods: Clinical data on 501 patients with epithelial malignancy of the appendix were collected prospectively. All patients had peritoneal seeding at the time of referral and were treated by cytoreductive surgery and perioperative intraperitoneal chemotherapy. The main independent variable for statistical analysis was the surgical procedure used to resect the primary cancer (appendicectomy alone versus right hemicolectomy). Nineteen other clinical and pathological variables were considered as control variables. The endpoint for all analyses was survival. Results: Median follow-up after the initial diagnosis was 4 years. The rate of regional lymph node positivity was 5·0 per cent. When the incidence of lymph node metastasis was determined by histological type, it was statistically significantly higher in intestinal (66·7 per cent) than in mucinous (4·2 per cent) tumours (P < 0·001). The presence of lymph node metastases had no influence on prognosis (P = 0·155). The surgical procedure (appendicectomy alone versus right hemicolectomy) had an influence on patient survival by univariate analysis (P < 0·001), but not by multivariate analysis (P = 0·258). Conclusion: Right hemicolectomy does not confer a survival advantage in patients with mucinous appendiceal tumours with peritoneal seeding. These data suggest that right hemicolectomy should be avoided unless metastatic involvement of the appendiceal or distal ileocolic lymph nodes is documented by biopsy, or the resection margin is inadequate. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Axillary disease recurrence after sentinel lymph node dissection for breast carcinomaCANCER, Issue 9 2005Karen K. Swenson M.S., R.N. Abstract BACKGROUND Surgical recommendation for early-stage breast carcinoma includes removal of the primary breast tumor and evaluation of the axillary lymph nodes on the ipsilateral side. Sentinel lymph node dissection (SLND) is increasingly being used to evaluate axillary lymph nodes in clinically lymph node negative patients as an alternative to axillary lymph node dissection (ALND). Results from SLND are highly predictive of metastatic involvement in the axilla, and are associated with fewer side effects. However, the greatest concern with SLND alone is the potential for a higher rate of axillary lymph node recurrence. The purpose of the current study was to review data collected on 700 consecutive patients with early-stage breast carcinoma who underwent SLND without concomitant ALND. METHODS A retrospective study was conducted using the oncology registry at Park Nicollet Health Services (Minneapolis, MN). Consecutive breast carcinoma cases with SLND only for axillary surgery, from January 28, 1999 to December 31, 2003, were included in the study. During this period, 700 patients with breast carcinoma were identified who had SLND alone. Fifty-two patients were excluded from the analysis because they had ductal carcinoma in situ. RESULTS With a median follow-up of 33 months (range, 2-73 mos), axillary lymph node recurrence occurred in 4 of 647 (0.62%) patients overall. In these 4 patients, the axillary lymph node recurrences were isolated to the axillary lymph nodes and amenable to surgery. CONCLUSIONS Data from the current study showed that axillary lymph node recurrence after SLND occurred very infrequently in early-stage breast carcinoma, and these results were comparable to other studies. Cancer 2005. © 2005 American Cancer Society. [source] | ||||||||||