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Results for “neoplasm micrometastasis”

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PubMed2026

Characterization of small intestinal neuroendocrine tumorlets.

Small intestine neuroendocrine tumors (SI-NETs) frequently present as multifocal primaries. We commonly observe microscopic lesions in the superficial layer of the small intestine of SI-NET patients. We aimed to define them as small intestinal neuroendocrine tumorlets (SINTs) and explore their clinical and biological significance. Twenty multifocal and twenty unifocal SI-NETs patients who received resection at a single institution were retrospectively reviewed. Four hundred and forty six archived pathological slides were examined for microscopic lesions located in the lamina propria, muscularis mucosa, and superficial submucosa. Clinicopathological associations and progression-free survival were analyzed. Previously published genomic data were re-analyzed. SINTs were identified in 50% of multifocal and 30% of unifocal SI-NET patients. Median SINT size was 95 μm, with a median distance of 2.2 mm from the nearest mass. Compared to the 'true unifocal' group (unifocal without SINT), the 'multifocal-spectrum' group (multifocal or unifocal with SINT) had higher BMI (median: 27.6 vs 22.8, P = 0.0060), higher rates of perineural invasion (OR: 5.5, P = 0.044), larger mesenteric mass (median: 2.6 vs 1.6 cm, P = 0.034), and more advanced pT stage (pT3 or pT4, OR: 7.2, P = 0.018). Genomic re-analysis suggested that 13% of cells in multifocal primary tumors could share clonal origins, possibly indicating clonal spread via SINTs. SINTs may serve as a new biomarker for multifocal spectrum with local aggressiveness. The actual frequency of multifocal SI-NET may be higher than currently recognized in clinical practice. Further studies are needed to validate their prognostic and biological significance.

Humans↗
PubMed1979

[High-dosage gestagen treatment in the therapy of advanced breast cancer].

The results obtained with a new hormonal treatment schedule involving the administration of medroxyprogesterone acetate in single and total doses never before used in the treatment of advanced breast cancer are reported. The results concern 100 patients, 13 of which in premenopause and 87 in postmenopause stage. 79 patients were treated with a single daily dose of 1500 mg i.m. for 30 days, subdivided into 2 equal doses administered at intervals of 12 hours, while 21 patients were treated with a dose of 2000 mg/day using the same modalities. In the 13 premenopausal patients, complete or partial objective remission was observed in 12/13 (92%) of cases, while the disease advanced in one of the patients (8%). Of the 87 postmenopausal patients, complete or partial objective remission was observed in 40/87 (46%) of cases, minimal remission in 9/87 (10%), while 18/87 (21%) remained stationary. The disease advanced in 20/87 (23%) of patients. In patients where metastasis mainly affected the bones and soft tissues complete or partial remission occurred in 41/52 (79%) of cases. Those where visceral metastasis was prevalent showed remission in 3/33 (9%) of cases. Median duration of remission was 6 months (range: 3--27). A significant reduction of pain was noticed in 68/74 (92%) of cases, of dyspnea in 20/25 (80%), of anorexia in 45/53 (85%), of asthenia in 49/70 (70%) and of restriction of movement in 24/39 (62%). On the basis of the present results, treatment with massive doses of medroxyprogesterone acetate should be considered: a) as first therapeutic measure in the treatment of postmenopausal patients with prevalent lesions in soft tissues and bones; b) as a subject of a particular study in premenopausal patients with breast cancer in an advanced stage, and c) as a possible alternative to polychemotherapy in the treatment of micrometastasis following mastectomy.

Breast Neoplasms↗
PubMed1978

In vivo monitoring of the death rate of artificial murine pulmonary micrometastases.

A system is described for direct monitoring of the death rate of artificial murine pulmonary microscopic metastases in vivo. Metastatic fibrosarcoma cells or benign connective tissue cells labeled with [125I]iododeoxyuridine were injected i.v. Comparison of the long-term radioactive decay rate of these two cell types in the lung permitted identification of the portion of the decay curve reflecting the initial period of micrometastasis development and growth. About 5% of the injected tumor cells were retained in the lung in micrometastasis, and their average death rate could be monitored by loss of radioactivity from the lung. Systemic methotrexate (75.0 mg/kg) was administered as a single dose 80 hr after injection of tumor cells at a time when micrometastases had not yet become vascularized. This treatment killed about 60% of the micrometases and suppressed the appearance of gross metastases at 14 days.

Animals↗
PubMed1978

Specific immunotherapy of established visceral micrometastases by BCG-tumor cell vaccine alone or as an adjunct to surgery.

A vaccine of Bacillus Calmette-Guérin (BCG) admixed with tumor cells induced systemic immunity and had a therapeutic effect on subclinical, disseminated micrometastases. Inbred strain 2 guinea pigs given intravenous injections of either 10(4), 10(5) or 10(6) syngeneic L10 hepatocarcinoma cells were vaccinated after metastatic foci were established in the lung parenchyma. The studies demonstrate that under defined conditions of vaccine preparation and regimen, nontumorigenic preparations of BCG and tumor cells can cure the majority of animals of otherwise lethal visceral metastases. Histopathologically it was determined that immunization with these vaccines prevented the progressive growth of pulmonary micrometastatic foci approximately 0.1 mm in diameter. However, in this micrometastasis therapy model, the number of metastatic tumor foci is a major limitation in the efficacy of vaccine therapy. No protection against L10 tumor was achieved when antigenically distinct but syngeneic L1 hepatocarcinoma was used in the vaccine, suggesting that this is a tumor-specific immunotherapeutic procedure. This BCG-L10 tumor vaccine was also effective in curing guinea pigs of minimal disseminated tumor burden when administered after surgery of an established skin tumor and draining lymph node.

Animals↗
PubMed1979

[Behavior of phosphoisomerase and lactate dehydrogenase in pediatric oncological pathology].

Two glycolytic enzymes, PHI and LDH, have been evaluated in 18 children affected by leukemia or solid tumors: 11 patients had just initiated therapy, 3 patients were about to initiate therapy, while 4 patients were out of therapy. The analysis of the data obtained has shown a good correlation with the course of the disease: we have found values above the normal range in patients with a favorable course of the disease (bone marrow relapse or CNS involvement in leukemic children; relapse or metastasis in solid tumors) almost always before it was possible to demonstrate by clinical and laboratory studies the inhanchement of tumoral cells growth. This was true in all patients except two children affected by neuroblastoma, who were in a favorable immunological status (presence in the serum of free specific antibodies), and who were out of therapy. In these patients the abnormal high values of PHI were interpretated as an index of necrotic phenomena of micrometastasis of tumor cells induced by specific committed T-lymphocytes. Values of PHI and LDH in the normal range were found in patients whose disease demonstrated a favorable course. The AA. suggest the introduction of these enzymatic parameters which may be a useful index of the efficacy of the chemotherapy in the follow-up of oncologic patients.

Child↗