• Title/Summary/Keyword: Metastatic lymph node

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Improved Survival of a Patient with Gastric and Other Multiple Metastases from Ovarian Cancer by Multimodal Treatment: A Case Report

  • Hwangbo, Seonmi;Kwon, Oh Kyoung;Chung, Ho Young;Yu, Wansik
    • Journal of Gastric Cancer
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    • v.15 no.3
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    • pp.218-221
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    • 2015
  • Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

Cell-based Immunotherapy for Colorectal Cancer with Cytokine-induced Killer Cells

  • Ji Sung Kim;Yong Guk Kim;Eun Jae Park;Boyeong Kim;Hong Kyung Lee;Jin Tae Hong;Youngsoo Kim;Sang-Bae Han
    • IMMUNE NETWORK
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    • v.16 no.2
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    • pp.99-108
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    • 2016
  • Colorectal cancer is the third leading cancer worldwide. Although incidence and mortality of colorectal cancer are gradually decreasing in the US, patients with metastatic colorectal cancer have poor prognosis with an estimated 5-year survival rate of less than 10%. Over the past decade, advances in combination chemotherapy regimens for colorectal cancer have led to significant improvement in progression-free and overall survival. However, patients with metastatic disease gain little clinical benefit from conventional therapy, which is associated with grade 3~4 toxicity with negative effects on quality of life. In previous clinical studies, cell-based immunotherapy using dendritic cell vaccines and sentinel lymph node T cell therapy showed promising therapeutic results for metastatic colorectal cancer. In our preclinical and previous clinical studies, cytokine-induced killer (CIK) cells treatment for colorectal cancer showed favorable responses without toxicities. Here, we review current treatment options for colorectal cancer and summarize available clinical studies utilizing cell-based immunotherapy. Based on these studies, we recommend the use CIK cell therapy as a promising therapeutic strategy for patients with metastatic colorectal cancer.

Is Helicobacter pylori a Poor Prognostic Factor for HER-2 SISH Positive Gastric Cancer?

  • Selcukbiricik, Fatih;Tural, Deniz;Erdamar, Sibel;Buyukunal, Evin;Demirelli, Fuat;Serdengecti, Suheyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3319-3322
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    • 2013
  • Background: Helicobacter pylori (H. pylori) is one of the risk factors for gastric cancer (GC). Any prognostic effect of HER-2 status in gastric lymph node metastasis in H. pylori positive cases is unknown. Materials and Methods: A total of 74 patients, 47 (64%) male, and 27 (34%) female, who had subtotal or total gastrectomy and also positive lymph nodes, were included in the study. Age range was 29-87 years, and median age was 58 years. HER-2 expression was assessed in both gastric resection samples and lymph node material with carcinoma metastasis of the same patient by immunohistochemistry (IHC) and silver in situ hybridization (SISH) methods. H. pylori status was examined in gastric materials of all patients. Relationships between HER-2 status in gastric cancers and lymph nodes and H. pylori status were investigated. Results: H. pylori was positive in 40 cases (54%), and negative in 34 (46%). While in the primary tissues of H. pylori positive cases, SISH positivity for HER-2 was observed in 13 cases (86%), SISH negativity was observed in 2 (14%), in metastatic lymph nodes 21 cases (72%) were SISH positive and 8 cases (28%) were SISH negative (P=0.005 and P=0.019, respectively). Initial CEA values were high in 18 cases (78%) with positive H. pylori and in 5 cases (22%) with negative H. pylori (P=0.009). While SISH data of patients were negative in 59 cases (80%) and positive in 15 cases (20%) in primary tissues, they were negative in 56 cases (75%) and positive in 18 cases (25%) in lymph nodes. Discrepancy between primary tissue and lymph node results was detected in 3 cases, in which SISH was negative in the primary tissue and HER-2 expression was positive in the lymph nodes. Conclusions: Clinical progression was poor in H. pylori positive cases with HER-2 negativity in primary gastric tissue, but HER-2 positivity in the lymph nodes. SISH positivity can be expected in H. pylori positive cases, and it may be predicted that these cases can benefit from trastuzumab treatment.

The Value of Mediastinoscopy in Preoperative Staging of Primary Lung Cancer (원발성 폐암에서 술전 종격동 검사의 의의)

  • Seo, Gang-Seok;Jeon, Sang-Hun;Jang, Bong-Hyeon
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.37-41
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    • 1995
  • To determine the role of mediastinoscopy in the preoperative staging of the primary lung cancer, we studied 23 patients from January 1993 to December 1993 and compared the results of mediastinoscopy and computed tomographic scanning with the findings at thoracotomy. Mediastinoscopy was performed in 14 patients when they had larger than 10mm mediastinal nodes at computed tomographic scanning. Six of them were found to have metastatic nodes. Nine patients, who had negative computed tomographic scanning and negative mediastinoscopic results,underwent thoracotomy. One of them was found to have a metastatic mediastinal lymph node. When results from both series of patients were compared, the sensitivity and specificity of computed tomographic scanning showed 83.3% and 47.1% respectively with an accuracy of 56.5%. The results of mediastinoscopy showed that the sensitivity was 85.7%, the specificity was 100% and the accuracy was 95.7%.Because of the low accuracy rate of computed tomographic scanning, a more routine use of mediastinoscopy seems to be justified.

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CD44v3 and VEGF-C Expression and its Relationship with Lymph Node Metastasis in Squamous Cell Carcinomas of the Uterine Cervix

  • Liu, Ye-Qing;Li, Hai-Feng;Han, Jing-Jing;Tang, Qiong-Lan;Sun, Qing;Huang, Zhi-Quan;Li, Hai-Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.5049-5053
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    • 2014
  • Background: To investigate the expression of CD44v3 and vascular endothelial growth factor-C (VEGF-C) and their relationship with lymph node metastasis in squamous cell carcinomas (SCC) of the uterine cervix. Materials and Methods: Expression of CD44v3 and VEGF-C was analyzed in 109 cases of cervical SCC by immunohistochemistry (IHC). The relationship was analyzed between expression and the patient age, histological differentiation, formation of tumor emboli in lymphoid vessels, lymph node metastasis, FIGO staging, and TNM classification. Results: Expression rates for both CD44v3 and VEGF-C were 43.1% in cervical SCC. The cells with positive immunohistochemical staining of CD44v3 were distributed mainly around the keratin pearls in well differentiated carcinomas, but distributed diffusely in the moderately and poorly differentiated lesions. VEGF-C was found stained positively in most of the tumor cells. There were differences in expression between normal epithelium and atypical hyperplasia as well as carcinoma. Both CD44v3 and VEGF-C were found to be associated positively with lymph node metastasis and TNM classification (both p=0.000). Neither CD44v3 nor VEGF-C was found to be associated with patient age, histological differentiation, formation of tumor emboli in lymphoid vessels and FIGO staging. CD44v3 was found to be associated with VEGF-C positively (p=0.000). Conclusions: Abnormal expression of CD44v3 and VEGF-C is associated closely with the lymph node metastasis in cervical SCC, and these agents may cooperate in carcinogenesis and development of metastatic lesions.

A Case of Pneumocytoma(Sclerosing Hemangioma) with Lymph Node Metastasis. -A Case Report (림프절 전이를 동반한 폐세포종(경화성 혈관종) - 1례 보고 -)

  • Jeong, Gyeong-Yeong;Kim, Gil-Dong;Im, Sang-Hyeon
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.548-551
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    • 1997
  • A case of pneumocytoma(so-called sclerosing hemangioma) with regional Iymph node metastasis is reported. A round lesion in the right hilar region was incidentally found in a 29-year-old man. He underwent right upper lobectomy and Iymph nodes dissection with preoperative impression of bronchogenic adenocarcinoma. The tumor was well circumscribed with characteristic histological feature of sclerosing hemangioma. Several Iymph nodes contained metastatic deposits of proliferating pale cells with formation of glandular spaces. A Ithough pneu ocytoma is said to be benign, quite rare cases apparently show metastatic potential.

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The Clinical Eelevance of nm23 Protein Expression in Resected Gastric Cancer Patient (위암 절제조직에서 nm23 단백질 발현의 임상적 의의)

  • Song, Sun-Kyo;Kim, Hong-Jin;Kim, Sang-Woon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.43-51
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    • 1999
  • The aim of present study was to elucidate whether the expression of nm23 protein might be of clinical value as a prognostic factor in gastric cancer. The expression of nm23 protein was analyzed using an immunohistochemical method with formalin-fixed and paraffin embedded tissue samples from 76 gastric carcinoma patients. The cytoplasmic immunoreactivity of nm23 protein were detected in 53.9% of the sample tissues(41/76). When the immunoreactivity of nm23 protein with TNM status and other histopathologic findings were compared by using Chi-Square test, nm23 was found to have correlations with lymph node metastasis(p=0.04), a number of metastatic lymph node, and the invasion of lymphatic vessels(p=0.007); however, it had no correlation with TNM status. The conventional prognostic factors such as the depth of invasion, the degree of lymph node metastasis and the presence of distant metastasis, a Borrmann type, size of tumor, and the curability with operation were found to have a strong correlation with the survival time(p<0.003). However, the expression of nm23 protein was not significantly correlated with survival time in survival analysis. These results showed that the expression of nm23 protein is not a useful prognostic indicator in gastric cancer.

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A CASE REPORT OF PAPILLARY THYROID CARCINOMA METASTASIZED TO MANDIBULAR CONDYLE (하악골과두부에 전이된 유두상 갑상선암의 치험례)

  • Kim, J.K.;Lee, B.I.;Kim, H.J.;Suh, C.H.;Cha, I.H.;Lee, E.W.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.442-446
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    • 1995
  • Thyroid carcinomas are usually classified as papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma. Among the thyroid carcinomas, the incidence of medullary and anaplastic thyroid carcinoma is low, but the rate of lymph node & distant metastasis from them are more common compared to other types. Follicular thyroid carcinoma has a low rate of lymph node metastasis as 10% and has a high occurrence of hematogenous metastasis to lung, bone, brain and liver. Papillary thyroid carcinoma accounts for $60{\sim}70%$ of whole thyroid carcinomas and the cervical lymph node metastasis is $21{\sim}81%$ including micrometastasis, but the distant metastasis is rare. In the case of bone metastasis, follicular type reveals most frequent, and the rate is about 5%, and more likely to be found on vertebra, pelvis, ribs, femur, and skull. The clinical symptoms of bone metastasis are pain, swelling, pathological fracture and radiologically osteolytic lesions can be observed. But distant metastasis of papillary thyroid carcinoma is very rare and especially, bone metastasis has hardly been reported. The treatment modalities of metastatic thyroid carcinoma to mandible are known as follows : thyroidectomy to treat primary site, resection of the affected site of mandible, external beam radiotherapy and radioiodine therapy etc.

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Evaluation of Merkel Cell Carcinoma Metastasis Using Positron Emission Topography/CT (양전자방출단층촬영술(PET/CT)을 이용한 메르켈 세포암(Merkel cell carcinoma)의 전이 평가)

  • Kwon, Soon Hong;Song, Jin Kyung;Yoo, Gyeol;Byeon, Jun Hee
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.233-236
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    • 2006
  • Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

Overexpression of Twist and Matrix Metalloproteinase-9 with Metastasis and Prognosis in Gastric Cancer

  • Gao, Xing-Hui;Yang, Xue-Qin;Wang, Bi-Cheng;Liu, Shao-Ping;Wang, Fu-Bing
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5055-5060
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    • 2013
  • Objective: Twist, a basic helix-loop-helix transcription factor, plays a key role in the metastatic progression of human cancer. Matrix metalloproteinase (MMP)-9 is an endopeptidase that digests basement membrane type IV collagen, therefore being possibly related to tumor progression. It has been reported that Twist and matrix metalloproteinase-9 (MMP-9) are expressed in gastric cancers. However, the exact roles of Twist and MMP-9 in tumor metastasis and prognosis remain unclear. The aim of this study was to casts light on this question. Methods:Twist and MMP-9 expression in tissue sections of 37 gastric carcinomas was evaluated with immunohistochemistry. The staining results were compared with clinicopatholgic features and to patients' outcome. Results: Twist positive expression was significantly increased in gastric cancer cases with lymph node metastasis (P=0.023). But no correlations were found between MMP-9 overexpression and clinicopathologic features, such as recurrence, TNM stage, and lymph node metastasis. Overall survival (OS) was significantly correlated with recurrence, serosa invasion, TNM stages, distant metastasis, and MMP-9 (P=0.027, 0.021, 0.000, 0.024 and 0.036, respectively). Disease-free survival (DFS) was prominently related to recurrence location, serosa invasion and TNM stages (P=0.000, 0.038 and 0.003, respectively). In the Cox regression multivariate analysis, TNM stage, distant metastasis and MMP-9 were significantly associated with prognosis of gastric cancer (P=0.002, 0.019, and 0.032, respectively). Conclusions: This study showed Twist positive expression to be significantly correlated with lymph node metastasis in gastric cancer. MMP-9 overexpression is associated with OS, suggesting that MMP-9 is a prognostic indicator for survival in patients with gastric cancer.