Abstract:
BACKGROUND:Brain metastases from soft tissue sarcoma (STS) are uncommon. To the authors' knowledge limited information is available regarding the influence of the initial STS site, the significance of parenchymal versus leptomeningeal metastases, and the role of surgical resection. METHODS:STS patients evaluated between July 1982 and March 1999 who presented with or developed brain metastases were identified from a prospective database. Association between factors was determined using the Fisher exact test. Survival was estimated using the Kaplan-Meier method. The influence of factors on the endpoint (disease specific survival [DSS]) was analyzed using the log-rank test. Significance was defined at P < or = 0.05. RESULTS:A total of 3829 STS patients were evaluated during the study interval; 21 patients presented with and 19 patients subsequently developed brain metastases, accounting for < 1% (40 of 3829 patients) of the total patient group. The STS presentation status for this group of patients (n = 40) included 15 patients with primary STS, 1 patient with local recurrence, and 24 patients with metastatic disease. The most frequent types of STS metastasizing to the brain were leiomyosarcoma (eight patients), liposarcoma (five patients), rhabdomyosarcoma (four patients), and malignant fibrous histiocytoma (MFH) (four patients). Fourteen other sarcoma types were determined in the remaining 19 patients. Of the 19 patients who developed subsequent brain metastases, 18 had lung metastases as the immediate prior site of disease. The median overall follow-up for the 40 patients was 14 months (range, 1-128 months); for survivors (n = 5), the median overall follow-up was 18 months. During follow-up, 34 patients died of disease and 1 patient died of other causes. Brain metastasectomy was performed in 27 of the 40 patients and was highly associated with the initial site of STS; 20 of the 27 patients who underwent resection versus 2 of the 13 patients who did not undergo resection initially had extremity or trunk STS (P < 0.001). No association was observed between parenchymal versus leptomeningeal site of metastases and any outcome factor. The 1-year and 2-year overall DSS for the 40 patients was 55% and 25%, respectively, with a median survival of 15 months. The 1-year and 2-year postmetastasis survival rates were 34% and 20%, respectively, with a median survival of 7 months. Metastasectomy (n = 27) was associated with an improved median postmetastasis survival (9.6 months vs. 2.7 months for unresected patients; P < 0.01). The 2-year postmetastasis survival was 27% for those patients who underwent resection and 0% for the unresected patients. CONCLUSIONS:Although brain metastases from STS are rare, vigilance is warranted. Symptomatic patients should be examined neurologically and investigated thoroughly for metastases. Surgical resection may be an appropriate treatment for selected patients; however, survival is dismal.
journal_name
Cancerjournal_title
Cancerauthors
Espat NJ,Bilsky M,Lewis JJ,Leung D,Brennan MFdoi
10.1002/cncr.10554subject
Has Abstractpub_date
2002-05-15 00:00:00pages
2706-11issue
10eissn
0008-543Xissn
1097-0142journal_volume
94pub_type
杂志文章相关文献
CANCER文献大全abstract:BACKGROUND:Constitutional or somatic mosaic epimutations are increasingly recognized as a mechanism of gene dysregulation resulting in cancer susceptibility. Beckwith-Wiedemann syndrome is the cancer predisposition syndrome most commonly associated with epimutation and is extremely variable in its phenotypic presentati...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.32907
更新日期:2020-07-01 00:00:00
abstract::Many clinicians use group support to reduce the psychosocial difficulties of persons with cancer. This study compared the long-term benefits of a thematic counseling model used both as a structure for group support and for counseling patients individually. The thematic model included eight counseling sessions focused ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19860101)57:1<183::aid-cncr28205
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Several of the large studies addressing prognosis and survival from hepatocellular carcinoma (HCC) have been from Europe and Asia, but only a few have emanated from North America. Survival statistics from other parts of the world may not be applicable to the North American population because of etiologic, de...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19950815)76:4<579::aid-cncr28207
更新日期:1995-08-15 00:00:00
abstract::The development of drug resistance limits the survival or patients with small cell anaplastic carcinoma of the lung (SCLC). The present study was undertaken to overcome this problem by administering two alternating noncross resistant combination chemotherapy regimens. One-hundred-one patients were entered on study, an...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19820615)49:12<2449::aid-cncr282
更新日期:1982-06-15 00:00:00
abstract::The percentage of T lymphocytes that form rosettes (RFC) with sheep erythrocytes (E rosettes), cutaneous delayed-type hypersensitivity, and in vitro lymphocyte transformation was measured in 15 patients with primary intracranial tumors. The ability of T lymphocytes to form E rosettes was significantly impaired. Thes...
journal_title:Cancer
pub_type: 临床试验,杂志文章
doi:10.1002/1097-0142(197604)37:4<1869::aid-cncr282037
更新日期:1976-04-01 00:00:00
abstract:BACKGROUND:Multidisciplinary management of head and neck cancer (HNC) must reconcile increasingly sophisticated subspecialty care with timeliness of care. Prior studies examined the individual effects of delays in diagnosis-to-treatment interval, postoperative interval, and radiation interval but did not consider them ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.31533
更新日期:2018-08-01 00:00:00
abstract::Characteristic alterations of marker enzymes and tumor-associated antigens have been detected in the preneoplastic lesions of experimental hepatocarcinogenesis. An identical pattern of enzyme activity (increased gammaglutamyl transferase, loss of glucose-6-phosphatase, and canalicular adenosine triphosphatase) was dem...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19810401)47:7<1796::aid-cncr2820
更新日期:1981-04-01 00:00:00
abstract::This trial determines the feasibility for patients with resectable Stages III/IV head and neck cancer who achieved a complete response to induction chemotherapy of eliminating surgery from their treatment program. Thirty patients were treated with three cycles of cisplatin and 5-fluorouracil (5-FU), followed by reendo...
journal_title:Cancer
pub_type: 临床试验,杂志文章
doi:10.1002/1097-0142(19870915)60:6<1178::aid-cncr2820
更新日期:1987-09-15 00:00:00
abstract::In search of tumor-associated components in human melanomas and gliomas, plasma membranes were isolated from these tumors and compared morphologically, biochemically and immunologically with those from normal human brain. The preparations exhibited a comparable ultrastructure of empty vesicles of various form and size...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19811201)48:11<2399::aid-cncr282
更新日期:1981-12-01 00:00:00
abstract::Late side effects of chemotherapy were studied in 51 women who had received at least 300 mg of melphalan for ovarian cancer and had survived for at least three years. Hematologic, statistical, and cytogenetic methods were employed. Six cases of iatrogenic leukemia were found. They appeared to represent a hematologic e...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19820601)49:11<2234::aid-cncr282
更新日期:1982-06-01 00:00:00
abstract::Based on laboratory studies showing enhanced cytotoxicity of floxuridine (FUDR) when used with high doses of leucovorin (LV), a pilot study of FUDR and LV through an implantable pump was initiated for the treatment of hepatic metastases from colorectal cancer. The highest dose of LV that could be administered, taking ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19900601)65:11<2446::aid-cncr282
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Cancer affects patients' incomes, but to the authors' knowledge few studies to date have examined how the income of the patients' spouses may be influenced. In this population-based study from Norway, the effects of cancer on both partners' earnings are analyzed. METHODS:The difference between labor earning...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.24582
更新日期:2009-09-15 00:00:00
abstract:BACKGROUND:Louisiana is one of the few Southern states that enacted the Medicaid expansion of the Patient Protection and Affordable Care Act (ACA). To the authors' knowledge, the issue of how this has affected the breast cancer landscape in Louisiana is unknown. The authors have postulated that ACA expansion had a posi...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.33265
更新日期:2020-11-03 00:00:00
abstract:BACKGROUND:Cancer and its treatment lead to increased financial distress for patients. To the authors' knowledge, to date, no standardized patient-reported outcome measure has been validated to assess this distress. METHODS:Patients with AJCC Stage IV solid tumors receiving chemotherapy for at least 2 months were recr...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.30369
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The psychological adaptation to a cancer diagnosis is characterized by significant distress. Although distress levels in cancer patients have been reported to be the highest shortly after diagnosis and before treatment, few attempts have been made to study emotional adjustment during the diagnostic period of...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.10564
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Although it is believed that p53 suppressor gene mutations, compared with mutations in the K-ras oncogene, occur at a later stage of colorectal tumorigenesis, the distribution of these genetic alterations at an early stage remains poorly characterized. METHODS:The authors analyzed the immunoreactivity for p...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.10198
更新日期:2002-01-01 00:00:00
abstract::Initial biopsy and resection specimens from 78 cerebral astrocytomas with anaplastic foci occurring in adults were examined for the presence of five specific histologic features traditionally considered indicative of anaplasia. Anaplastic astrocytomas with foci of tumor necrosis had been classified as glioblastoma mul...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19850301)55:5<928::aid-cncr28205
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:The induction of estrogen and progesterone receptors (ER and PGR) has been reported in breast and endometrial cancer cells exposed to human fibroblast interferon-beta (hIFN-beta). Clinical verification of this finding might provide the rationale for new therapeutic approaches. This study was designed to eval...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/(SICI)1097-0142(19960801)78:3<448::AID-CNC
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:A proposed pathologic (pTNM) classification system for prostate carcinoma was analyzed for its impact on survival outcome in the prostate specific antigen (PSA) era. The impact of margin status on the survival outcome of patients with otherwise organ-confined disease (i.e., without extraprostatic extension o...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/(sici)1097-0142(19980301)82:5<902::aid-cnc
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Prior literature has suggested synergy between immune checkpoint therapy (ICT) and radiotherapy (RT) for the treatment of brain metastases (BrM), but to the authors' knowledge the optimal timing of therapy to maximize this synergy is unclear. METHODS:A total of 199 patients with melanoma and non-small cell ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.33196
更新日期:2020-12-15 00:00:00
abstract::To determine the impact of pulmonary infections on survival in patients with lung cancer, a retrospective review of the records of 121 such patients treated at Howard University Hospital in Washington, DC, was done. There were 77 men and 44 women; 118 were black. The mean age was 63.5 years. Forty-three patients had s...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19900801)66:3<593::aid-cncr28206
更新日期:1990-08-01 00:00:00
abstract::One hundred ninety patients who had advanced active Hodgkin's disease, lymphosarcoma, or reticulum cell sarcoma were treated with a combination of cyclophosphamide, vincristine, procarbazine, and prednisone (COPP) given in a cyclical fashion every month. Complete remission was produced in 91 of 138 (66%) patients with...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(197510)36:4<1241::aid-cncr282036
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Even when they are analogous in microscopic and macroscopic appearance, tumors vary in their response rates to radiotherapy. Cell culture and xenograft experiments with colorectal cell lines have demonstrated that wild-type p53 increases radiosensitivity. Hence, the authors investigated, in a well-defined po...
journal_title:Cancer
pub_type: 杂志文章
doi:
更新日期:1999-06-15 00:00:00
abstract:BACKGROUND:Commission on Cancer data from the National Cancer Data Base (NCDB) report time trends in stage of disease, treatment patterns, and survival for patients with selected cancers. The most current data (1993) for patients with colon cancer are described. METHODS:Five calls for data yielded 3,700,000 cases of c...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/(SICI)1097-0142(19960815)78:4<918::AID-CNC
更新日期:1996-08-15 00:00:00
abstract:BACKGROUND:As increasing numbers of young patients with cancer survive, interest in the late effects of therapy is rising. METHODS:The sequelae of treatment were reviewed after a minimum of 5 years of observation in 109 surviving patients with sarcoma of the bladder or prostate who were enrolled in the Intergroup Rhab...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19930401)71:7<2387::aid-cncr2820
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:The chromophobe variant of renal cell carcinoma is a recently described and frequently unrecognized tumor. Because the prognosis of the chromophobe variant appears to be intermediate between that of oncocytoma and the clear cell variant of renal cell carcinoma, accurate diagnosis may be important for appropr...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/(sici)1097-0142(19970425)81:2<122::aid-cnc
更新日期:1997-04-25 00:00:00
abstract::Univariate and multivariate regression methods were used to analyze 17 potential clinical prognostic factors among 138 patients with advanced breast cancer who received Adriamycin-cyclophosphamide combination chemotherapy between 1973 and 1977 at the University of Arizona. Follow-up of patients was through September 1...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19801201)46:11<2380::aid-cncr282
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Methotrexate is readily absorbed from the intestinal tract. When given to patients with urinary diversion to the intestinal tract, methotrexate may be reabsorbed into the circulation, thus increasing its serum concentration and potentially increasing its toxicity. METHODS:Forty-eight patients with transitio...
journal_title:Cancer
pub_type: 杂志文章
doi:
更新日期:1998-03-15 00:00:00
abstract:BACKGROUND:There are few reports comparing the clinicopathologic features of sarcomas of the aorta (SA), sarcomas of the inferior vena cava (SIVC), and sarcomas of the pulmonary artery (SPA). METHODS:The authors retrospectively reviewed 11 SA, 16 SIVC, and 16 SPA, and compared clinical, pathologic, and immunohistochem...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19930301)71:5<1761::aid-cncr2820
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Despite optimal therapy with surgery and radiotherapy, the prognosis of patients with glioblastomas remains poor. Stereotactic brachytherapy involves the accurate placement of radioactive isotopes within brain tumors, significantly increasing the dose of radiation that can be delivered to the tumor bed witho...
journal_title:Cancer
pub_type: 临床试验,杂志文章
doi:10.1002/1097-0142(19940615)73:12<3029::aid-cncr282
更新日期:1994-06-15 00:00:00