Lymph metastases

Abe, R., and Taneichi, N. (1972). Lymphatic metastasis in experimental cecal cancer Effectiveness of lymph nodes as barriers to the spread of tumor cells. Arch. Surg.. 104, 95-98. 

Staging [determination of the primary tumor size, extent of lymph node involvement, and the presence or absence of metastases, or sometimes referred to theTNM system (Table 85-2)]. Many tumors are staged according to the TNM system. Metastases are cancer cells that have spread to sites distant from the primary tumor site and have started to grow. The most frequently occurring sites of metastasis are the brain, bone, liver and lungs. 

N, Metastasis in one to three pericolic or perirectal lymph nodes... 

Dp Pelvic lymph nodes or ureteral Np Metastasis in a single lymph node, 2 cm or... 

D2 Bone, distant lymph node, organ, N2 Metastasis in single lymph node more than 2 cm... 

Tumor involves one or both ovaries with microscopic confirmed peritoneal metastasis outside pelvis and/or regional lymph node metastasis... 

Stage IIB, IIC, and III melanoma are considered to be high risk because of their potential for recurrence and distant metastasis. The primary treatment modality is surgical excision of the tumor and a lymphadenectomy for patients with positive lymph nodes. 

IV Mla Skin, subcutaneous tissue, or distant lymph nodes with normal lactate dehydrogenase Mlb Lung with normal lactate dehydrogenase Mlc To all other visceral sites (liver) or distant metastasis at any site with elevated serum LDH 7-19% 3-16%... 

In patients with SCC, metastatic spread to the lymph nodes occurs in less than 5%.32 The lymph nodes of the head and neck are the most common sites of metastasis. Patients are still curable with this stage of the disease, but they are at high risk of experiencing regional relapse and distant metastasis to the bones and lungs. As may be expected, survival is decreased compared with patients who do not present with nodal involvement. Factors that may be useful in... 

Radiation is not standard therapy for the treatment of skin cancer however, there are circumstances in which radiation may be preferred. It is used as adjunctive therapy after surgical resection for patients with head and neck MM with metastasis to regional lymph nodes.40 Radiation is also indicated for patients with unresectable metastases or brain metastases or for palliation of symptoms from metastases.40 Older patients or patients who are poor candidates for surgery may be offered radiation as an option.40 Radiation offers good cosmetic results,... 

Metastasis The migration of cancer cells from the original tumor site through the blood and lymph vessels to produce cancers in other tissues. 

CCL19 and CCL21, are expressed constitutively in lymph nodes, interaction of CCR7 with these ligands is predicted to promote metastasis to lymph nodes in a manner analogous to CXCR4/CXCL12. 

Kato M, Kitayama J, Kazama S, Nagawa H. Expression pattern of CXC chemokine receptor-4 is correlated with lymph node metastasis in human invasive ductal carcinoma. Breast Cancer Res 2003 5 144-150. 

Kawada K, Sonoshita M, Sakashita H, et al. Pivotal role of CXCR3 in melanoma cell metastasis to lymph nodes. Cancer Res 2004 64 4010 1017. 

Ding Y, Shimada Y, Maeda M, et al. Association of CC chemokine receptor 7 with lymph node metastasis of esophageal squamous cell carcinoma. Clin Cancer Res 2003 9 3406-3412. 

Gunther K, Leier J, Henning G, et al. Prediction of lymph node metastasis in colorectal carcinoma by expression of chemokine receptor CCR7. Int J Oncol 2005 116 726-733. 

Mashino K, Sadanaga N, Yamaguchi H, et al. Expression of chemokine receptor CCR7 is associated with lymph node metastasis of gastric carcinoma. Cancer Res 2002 62 2937-2941. 

Takanami, I. Overexpression of CCR7 mRNA in nonsmall cell lung cancer correlation with lymph node metastasis. Int J Cancer 2003 105 186-189. 

Wiley HE, Gonzalez EB, Maki W, Wu M-T, Hwang ST. Expression of CC chemokine receptor-7 and regional lymph node metastasis of B16 murine melanoma. J Nat Cancer Inst 2001 93 1638-1643. 

In humans, also, preferential sites exist for the formation of metastasis from various primary tumors [reviewed in Zetter (Zl)]. Thus, bone is a preferred site for metastasis from primary malignancies in breast, prostate, and kidney, while liver is a frequent metastatic site for tumors originating in the colon. Different types of leukemias vary widely in their ability to spread to liver, lymph, bone, and spleen. Some organs, however, are rarely colonized by metastatic growth. These resistant sites include skeletal muscle, heart, and skin. 

Ewing s hypothesis may explain certain patterns of metastasis observed in humans, such as the colonization of regional lymph nodes from some primary cancer in humans. There are, however, human cancers that form distant metastases in a variety of organs without any evidence of local lymph node involvement. 

Traditional markers of prognosis in cancer have relied on histological features such as tumor size and grade and whether or not local lymph nodes have metastasis. While these histological variables have been widely used over the years in assessing patient outcome, none is ideal. 

The presence or absence of metastases in local lymph nodes is widely used as a prognostic marker. Generally, patients with metastasis in these lymph nodes have a significantly poorer outcome than those patients without metastases. However, at least in the case of breast cancer, about 25-30% of node-negative patients die from their disease within 10 years. As mentioned earlier, there is a particular urgent need for new markers to identify those high-risk, axillary node-negative breast cancer patients. 

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