Metastases surgery

Brain metastasis is common in melanoma, and treatment options for brain metastasis include surgery, radiation, and chemotherapy. The choice of therapy depends on the number of metastatic lesions, accessibility of the lesions for surgery, the presence of neurologic symptoms, and the status of extracranial disease. 

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,... 

A 75-year-old male, postprostatectomy for carcinoma of the prostate with local metastasis found during surgery would best be treated with which of the following ... 

Page, G.G., Ben-Eliyahu, S., and Liebeskind, J.C., The role of LGL/NK cells in surgery-induced promotion of metastasis and its attenuation by morphine, Brain Behav. Immun., 8, 241, 1994. 

Direct laparoscopic visualization of the peritoneum, omentum, and liver surface can spare patients unnecessary surgery. Once a pancreatic mass is considered to be unresectable or if metastasis occurs, then a histologic diagnosis should be established by using direct fine-needle aspiration. 

We investigated the relevance of S100A4 to clinical cancer in several archival colon cancer specimens, without metastasis at the time of surgery (Stein et al.,... 

The AFP level is a good indicator for monitoring therapy and the change in clinical status. Elevated AFP levels after surgery may indicate incomplete removal of the tumor or the presence of metastasis. Falling or rising AFP levels after therapy may determine the success or failure of the treatment regimen. A notable increase of AFP levels in patients considered free of metastatic tumor may indicate the development of metastasis. 

In spite of the triple-systems attack—surgery, radiation, and chemotherapy—possible on most types of cancer, with several exceptions, the prognosis for cures is generally not favorable. Relapses from symptom remissions frequently with metastasis and development of resistance to drugs are common. Table 4-1 lists the estimated percentage of 5-year survivors who are apparently free of commonly encountered cancers. 

Three patients suffered metastasis from melanotic melanoma which had a median survival after PDT of 12 months. One patient suffered from metastasis of a squamous carcinoma of the lung with two recurrences every 3 months despite radiotherapy after the first relapse. The tumor recurred again 6 months after reoperation and PDT. A second patient suffered from metastasis of an adenocarcinoma of unknown primary location with recurrence within 3 months after surgery and no adjuvant treatment. After reoperation, PDT and conventional radiotherapy of 45 Gy the patient has been recurrence free for over 7 years. 

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