Tumor primary

A second family of carbohydrate-degrading enzymes, the lysozymes, produces synergistic antimetastatic activity when co-adrninistered with cisplatin [15663-27-1] to mice whose primary tumor had been surgically removed (51). 

Currently, 13-cis-retinoic acid is the most studied chemopreventive agent that decreases the incidence of second primary tumors in patients with head-and-neck cancer, reverses premalignant lesions, and reduces appearance of nonmelanoma skin cancer in patients with xeroderma pigmentosum. Unfortunately, this vitamin A derivative has a significant clinical toxicity, which limits its utility in a practice setting. 

Intraarterial infusion of microspheres containing adriamycin was used for the local treatment of breast cancer and recurrent breast cancer with liver metastases (123). A reduction in tumor size was noted when the microspheres were injected into the internal and lateral thoracic arteries for treatment of the primary tumor. However, hepatic artery injection for liver metastases resulted in improvement in only one of three patients treated. 

Many tumors are staged according to the tumor, nodes, metastases (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 of solid tumors are the brain, bone, liver, and lungs. 

Tumors are either benign or malignant.4 Benign tumors often are encapsulated, localized, and indolent they seldom metastasize and they recur rarely once removed. Histologically, the cells resemble the cells from which they developed. Malignant tumors are invasive and spread to other locations, even if the primary tumor is removed. The cells no longer perform their usual functions, and their cellular architecture changes. Anaplasia is defined as the loss of structure and function. 

A cure in oncology implies that the cancer is completely gone, and the patient will have the same life expectancy as a patient without cancer. A complete response (CR) refers to complete disappearance of all cancer for 1 month after treatment. A partial response (PR) is defined as a 50% decrease in tumor diameter along with no new disease for 1 month. The term overall objective response rate refers to the combination of PR and CR. Stable disease refers to tumor that has not grown and has shrunk by less than 25% of the diameter. Disease progression refers to tumor that has spread or the primary tumor has increased in size by 25%. Some cancers, such as leukemia, cannot be measured by size, so biopsy of the bone marrow provides a cellular indication of absence or presence of disease. 

Locally advanced cancer breast cancer generally refers to breast carcinomas with significant primary tumor and nodal disease but in which distant metastases cannot be documented. A wide variety of clinical scenarios can be seen within this group of patients, including neglected tumors that have spread locally and inflammatory breast cancers that are a unique clinical entity. Many locally advanced breast cancers are diagnosed in patients who have had symptoms for months to years and have neglected to seek medical attention. Patients with inflammatory breast cancer often are treated inappropriately for cellulitis with antibiotics for several weeks to months. 

The choice of therapy for metastatic disease is based on the site of disease involvement and presence or absence of certain characteristics (i.e., hormonal status of the primary tumor and disease location). For example, patients who experience a long DFS following local-regional therapy or have disease that is located primarily in the bone or soft tissue likely will respond to endocrine therapy. Patients with asymptomatic visceral involvement (e.g., liver or lung) may be candidates for hormonal therapy depending on the clinical circumstance (generally... 

Symptoms owing to the direct effects of the primary tumor are often the first to appear and are the most common. These include... 

The term adjuvant therapy refers to the use of chemotherapy or radiotherapy following surgical resection of a tumor mass. The rationale behind adjuvant chemotherapy is to eradicate micrometastases or other tumor cells that may have been missed during removal of the primary tumor. The recent results of five relatively large prospective trials (n = 344—1867) suggest that there is benefit from adjuvant chemotherapy. The largest study, the International Adjuvant Lung Trial (IALT),24 has led to the... 

KM underwent surgical resection of the primary tumor, and an SLN biopsy was positive for lymph node involvement. A lymphadenectomy was performed. After extensive discussion with his oncologist, the decision was made to start KM on interferon-oc2b. 

A delicate balance of normal pressure is maintained in the brain and spinal cord by brain, blood, and cerebrospinal fluid (CSF) volume. Since the brain is contained within a confined space (skull), any foreign mass contained within that space causes adverse sequelae. This results in either destruction or displacement of normal brain tissue with associated edema. Most brain metastases occur through hematogenous spread of the primary tumor, and around 80% of patients will have multiple sites of metastases within the brain. 

First clinical human gene therapy trials with polyplexes were performed using cancer vaccines based on autologous patient tumor cells. These were modified ex vivo with interleukin-2 pDNA. To obtain high level transfection rates of patient s primary tumor cells, Tf-PLL/pDNA polyplexes linked with inactivated endosomolytic adenovirus particles were applied [221]. Polymer-based in vivo human gene transfer studies were performed with PEGylated PLL polyplexes, delivering CFTR pDNA to the airway epithelium of cystic fibrosis patients [222],... 

Stage is based on the size of the primary tumor (T ), presence and extent of lymph node involvement (N1 3), and presence or absence of distant metastases (Mq ). Simplistically stated, these stages may be represented as follows ... 

Stage I Small primary tumor without lymph node involvement. 

Stage IV Metastases in organs distant from the primary tumor. 

Breast-conserving therapy (BCT) is appropriate primary therapy for most women with stage I and II disease it is preferable to modified radical mastectomy because it produces equivalent survival rates with cosmetically superior results. BCT consists of lumpectomy (i.e., excision of the primary tumor and adjacent breast tissue) followed by radiation therapy (RT) to prevent local recurrence. 

Genetic tests are being prospectively validated as decision-support tools for adjuvant chemotherapy in node-negative patients to identify characteristics of the primary tumor that may predict for the likelihood of metastases and death. 

Chemotherapy should be initiated within 3 weeks of surgical removal of the primary tumor. The optimal duration of treatment is about 12 to 24... 

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