ABSTRACT
Radical hepatectomy was carried out on a patient with hepatocellular carcinoma (HCC) located in segment VIII of the liver. The patient was a 56-year-old man who showed positive for hepatitis C antibody and negative for hepatitis B surface antigen. Six months after hepatectomy, a lumbar plane X-ray and computed tomography examination revealed bone metastases in the lumbar vertebrae. The patient was subsequently treated by radiation to the lumbar vertebrae in response to lumbago. The metastatic lesion has been well controlled by radiotherapy on an outpatient basis with no recurrence for 5 years and 3 months. The prognosis of patients with HCC with distant metastases is poor. It is believed that the long survival of this patient can be attributed to successful radiotherapy of the bone metastasis after hepatectomy and the lack of recurrence in the liver.
Subject(s)
Carcinoma, Hepatocellular/radiotherapy , Liver Neoplasms/radiotherapy , Spinal Neoplasms/radiotherapy , Aged , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Hepatectomy , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Lumbar Vertebrae/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Radiography , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/metabolism , Tomography Scanners, X-Ray Computed , Treatment OutcomeABSTRACT
A multi-institutional prospective study for the analysis of prognostic factors for patients with osseous metastasis was performed. From February 1986 through June 1988, a total of 216 patients were included in this study. Cox's regression model made it clear that the most significant overall prognostic factor was primary site (p = 0.0002). In the lung cancer group, performance status (p = 0.0036) and metastasis of organs than bone (p = 0.0105) were also significant prognostic factors. In the breast cancer group, no significant factors were obtained. In the hepatoma group, the values for alkaline phosphatase (ALP) (p = 0.0021), lactate dehydrogenase (LDH) (p = 0.0195), and sex (p = 0.0264) proved significant. In the group of other cases, the most significant prognostic factor was the value for urinary hydroxyproline/creatinine ratio (p = 0.0001), followed by the pain score of RTOG (p = 0.0018). These factors and actual survival periods obtained in this study will be useful for the future stratification of patients for individualized optimal radiation schedules.
Subject(s)
Bone Neoplasms/secondary , Adult , Aged , Aged, 80 and over , Bone Neoplasms/mortality , Bone Neoplasms/radiotherapy , Female , Follow-Up Studies , Humans , Japan , Male , Middle Aged , Multicenter Studies as Topic , Prognosis , Prospective Studies , Survival AnalysisABSTRACT
A prospective randomized study for the analysis of optimal schedule for the patients with bone metastases was performed. From February 1986 through January 1987, a total of 131 patients entered on this trial. The data from 129 patients out of 131 were available for the analysis of prognostic factors by Cox's regression model. As a whole, it was clear that first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0001), second primary site (p = 0.0001), third pain score (p = 0.0005) and fourth other organ metastasis except bone (p = 0.0006). In the group of lung cancer, first significant prognostic factor was urinary hydroxyproline/creatinine ratio (p = 0.0007), second multiplicity of bone metastasis (p = 0.0113), and third pain score (p = 0.0270).
Subject(s)
Bone Neoplasms/radiotherapy , Bone Neoplasms/mortality , Bone Neoplasms/secondary , Creatinine/urine , Humans , Hydroxyproline/urine , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Multicenter Studies as Topic , Prognosis , Prospective Studies , Randomized Controlled Trials as Topic , Time FactorsSubject(s)
Bone Neoplasms/secondary , Adult , Aged , Aged, 80 and over , Bone Neoplasms/radiotherapy , Female , Humans , Japan , Male , Middle Aged , Multicenter Studies as Topic , Pain/radiotherapy , Prospective Studies , Random AllocationABSTRACT
During the period between 1972 and 1978, 226 patients were operated on for carcinoma of the uterine cervix at Hiroshima University, and 91 patients were treated by postoperative external irradiation. Patients with lymph node metastasis showed markedly lower five-year survival rates stage I: 44.4%; stage II: 45.0%) than those without lymph node metastasis (99.3% and 84.0%, respectively). In view of benefits of postoperative radiotherapy in the treatment of cervical cancer, only to the node positive and tumor rest patients is recommended.
Subject(s)
Uterine Cervical Neoplasms/radiotherapy , Combined Modality Therapy , Female , Humans , Hysterectomy , Lymph Node Excision , Lymphatic Metastasis , Neoplasm Staging , Prognosis , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/surgeryABSTRACT
A 28-year-old woman with primary ovarian carcinoma which was found with intracranial metastasis is reported. The patient was operated on because of metastatic brain tumor with unknown primary lesion. Subsequently, left ovarian tumor was found, and left salpingo-oophorectomy was performed. The histological diagnosis was endometrioid carcinoma. A review of the literature shows that intracranial metastasis by ovarian carcinoma is very rare. The incidence is lower than 2.1%. The present case in which intracranial metastasis manifested itself before primary ovarian carcinoma seems to be extremely rare.
