Patterns of regional lymph node metastases from cutaneous melanomas of the head and neck

Article Abstract:

Malignant melanoma is a tumor, usually involving the skin, that contains melanocytes (cells containing melanin pigment). Some other types of cancer of the head and neck are known to spread (metastasize) to the regional lymph nodes in an orderly fashion, justifying the use of limited neck dissection. However, there is little information regarding the pattern of spread of malignant melanoma of the head and neck, and elective removal of all regional lymph nodes remains controversial. To determine the pattern of metastasis, an evaluation was made of 111 patients with primary malignant melanoma of the skin of the head and neck with proven metastasis to the regional lymph nodes. The original melanoma sites were the face (34 patients), the front of the scalp (25 patients), the neck (16 patients), the back of the scalp (15 patients), the ear (11 patients), and the back of the neck (10 patients). All patients underwent radical neck dissection; 80 procedures were considered therapeutic, and 31 were considered elective. Radical neck dissection is a procedure in which all the lymph nodes from the jaw to collar bone are removed. Side effects of the surgery include reduced shoulder function, facial swelling as a result of removal of the internal jugular vein, and possibly abnormal nerve function. A parotid gland (one of the largest pair of salivary glands, located at the side of the face just below and in front of the ear) was removed in 37 patients; 33 had evidence of metastasis. There were 37 elective parotidectomies (parotid gland removals), 19 of these were positive for cancer. Three observations were made based on the patterns of metastases to the parotid gland and lymph nodes. Patients with melanoma of the face, ear, and front scalp should be considered for parotid gland removal. If surgery is therapeutic, complete neck dissection should be performed because of the unpredictable pattern of nodal metastasis. Based on anatomic site and in selected patients, limited neck dissection may be justified when elective lymph node removal is performed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Surgery, Cancer metastasis, Melanoma, Head and neck cancer, Radical neck dissection, Parotidectomy

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Clenbuterol plus acivicin decrease tumor growth and increase muscle mass in rats maintained on total parenteral nutrition

Article Abstract:

The depletion of lean body tissue, or cachexia, contributes to increased level of illness and death in cancer patients. Cachexia may prevent the use of aggressive cancer treatments and the poor nutrition itself is correlated with a poor treatment outcome. Because of this, an important goal of cancer treatment is to keep the patient well supplied with protein. Unfortunately, providing supplemental nutrition generally does not result in significant replenishment of protein. Results of animal studies indicate that providing total parenteral (non-oral) nutrition to rats with cancer may actually stimulate growth of the tumor. Glutamine is an amino acid essential for tumor growth; studies suggest that the glutamine antimetabolite, acivicin, may inhibit tumor growth. In rats with tumors, treatment with clenbuterol, a beta adrenergic agonist, has produced muscle saving and replenished protein. A study of tumor-bearing rats was undertaken to determine the effect of a combination of acivicin and clenbuterol on tumor growth and protein repletion. Rats were maintained on total parenteral nutrition. One group was treated with acivicin and clenbuterol; this group showed arrested tumor growth, increased muscle mass and protein content, increased mass of the intestines, and decreased blood lipid (fat) level. The parenteral nutrition increased the expenditure of resting energy; the combination of acivicin and clenbuterol produced a further increased. It is concluded that tumor growth and muscle wasting can be controlled while an animal with cancer receives total parenteral nutrition. In the future, a similar combination of nutrition and drugs may be available for cachectic cancer patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Parenteral feeding, Parenteral nutrition, Adrenergic beta agonists, Adrenergic beta-agonists, Clenbuterol

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Factors affecting the incidence of lymph node metastases in small cancers of the breast

Article Abstract:

A ten year study of 626 cases of breast cancer with tumors smaller than 2 centimeters was conducted to determine the correlation between the metastases (spread) of cancer to the axillary (located in the armpit) lymph nodes (where disease-fighting white blood cells are returned to the blood) and such factors as patient age, tumor location, tumor size, degree of tumor cell differentiation, and the status of the patient's estrogen receptors (respond to estrogen, the female hormone). Only tumor size correlated significantly with the spread of cancer to the axillary lymph nodes. The degree to which the tumor cells had differentiated correlated with the degree of lymph node involvement, but was not statistically significant. Forty-five tumors that had not invaded surrounding tissues were identified and none of these were associated with axillary metastases. These findings support early screening of women for breast cancer using X-ray mammography.

Research, Breast cancer, Lymphatic metastasis

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