Typical sites for metastasic spread (stage IV disease) are the liver, peritoneal cavity and lungs, all of which occur in 50% or more of fully advanced cases.
Prognostic factors in NSCLC include presence or absence of pulmonary symptoms, tumor size, cell type (histology), degree of spread (stage) and metastases to multiple lymph nodes, and vascular invasion.
Due to the nature of the metastatic spread, staging includes bone scintigraphy, MRI brain and CT chest.
To investigate the value of neoadjuvant chemotherapy (NACT), followed by interval debulking surgery (IDS), in endometrial cancer with transperitoneal spread (stage IV).
The patients were classified at the discovery of disease, both according to spread (stages I-IV according to the Ann Arbor classification) and to tumour histology (the Kiel classification).
Other independent factors associated with poorer DSS included age (HR: 1.07 95% CI 1.06 1.08); regional spread stage at presentation (HR: 2.36 95% CI 2.04 2.74) and distant spread (HR: 7.65, 95% CI 6.48 9.04) compared to the localized spread.
However, prognosis worsens rapidly with advancing stage where patients diagnosed with a regional spread (stage III) and metastatic disease (stage IV) have a 5-year survival rate of 69.2 and 11.7%, respectively (Siegel et al, 2012).
Given these similarities and given our current findings, we believe that the data obtained in stage IIIc ovarian cancer might be extrapolated to endometrial cancer with transperitoneal spread (stage IV).
In 2001 2002, radiotherapy or chemoradiotherapy would have been the preferred treatment for most women, except those eligible for radical surgery, with extrapelvic spread (stage IVB), the very frail or elderly.
The degree of processing of proNPY to NPY in tumour tissue was lower in advanced neuroblastomas with regional or metastatic spread (stage 3 and 4) (n = 6), (41%, 12 100%, median, range), compared to the less aggressive stage 1, 2 and 4S tumours (n = 12), (93%; 69 100%), (P = 0.012).
