bluuebunny/crossref_metadata_2025 huggingface dataset:
Degenerative changes of the thoracic spine do exist in patients with diffuse idiopathic skeletal hyperostosis: a detailed thoracic spine CT analysis
Authors: Slonimsky Einat , Lidar Merav , Stern Myriam , Eshed Iris
Published: February 2018

Background

Degenerative intervertebral disease (DID) is an exclusion criterion in the Resnick and Niwayama radiographic classification for diffuse idiopathic skeletal hyperostosis (DISH). However, although DID was previously described in DISH, no systematic computed tomography (CT) analysis has been reported so far.

Purpose

To assess for the presence and prevalence of such changes on CT examinations of the thoracic spine of individuals with DISH.

Material and Methods

Intervertebral space (D1–L1) on chest CT examinations of DISH patients was retrospectively evaluated for the presence of DID. Parameters evaluated were disc space height, disc protrusion, subchondral cysts/sclerosis, Schmorl nodes, vacuum phenomenon, and posterior elements including costovertebral and facet joints. Parameters were compared with two age- and gender-matched control groups of individuals whose entire spine CT lacked evidence of DISH (Control 1 individuals < 2 flowing osteophytes, Control 2 individuals < 4 and ≥ 2 flowing osteophytes).

Results

A total of 158 participants (DISH/Control 1/Control 2 = 54/54/50; 106 men, 52 women; average age = 70.6 years) were evaluated. Average intervertebral disc height was significantly lower in the DISH group compared with both control groups (DISH/Control 1/Control 2 = 4.55/5.13/5.01 mm, P < 0.001). Costovertebral degenerative changes were more prevalent in DISH patients ( P < 0.05) and, except for vacuum phenomenon (more prevalent in controls), other DID changes were as prevalent in DISH as in controls.

Conclusion

The presence of degenerative intervertebral changes on thoracic CT should not deter from diagnosing DISH. Thus, the radiographic Resnick and Niwayama DISH criteria cannot be directly adapted to CT.
Preoperative Chemoradiation and Intra-Operative Radiotherapy for Pancreatic Carcinoma
Authors: Macchia Gabriella , Valentini Vincenzo , Mattiucci Gian Carlo , Mantini Giovanna , Alfieri Sergio , Digesù Cinzia , Deodato Francesco , Trodella Lucio , Doglietto Gian Battista , Cellini Numa , Morganti Alessio Giuseppe
Published: February 2018

Aims and background

In recent years, preoperative chemoradiation has received growing interest for the treatment of locally advanced pancreatic cancer. In an attempt to improve resectability and disease control, we used preoperative radiation therapy and concomitant 5-fluorouracil in a combined modality therapy protocol. The aim of the study was to evaluate definitive results in terms of toxicity, response and clinical outcome.

Material and methods

Twenty-eight patients with unresectable (cT4,19 patients) or resectable (cT3, 9 patients) nonmetastatic pancreatic tumors received radiotherapy (39.6 Gy) plus 5-fluorouracil (continuous infusion, days 1-4 at 1000 mg/m2/day). After 4 weeks, patients were evaluated for surgical resection. In 9 resected patients, electron-beam intra-operative radiotherapy (10 Gy) was given before reconstruction. Thereafter, in resected patients, adjuvant chemotherapy was prescribed.

Results

During chemoradiation, 1 patient (3.6%) developed grade 3 acute gastrointestinal toxicity and 2 patients (7.1%) developed grade 3 hematological toxicity. Three of 19 patients with unresectable tumors had tumor downstaging (15.8%). Two patients showed partial response (response rate, 7.1%; 95% CI, 0.2-25.3) and 4 patients (14.3%) had minimal tumor response. Four patients (14.3%) showed progressive disease after chemoradiation. One postoperative death was recorded. The median survival time was 11.3 months (20.5 and 9.0 months in resected and unresected patients, respectively). Only one local failure was recorded in 8 patients resected with negative margins.

Conclusions

Although the response rate is still low, our preliminary results suggest that preoperative 5-fluorouracil chemoradiation is well tolerated and may result in tumor downstaging. Delivery of intra-operative radiotherapy seems to be associated with a low rate of local recurrences.
Anxiety Levels in Cancer Patients and “Life Sound” Experience
Authors: Aitini Enrico , Sempreboni Alessia , Aleotti Paola , Zamagni Donatella , Cavazzini Giovanna , Barbieri Roberto , Cengarle Rita , Rabbi Carla , Pari Franca , Vivorio Beatrice
Published: February 2018

Aims and background

For the hospitalized cancer patient, time takes on a rhythm which is very different from the external reality. Based on the idea that time represents a fundamental dimension of human existence and is connected to future plans, time spent waiting and memories, we carried out this experience entitled “Life Sound” project. The objectives of the project were to experiment different and unusual ways of spending time in hospital in order to improve the quality of life of the hospitalized cancer patient, to help the patient adapt to the hospital environment, to encourage awareness of self and to give a different meaning to time spent in the hospital. In particular, we evaluated the reduction in the levels of anxiety, in psychological suffering and the improvement in communication.

Methods

We met with patients, family members, friends, volunteers and department personnel (doctors, psychologists, nurses) in a room in the Oncology and Hematology Department set aside specifically for recreation activities such as having a cup of tea while listening to music, talking, joking, listening to people's memories and celebrating birthdays, anniversaries and other special days. The study, which involved 109 patients, was carried out through the use of the questionnaire STAI-Y distributed before and after the event.

Results

The results showed a statistically significant difference in anxiety levels 2 hrs before participation (mean = 38.33) and 2 hrs after participation (mean = 34.77) in the program. This variation was also assessed based on gender, age, cancer stage, time since diagnosis and performance status but did not result in any statistically significant difference.

Conclusions

The “Life Sound” project encourages the emergence of positive feelings, of a renewed willingness to invest in personal and caring relationships, which are connected to the patient's ability to face this illness, and the opening of new channels of communication with family members and hospital staff.
A Translocation T(4;13)(q21;q14) as Single Clonal Chromosomal Abnormality in a Parathyroid Adenoma
Authors: Sammarelli Gabriella , Zannoni Marco , Bonomini Sabrina , Delsignore Roberto , Rizzoli Vittorio , Sianesi Mario , Caramatti Cecilia
Published: February 2018

Most of the information about the genetic composition of parathyroid tumors has been obtained by comparative genomic hybridization (CGH) and loss of heterozygosity (LOH) studies, whereas only few conventional cytogenetic investigation results are available. We have performed cytogenetic analysis of short-term cultures from 3 parathyroid adenoma tissue samples. Two cases showed a normal karyotype in all the metaphases obtained from independent primary cultures. In one case 5 metaphases (in a total of 25) from 2 independent cultures showed a nonrandom translocation t(4;13)(q21;q14), which was therefore accepted as clonal. To our knowledge this is the second clonal translocation described in this tumor type. Further conventional cytogenetic analysis of more parathyroid tumor specimens would be necessary to identify other specific abnormalities and the involved genes with a potential important role in the diagnosis, prognosis and pathogenesis of parathyroid tumors.
Glucose-6-Phosphate Dehydrogenase Polymorphism and Lymphoma Risk
Authors: Cocco Pierluigi , Ennas Maria G , Melis Maria A , Sollaino Carla , Collu Stefania , Fadda Domenica , Gabbas Attilio , Massarelli Giovannino , Rais Marco , Todde Pierfelice , Angelucci Emanuele
Published: February 2018

Aims and Background

Evidence linking the glucose-6-phosphate dehydrogenase (G6PD) polymorphism and risk of non-Hodgkin's lymphoma is conflicting. Risk of non-Hodgkin's lymphoma was increased in subjects expressing the G6PD deficient phenotype, whereas subjects under medication with statins, a lipid-lowering class of drugs partially mimicking G6PD deficiency, seemed to enjoy a protective effect.

Methods

We conducted a case-control study on lymphoma risk associated with the self-reported G6PD deficient phenotype in 122 lymphoma male cases and 116 male controls in Sardinia, Italy. The association with the GdMed+ genotype, the most frequent variant expressing a deficient enzyme activity, was also tested in 49 male lymphoma cases and 31 controls. The WHO classification was used to identify lymphoma subentities.

Results

Neither self-reported G6PD deficient phenotype nor the GdMed+ genotype showed an association with lymphoma risk or its subentities.

Conclusions

Our results do not confirm an association either positive or negative between the G6PD polymorphism and lymphoma risk.
Risk of Cancer of the Prostate and of the Kidney Parenchyma following Bladder Cancer
Authors: Fabbri Carla , Ravaioli Alberto , Ravaioli Alessandra , Bucchi Lauro , Balducci Chiara , Canuti Debora , Desiderio Franco , Foca Flavia , Panzini Ilaria , Falcini Fabio
Published: February 2018

Aims and Background

A registry-based cohort study of male patients with bladder cancer was conducted to determine the relative risk of second primary cancer of the prostate and kidney, the uni-/multivariate differences in relative risk according to patient characteristics, the cumulative risk by duration of the follow-up, and the prevalence:incidence ratio of prostate and kidney cancer cases detected in the first 6 months after the diagnosis of bladder cancer.

Methods

The complete case records of all male patients (n = 2025) diagnosed with bladder cancer between 1986 and 2002 were extracted from the database of the Romagna Cancer Registry: 1539 patients were eligible for analysis of the incidence of following prostate and kidney cancers, of the relative risk and the standardized incidence ratio specific for the time interval of follow-up.

Results

A total of 108 prostate cancer cases and 23 kidney cancer cases were observed during the follow-up. The relative risk of second primary cancer of the prostate and kidney was respectively 3.52 (95% CI, 2.89-4.25) and 3.90 (95% CI, 2.475.85). The absolute excess risk was 11.8 × 1000 for prostate cancer and 2.5 × 1000 for kidney cancer. The number of prevalent cases of prostate and kidney cancer detected was approximately 10 times greater than the expected number based on incidence rates from the general population. During the follow-up, incidence of prostate cancer stabilized at a level that was 3- to 4-fold greater than that expected. Despite fluctuations, a decrease was also observed for incidence of kidney cancer.

Conclusions

In summary, our study showed the relatively constant high incidence of prostate and kidney cancers in bladder cancer patients over time. The possibility of subsequent cancer implies that an appropriate long surveillance is required. The pertinence depends on the duration of the follow- up as well as the degree of surveillance.
Intermittent Capecitabine Monotherapy with Lower Dose Intensity in Heavily Pretreated Patients with Metastatic Breast Cancer
Authors: Osako Tomo , Ito Yoshinori , Takahashi Shunji , Tokudome Nahomi , Iwase Takuji , Hatake Kiyohiko
Published: February 2018

Aims and Background

The purpose of the present retrospective study was to evaluate efficacy and safety of a lower dose-intensity capecitabine monotherapy regimen in heavily pretreated patients with metastatic breast cancer.

Methods

Patients with metastatic breast cancer who had been administered capecitabine monotherapy between June 2003 and August 2004 at our hospital were retrospectively reviewed. Oral capecitabine (828 mg/m2) was given twice daily for three weeks followed by a one-week rest period; this was repeated every four weeks.

Results

One-hundred and two patients were assessed. Median follow-up of patients was 16.4 months. One hundred patients (98%) had been pretreated with either anthracyclines or taxanes, 81 patients (79%) with both anthracyclines and taxanes. Response rate was 17% (95% CI, 9-24%), and clinical benefit rate was 41% (95% CI, 32-51%). Median time-to-treatment failure was 4.9 months, and median overall survival time was 24.3 months. This regimen was well tolerated. The most frequent grade 3 or 4 adverse event was hand-foot syndrome (6%). Other grade 3 or 4 adverse events were seen in only 1%-3% of patients.

Conclusions

Intermittent capecitabine monotherapy with lower dose intensity achieved a high tumor control rate with low toxicity in heavily pretreated metastatic breast cancer patients.
Renal Cell Cancer and Sorafenib: Skin Toxicity and Treatment Outcome
Authors: Bajetta Emilio , Procopio Giuseppe , Verzoni Elena , Catena Laura , De Dosso Sara , Platania Marco , Gevorgyan Arpine
Published: February 2018

We describe the case of a young man with refractory renal cell carcinoma who achieved an objective response in a metastatic lesion after biotherapy with the multikinase inhibitor sorafenib and also developed a severe skin reaction. The patient had been previously treated with various combinations of immunochemotherapy without any clinical benefit. We performed a brief review of the literature where similar cases were documented with the use of various anti-EGFR agents. The hypothesis of the correlation of skin toxicity with disease response is not new, but in the absence of any strong evidence remains controversial.
Synchronous Bilateral Breast Cancer in Men: A Case Report and Review of the Literature
Authors: Sosnovskikh Irina , Naninato Paola , Gatti Giovanna , Caldarella Pietro , Masullo Michele , De Brito Luciana Lima , Luini Alberto
Published: February 2018

Breast carcinoma is a rare disease in men, and bilateral cases are extremely uncommon. The rarity of male breast carcinoma and the small number of large studies on this topic have made it necessary to extrapolate treatment standards and outcomes from those established for women. Between 1997 and 2007, 75 men with breast cancer were referred to our institute, and the bilateral case we present here was the only one we have observed since 1994. The goal of our work was to contribute to the available literature with this extremely unusual presentation of the disease.
Prostate Cancer Metastasis to Thyroid Gland
Authors: Selimoglu Hadi , Duran Cevdet , Saraydaroglu Ozlem , Guclu Metin , Kiyici Sinem , Ersoy Canan , Eren Mehmet Ali , Tuncel Ercan , Imamoglu Sazi
Published: February 2018

Metastases to the thyroid gland are rarely encountered in clinical practice. They may originate from various primary sites, mainly kidney, lung, breast, esophagus and uterus. Prostate cancer is one of the most frequent malignancies in men. It generally has a favorable course, and autopsy series have shown occult prostate cancer in many subjects, especially in aged males. However, prostate cancer sometimes exhibits an aggressive behavior and cases with a poor prognosis have been reported. Occasional reports of metastasis from prostate cancer to the thyroid gland have been documented. We describe the case of a 73-year-old patient presenting with thyroid metastasis from long-standing prostate cancer.
Cervical Sympathetic Chain Schwannoma: two Different Clinical Presentations
Authors: Ozlugedik Samet , Ozcan Muge , Unal Tuba , Unal Adnan , Tezer Mesut Sabri , Seckin Selda
Published: February 2018

In this report we present 2 cervical sympathetic chain schwannoma (CSCS) cases with different clinical presentations, one being a pulsatile neck mass associated with Horner's syndrome and the other being an asymptomatic neck mass. CSCS usually presents as an asymptomatic neck mass and atypical findings such as Horner's syndrome and/or pulsation may occur in rare cases. Pulsatile CSCSs are generally diagnosed as carotid body tumors at initial workup and patients are referred to vascular surgeons. The differences in symptomatology, the preoperative management, and the importance of differential diagnosis are discussed.
Large Discrepancies between Planned and Actually Delivere dose in Imrt of Head and Neck Cancer. A Case Report
Authors: Piermattei Angelo , Cilla Savino , D'Onofrio Guido , Grimaldi Luca , Digesù Cinzia , Macchia Gabriella , Deodato Francesco , Morganti Alessio G
Published: February 2018

The case is reported of a patient with locally recurrent carcinoma of the tongue treated with intensity-modulated radiotherapy (IMRT) (simultaneous integrated boost) plus concurrent chemotherapy, who during the third week of radiotherapy developed grade 3 mucositis. Treatment was interrupted for 10 days until significant resolution of the symptoms. At the time of treatment resumption the patient showed 8% weight loss, and in vivo portal dose verification revealed large discrepancies between the computed and measured doses. A new CT scan showed marked tumor shrinkage and modifications to the critical structures. The comparison between the original plan and the hybrid IMRT showed a minimal dose increase in the new target volumes and a marked dose increase in the organs at risk.

This case confirms the need for a robust quality assurance program when using IMRT, the feasibility and efficacy of in vivo dosimetry to detect significant discrepancies between planned and delivered dose, and the need to combine IMRT with 4-dimensional radiotherapy, at least for head and neck cancer.
Merkel Cell Carcinoma after Liver Transplantation: A Case Report
Authors: Bajetta Emilio , Platania Marco , Catena Laura , Bichisao Ettore , Fabbri Alessandra , Procopio Giuseppe , De Dosso Sara , Buzzoni Roberto
Published: February 2018

Background

Merkel cell carcinoma is a rare and aggressive neuroendocrine skin cancer with a very low incidence in the general population. MCC seems to be common in transplant recipients and 52 cases have been reported in the literature.

Methods and results

This report describes a Merkel cell carcinoma which developed in a liver transplant recipient. To our knowledge, this is the second such case reported, as Merkel cell carcinoma most commonly occurs after kidney and heart transplants. The treatment approach is described and the literature on the subject is reviewed.

Conclusion

There is currently no consensus regarding the optimal therapeutic approach to Merkel cell carcinoma. In transplant recipients, such tumors are more common and more aggressive but their treatment does not differ from the treatment of Merkel cell carcinomas in the general population.
Regional Estimates of Lung Cancer Burden in Italy
Authors: Inghelmann Riccardo , Grande Enrico , Francisci Silvia , Verdecchia Arduino , Micheli Andrea , Baili Paolo , Capocaccia Riccardo , De Angelis Roberta
Published: February 2018

Aims and background

The aim of this paper is to present the Italian regional and national estimates of the mortality, incidence and prevalence over the period 1970-2010 for lung cancer, one of the most common cancers in Italy and Europe, especially among men.

Methods

The estimates were obtained with the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures using mortality and relative survival data. Published survival data from the Italian cancer registries were appropriately modelled in order to estimate survival at regional and national level.

Results

For men, the Italian lung cancer mortality and incidence rates reached their maximum values during the late 1980s and steeply decreased thereafter. This pattern is quite uniform across all regions, even though the decrease was delayed and less steep in the South of the country. For women, both indicators appear to be increasing at the national level, even though a certain regional variability in incidence trends remains within the country: some regions (such as Lazio, Umbria, Marche, Campania, Sardegna and Friuli Venezia Giulia) present increasing trends, while in others a clear levelling off is visible. A total of 33,500 incident cases, 72,000 prevalent cases and 28,000 deaths are estimated in Italy in 2005.

Conclusions

This study produced an up-to-date description of lung cancer epidemiology both at national and regional level. The marked difference in lung cancer figures and trends between sexes suggests that prevention policies have led to changes in smoking habits for men, while for women they were lacking in efficacy. The attention should now focus on women, whose risk trend is the least favorable.
The Variability of Applicator Position among High Dose Rate Intracavitary Brachytherapy Applications in Cervical Cancer Patients Treated with Ring & Tandem Applicators
Authors: Ebruli Cuneyt , Demiral Ayşe Nur , Çetingöz Riza , Eyiler Ferhat , Kinay Münir
Published: February 2018

Objective

To evaluate the interindividual and intraindividual applicator position variability in high dose rate ring and tandem intracavitary brachytherapy applications in locally advanced cervical cancer.

Patients and Methods

Eight patients with locally advanced cervical cancer formed the study population. They had been treated in Dokuz Eylül University Department of Radiation Oncology between the years 2000 and 2005 with high dose rate intracavitary brachytherapy using ring and tandem applicators. The 3-dimensional geometric variation of the applicator center in craniocaudal, mediolateral and anteroposterior directions was determined on the basis of bony reference points in 24 pairs of orthogonal films obtained in the conventional simulator. Then the following evaluations were performed: 1) the applicator position variability in all applications (interindividual variability), 2) the intraindividual applicator position variability relative to the first application, 3) the intraindividual applicator position variability relative to the average of three applications. Among the potential factors that might influence the reproducibility of ring and tandem applications, age, stage, the period between external radiotherapy and brachytherapy were evaluated by univariate analysis.

Results

Standard deviation of interindividual applicator variability was 3.83 mm in craniocaudal, 0.39 mm in mediolateral and 2.86 mm in anteroposterior directions. The standard deviation of intraindividual variability relative to the first application was 1.91 mm in craniocaudal, 0.4 mm in mediolateral, and 4.26 mm in anteroposterior directions. The standard deviation of intraindividual variability relative to the average of three applications was 0.95 mm in craniocaudal, 1.86 mm in mediolateral, and 1.24 mm in anteroposterior directions. According to univariate analysis, no factor influenced applicator position variability.

Conclusions

In order to extract definitive conclusions about factors that affect positional reproducibility of ring and tandem applicators, studies are needed that include larger numbers of patients.
Curative Surgery for Gastric Cancer in the Elderly: Treatment Decisions, Surgical Morbidity, Mortality, Prognosis and Quality of Life
Authors: Pisanu Adolfo , Montisci Alessandro , Piu Sara , Uccheddu Alessandro
Published: February 2018

Aims and Background

Surgical risk is deemed to be higher in the aged population because there are often comorbidities that may affect the postoperative result. This consideration is important for the treatment decision-making for gastric cancer in the elderly. The aim of this study was to identify factors influencing mortality, morbidity, survival and quality of life after curative surgery for gastric cancer in patients aged 75 years and older, and to plan their appropriate management.

Methods and Study Design

From January 1993 to December 2004, 135 patients underwent surgery at our department because of gastric cancer. Ninety-four of these patients (69.6%) underwent potentially curative gastrectomy. A cross-sectional study of 23 patients aged 75 years and older and 71 younger patients who underwent curative gastrectomy was carried out: patient characteristics, tumor characteristics, management, morbidity, mortality, survival, and quality of life were evaluated.

Results

Elderly patients had significantly more comorbidities and a poorer nutritional status than younger patients. The surgical procedures were similar in both groups and the overall morbidity rate was 27.9% and the overall mortality rate 8.5%. Medical mortality was significantly higher in elderly patients, and the presence of comorbidities was the only independent factor affecting mortality. The 5-year survival rate was 56.2% in the older group versus 62.1% in the younger group and tumor stage was the only prognostic factor influencing survival. Quality of life after surgery was similar in both groups. The significantly better postoperative functional outcome after subtotal gastrectomy suggested a better compliance of elderly patients with subtotal than total gastrectomy.

Conclusions

In the elderly, surgical strategies must be modulated on the basis of comorbidities, tumor stage and future quality of life. Since elderly patients have no worse prognosis than younger patients, age is not a contraindication to curative resection for gastric cancer. Subtotal gastrectomy should be the procedure of choice mainly in elderly patients as it offers better quality of life.
Neuroendocrine Carcinomas of the Upper Airways: A Small Case Series with Histopathological Considerations
Authors: Capelli Marco , Bertino Giulia , Morbini Patrizia , Villa Chiara , Zorzi Stefano , Benazzo Marco
Published: February 2018

Neuroendocrine carcinomas are rare tumors. In the head and neck region they are most common in the larynx, where they represent 0.5-1% of epithelial cancers. Diagnosis requires the recognition of the typical neuroendocrine architecture and morphology and the immunohistochemical confirmation of neuroendocrine differentiation. In the 1991 WHO classification laryngeal neuroendocrine carcinomas have been divided into carcinoids, atypical carcinoids, small cell carcinomas and paragangliomas. Atypical carcinoids in the head and neck region usually show an aggressive behavior analogous to poorly differentiated carcinomas, and are resistant to chemo- and radiotherapy. For this reason, it was recently proposed to change their designation to “moderately differentiated neuroendocrine carcinomas”.

We present the clinical and histopathological features of 2 moderately differentiated neuroendocrine carcinomas of the larynx, one large cell poorly differentiated neuroendocrine carcinoma of the oropharynx, and one small cell carcinoma of the minor salivary glands of the tongue. The patient with small cell carcinoma was free from disease 26 months after radical surgery, while the other patients showed liver, lung and bone metastases 18, 26 and 24 months after the diagnosis despite radical surgery or concomitant intra-arterial chemotherapy and radiotherapy.
Solid-Cystic Pseudopapillary Tumor of Pancreas: Description of two Cases and Literature Review
Authors: Freda Fulvio , Procaccini Eugenio , Ruggiero Roberto , Antropoli Massimo , Manganiello Amelia , Nunziata Luigi , Petronella Pasquale , Lo Schiavo Francesco
Published: February 2018

The authors report the cases of two young female patients aged 17 and 27 years who underwent surgery for a rare tumor of the pancreas, Frantz's tumor or solid-cystic pseudopapillary tumor. Solid-cystic pseudopapillary tumor of the pancreas is a rare tumor, accounting for 2.7% of pancreatic exocrine tumors. About 90% of these tumors occur in young women and they can reach very large dimensions. Due to their rareness and behavior, they are often associated with diagnostic and therapeutic problems. In most cases surgical treatment is curative and neither chemotherapy nor radiotherapy should be added. In the few cases where surgery is not possible, radiotherapy can be used because these tumors appear to be radiosensitive.
Rectal Injury in Radical Perineal Prostatectomy
Authors: de Arruda Homero Oliveira , Cury Jose , Ortiz Valdemar , Srougi Miguel
Published: February 2018

Objective

To report our experience in treating patients with rectal injury with radical perineal prostatectomy.

Methods

Medical charts of 176 patients submitted to radical perineal prostatectomy from 1996 to 2005 were reviewed to identify rectal problems. A review of rectal injury in prostatectomy is provided.

Results

Of 176 patients who underwent radical perineal prostatectomy, 10 (5.7%) had rectal injury and 4 (2.3%) presented rectal fistula. Two (1.1%) patients were submitted to colostomy. We discuss how to avoid and treat the complications.

Conclusions

There is a real risk of rectal injury during radical perineal prostatectomy, particularly during the learning period or if the approach is not often performed. Fistula might occur, but colostomy is actually unnecessary and rare. A better understanding of the perineal anatomy and knowledge about the technique is recommended before practicing radical perineal prostatectomy.
Natural Fluorescence Spectroscopy of Human Blood Plasma in the Diagnosis of Colorectal Cancer: Feasibility Study and Preliminary Results
Authors: Lualdi Manuela , Colombo Ambrogio , Leo Ermanno , Morelli Daniele , Vannelli Alberto , Battaglia Luigi , Poiasina Elia , Marchesini Renato
Published: February 2018

Aim and background

Fluorescence spectroscopy of biomolecules is considered a promising method to discriminate in vivo normal tissue from malignant tissue at various sites including breast, cervix, lung, and colon. However, only few studies have been reported on the feasibility of exploiting fluorescence spectroscopy of blood to characterize pathological changes usable in diagnostic oncology. In this study, the fluorescence characteristics of human blood plasma have been studied in the visible spectral range in an attempt to discriminate patients with colorectal cancer from subjects of a control population.

Patients and methods

The study involved 341 subjects, including 169 blood donors with no evidence of disease, 143 patients bearing colorectal adenocarcinomas (36 in the colon, 38 in the sigmoid colon and 69 in the rectum), 11 patients with local relapse, 10 patients with familial adenomatous polyposis and 8 with single adenomas. Blood samples were collected from all subjects and plasma fluorescence spectrum was analyzed using a conventional spectrofluorometer.

Results

The intensity of a fluorescence emission peak around 615–635 nm, which could reasonably be ascribed to endogenous porphyrins, was significantly different between patients bearing colorectal cancer and blood donors. The diagnostic capacity of the method was tested by ROC analysis, which resulted in an area under the curve of 0.72, close to that reported for the CEA test.

Conclusion

These results, although preliminary, suggest the potential of fluorescence measurements of blood plasma as an additional method for diagnostic application in colon cancer.
Appendectomy or Right Hemicolectomy in the Treatment of Appendiceal Carcinoid Tumors?
Authors: Fornaro Rosario , Frascio Marco , Sticchi Camilla , De Salvo Luigi , Stabilini Cesare , Mandolfino Francesca , Ricci Barbara , Gianetta Ezio
Published: February 2018

Aims and background

Carcinoids of the appendix continue to be of interest, despite their low incidence. There is still considerable controversy surrounding these tumors, especially with regard to the role of right hemicolectomy in the surgical management. The aim of this work was to explicate the current therapeutic knowledge and to review the criteria for the indications of appendectomy or hemicolectomy.

Methods

The records of patients who underwent appendectomies from 1990 to 2000 were analyzed. Seven patients were included in the study. The clinical data were reviewed for demographic details, tumor size, localization in the appendix, histological patterns and surgical procedures. All patients underwent appendectomy including removal of the mesenteriolum, and in one of them a right hemicolectomy was performed 3 weeks later. The mean follow-up was 7 years (range, 4–14). Follow-up data included symptoms, urinary 5-hydroxyin-doleacetic acid, ultrasound examination, computerized tomography, and octreotide scanning.

Results

Seven patients (0.9% of all appendectomies) were reported to have carcinoid tumors of the appendix. They were 3 men and 4 women with a mean age of 29 years. All patients were admitted for appendicitis. None suffered from the carcinoid syndrome. The site of the tumor was the apex of the appendix in 4 cases, the body in 2 cases and the base in 1 case. Mean tumor diameter was 8 mm (range, 5–29 mm); in 6 patients it was <2 cm. Treatment was appendectomy in all cases; additional right hemicolectomy was necessary in one case because of a tumor of more than 2 cm with invasion of the mesoappendix and lymph nodes. The 7-year survival rate is 100%. Six patients are without disease, while 1 patient (the one who underwent a right hemicolectomy) developed metastases in the liver 6 years after the operation. This patient, who was treated with a liver resection, is still alive.

Conclusions

According to current guidelines, an appendectomy may be performed for small carcinoid tumors (<1 cm). Reasons for more extensive surgery than appendectomy are tumor size >2 cm, lymphatic invasion, lymph node involvement, spread to the mesoappendix, tumor-positive resection margins, and cellular pleomorphism with a high mitotic index. The criteria that direct us towards major (hemicolectomy) or minor surgery (appendectomy) are controversial. Tumor size is still considered the most important prognostic factor, with a presumed increase in the risk of metastasis for tumors greater than 2.0 cm. The accepted treatment of such tumors is a right hemicolectomy. However, there is no evidence demonstrating a survival benefit for right hemicolectomy over simple appendectomy in patients with carcinoids greater than 2.0 cm in diameter.
Importance of Novel Sequence Alterations in the FHIT Gene on Formation of Breast Cancer
Authors: Çeçener Gülşah , Egeli Ünal , Tunca Berrin , şdelen İsmet Ta , Tolunay Şahsine , Bilgel Nazan
Published: February 2018

Aims and background

The character, role and impact of FHIT gene alterations, for which recent studies have shown that the gene has a role in the early stage of carcinogenesis in breast cancer, are still unclear. Thus, the current study evaluated FHIT gene mutations from breast tissue of women with malignant and benign breast disease and to elucidate the frequency and type of mutations in this gene.

Patients and methods

Mutations in exons 5–9 of the FHIT gene were screened using the intronic primer pairs in 83 breast (67 malignant and 16 benign) tissue samples by single-strand conformational polymorphism and sequencing analysis.

Results

FHIT mutations were detected in 13 of the 67 malignant cases (19.4%) and 2 of the 16 benign cases (12.5%). Four different sequence variants were determined: two novel frame shift mutations (codon 90 insA, codon 146 delT), one intronic novel mutation (IVS8 −17 insA), and one previously identified silent transition type alteration (codon 88 C to T). In addition, determination of this silent alteration caused formation of new exonic splicing enhancer (ESE) motifs on mutated sequences by using the ESEfinder program.

Conclusions

Our data contribute significantly to that currently known about the presence of FHIT gene mutations on the formation of breast cancer.
Duodenal Epithelioid Angiosarcoma: Immunohistochemical and Clinical Findings. A Case Report
Authors: Mignogna Chiara , Simonetti Sara , Galloro Giuseppe , Magno Luca , De Cecio Rossella , Insabato Luigi
Published: February 2018

Angiosarcomas are uncommon malignant tumors of vascular endothelium that represent less than 1% of all sarcomas. The epithelioid variant of angiosarcomas is exceptionally rare, and the gastrointestinal tract is rarely involved. Angiosarcomas mainly involve skin and soft tissue and rarely occur in breast, liver, bone, and spleen. We present the case of a 30-year-old man who underwent an upper gastrointestinal endoscopy for melena. A duodenal reddish polypoid lesion was found, which on microscopic examination turned out to be an epithelioid angiosarcoma. The immunohistochemical features of the lesion supported this diagnosis. The patient died eight months after the diagnosis. Epithelioid angiosarcoma is an aggressive variant of angiosarcoma and must be considered in the differential diagnosis of gastrointestinal tumors.
Clinical Stage I Seminoma
Authors: Consoli Francesca , Sava Teodoro , Cetto Gian Luigi
Published: February 2018

Stage I seminoma is highly curable. There are different treatment options for this disease: radiotherapy, surveillance and chemotherapy. In recent years, adjuvant chemotherapy in particular has been extensively evaluated. This paper offers suggestions about the advantages and disadvantages of the different strategies, which will be discussed considering prognostic factors; future perspectives will also be evaluated. Through a review of the literature and their clinical experience, the authors outline the importance of prognostic factors in the management of patients suffering from seminomas.

Although no treatment modalities have demonstrated survival advantages over others, acute and late side effects, acceptability and quality of life are the main elements of comparison between them. Our findings support the hypothesis that the final decision about the treatment of these tumors depends essentially on three different aspects: risk factors, the patient's own preferences, and single-center expertise. These aspects should play a fundamental role in the final decision-making.
Thyroid as a Target of Metastases. A Case of Foregut Neuroendocrine Carcinoma with Multiple Abdominal Metastases and a Thyroid Localization after 21 Years
Authors: Mattavelli Franco , Collini Paola , Pizzi Natalia , Gervasoni Carlo , Pennacchioli Elisabetta , Mazzaferro Vincenzo ,   Thyroid Cancer Study Group of INT, Milan
Published: February 2018

The thyroid gland is quite often the target of metastases. For this reason any thyroid nodule in a patient with a previous history of cancer needs to be evaluated. In case of thyroid metastases, the site of the primary tumor is most often the breast, lung or kidney. A thyroid metastasis from a foregut neuroendocrine tumor is very unusual and requires a differential diagnosis with primary neuroendocrine tumor of the gland itself, i.e., a medullary thyroid carcinoma. This case report is peculiar because of the multiple sites of abdominal relapses, the long time interval between relapses (21 years), and the positive outcome after surgical treatment.
Training and Mobility: A Priority for the Organisation of the European Cancer Institutes. How a National Mobility Initiative Could Enhance EU Cooperation in Cancer Research Contributing to the Development of an European Research Area: The Example of the Italian Comprehensive Cancer Centers’ Network “Alleanza Contro il Cancro”
Authors: Lombardo Claudio , Albanese Daniela , Belardelli Filippo , d'Alessandro Francesca , Giacomini Mauro , Rondanina Tania , Spagnoli Luigi G
Published: February 2018

It is widely recognized that productivity gains, sustained economic growth and employment are largely determined by technological progress, innovation and human capital. The 2000 Lisbon strategy to make Europe a competitive knowledge-based economy by 2010 and, more specifically, the Barcelona objectives agreed upon in 2002 to increase R&D investment in the EU to approach 3% of GDP, ensuring that there are sufficient human resources for research, are a preliminary step in this direction. If we want to reach this goal we have to succeed in retaining the best researchers, creating the right environment where they can perform their activities and develop their careers.

To this aim the Organization of European Cancer Institutes (OECI) has set up a working group on Education and Training with the mandate to encourage continuing education in cancer research and applications and to verify the feasibility to promote mobility programs inside the network and in association with industries.

Until now only few OECI training programs have been launched and a full mobility program has not been developed yet due to limited budget resources.

The Italian Network of Comprehensive Cancer Centers, Alleanza Contro il Cancro, has planned the launch of a mobility program awarding 70 annual fellowships over a period of 36 months. This program, which will be open to the world research community, could represent a first interaction through mobility among the members of the OECI network also involving industries. The program is a tangible approach to sustain the translational process needed for the development of an European Research Area in the field of cancer and its related biomedical disciplines, thus providing a practical answer to the 2005 renewed Lisbon Strategy.
OECI TuBaFrost Tumor Biobanking
Authors: Riegman Peter HJ , Bosch Antonio Llombart ,   the OECI TuBaFrost Consortium*, Riegman PHJ , Dinjens WNM , Oomen MHA , Spatz A , Ratcliffe C , Knox K , Mager R , Kerr D , Pezzella F. , van Damme B , van de Vijver M , van Boven H , Morente MM , Alonso S , Kerjaschki D , Pammer J , Lopez-Guerrero JA , Bosch A Llombart , Carbone A , Gloghini A , Teodorovic I , Isabelle M , Jaminé D , Passioukov A , Lejeune S , Therasse P , van Veen EB , Lam KH , Oosterhuis JW
Published: February 2018

OECI TuBaFrost harbors a complete infrastructure for the exchange of frozen tumor samples between European countries. OECI TuBaFrost consists of: • A code of conduct on how to exchange human residual samples in Europe • A central database application accessible over the Internet ( www.tubafrost.org ) where data can be uploaded and searched from samples that can be selected and ordered • Access rules with incentives for collectors • Standardization needed to enable the analysis of high quality samples derived from different centers • Virtual Microscopy to support sample selection with difficult pathology

The entire infrastructure was, after completion, which was entirely financed by the European Commission, implemented in the OECI. But so far it has not been used to its capacity. A recent survey held amongst the OECI members shed light on the causes. The main conclusion is that all responders see OECI TuBaFrost as a good platform for exchange of samples, however, the biggest bottleneck found was that potential users are too unfamiliar with the communication between their own biobank tracking system and the TuBaFrost central database application. Therefore, new future plans are drawn. In addition, new infrastructure plans have been developed and the first preparatory steps have been set. For biobanks the BBMRI project has started aiming for Pan-European Biobanking and Biomolecular Resources Research Infrastructure.
The Italian Network for Tumor Biotherapy (NIBIT). Sharing Visions, Goals and Efforts at European Level
Authors: Maio Michele , Fonsatti Ester , Burigo Arianna , Parmiani Giorgio
Published: February 2018

In the context of the Scientific Week 2008 of the Organisation of the European Cancer Institutes, the Italian Network for Tumor Biotherapy (NIBIT), within its initiatives sponsored by Alleanza Contro il Cancro, the Italian Network of Comprehensive Cancer Centers has contributed to organize the Workshop of the European Networks for bio-immunotherapy of tumors. Representatives from the Nordic Center of Excellence for the Development of Anti-Tumor Vaccines (Sweden), the German Network of Immunotherapy of Tumors (Germany), the Biotherapy Development Association and NIBIT gathered to present their organization and ongoing scientific activities, as well as to identify common strategies and shared efforts to push the field of cancer bio-immunotherapy forward at a European level. This article briefly summarizes the history and objectives of NIBIT, along with the actions so far taken by the Network.
Drug Delivery Systems: Application of Liposomal Anti-Tumor Agents to Neuroectodermal Cancer Treatment
Authors: Di Paolo Daniela , Pastorino Fabio , Brignole Chiara , Marimpietri Danilo , Loi Monica , Ponzoni Mirco , Pagnan Gabriella
Published: February 2018

Disseminated neuroectoderma-derived tumors, mainly neuroblastoma in childhood and melanoma in the adulthood, are refractory to most current therapeutic regimens and hence the prognosis remains very poor. Preclinical research studies have indicated several agents that show promising therapeutic potential for these neoplasms. However, there appears to be a limitation to their in vivo applicability, mainly due to unfavorable pharmacokinetic properties that lead to insufficient drug delivery to the tumor or metastatic sites or to high systemic or organ-specific toxicity. In this scenario, the focus is on targeted cancer therapy. Encapsulating anticancer drugs in liposomes enables targeted drug delivery to tumor tissue and prevents damage to the normal surrounding tissue. Indeed, sterically stabilized liposomes have been shown to enhance the selective localization of entrapped drugs to solid tumors, with improvements in therapeutic indices. The identification of tumor-associated antigens and/or genes and the relative ease of manipulating the physicochemical features of liposome hold promise for the development of novel therapeutic strategies that selectively target tumor cells. Combined targeting is still investigated, especially the availability to simultaneously target and kill both the cancer cells and the tumor vasculature. Animal models make it possible to link molecular genetics and biochemistry information to the physiological basis of disease and are important predictive tools that offer a frontline testing system for studying the involvement of specific genes and the efficacy of novel therapeutics approaches. Relevant experimental models of human neuroblastoma and melanoma, which better reflect the tumor behavior in patients, are required to evaluate the effectiveness of the various targeted liposomal formulations and their possible systemic and organ-specific toxicity. The most multifunctional targeted liposomes are herein described, with primary attention on testing their efficacy in clinically relevant animal models for the treatment of neuroblastoma and melanoma.
Nanoparticles for Imaging and Tumor Gene Delivery
Authors: Richard Cyrille , Le Masne De Chermont Quentin , Scherman Daniel
Published: February 2018

Molecular imaging of receptors expressed on the surface of tumor cells is becoming a major field of investigation in clinical oncology, especially for the detection of cancer at its earliest stages. Nowadays, MRI, microcomputed tomography (microCT), ultrasound, positron emission tomography (PET), optical coherence tomography (OCT), and other major imaging systems are available to scientists and clinicians. Each technique has advantages and limitations, thus making them complementary. We report herein our investigations on the synthesis and use of new probes for small animal imaging as well as on the preparation and use of targeting complexes to deliver specific gene in tumors cells.