bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Serum Alkaline Phosphatase in Osteosarcoma
Authors: Bacci Gaetano , Picci Piero , Orlandi Maurizio , Avella Maddalena , Manfrini Marco , Pignatti Giovanni , Dallari Dante , Manduchi Riccardo
Published: April 2018

In 163 patients with osteosarcoma of the extremities treated with adjuvant chemotherapy, serum alkaline phosphatase (SAP) levels were evaluated before treatment and successively closely monitored in an attempt to determine whether serum levels of this enzyme had clinical value in predicting the course of the disease. Of 121 patients with elevated preoperative SAP levels, 78 (64%) recurred. Of 42 patients with normal preoperative SAP levels, only 8 (19%) recurred (P < 0.00001). Of the 140 patients locally treated with amputation, SAP returned to normal values in 77 patients; 46 of these (59%) relapsed. Of the 21 patients whose SAP remained elevated after amputation, all but 2 relapsed (90%). Among 119 patients with normal postoperative values of SAP, at the time of relapse SAP resulted elevated in 22 of 41 patients (53%). These data confirm that in osteosarcoma, preoperative SAP levels have a definite value in establishing the prognosis and that posttreatment follow-up examination should include SAP determination, since persistent elevated or increasing values herald the appearance of a recurrence.
Ovarian Cancer: Ten-Year Experience in a Community Hospital
Authors: Franchin Giovanni , Crivellari Diana , Tumolo Salvatore , Scarabelli Carlo , De Paoli Antonino , Frustaci Sergio , Ciampi Antonio , Del Ben Loredana , Talamini Renato , Trovò Mauro , Grigoletto Eligio
Published: April 2018

We reviewed 187 patients with epithelial ovarian cancer treated, from 1975 to 1985, at the Division of Radiotherapy and Medical Oncology, Pordenone General Hospital, Italy. It seemed of interest to report an experience carried out in a community hospital in a consecutive unselected series of patients affected by ovarian cancer. Survival time was evaluated from the day of the primary surgical approach to the end of the study (March 1985). The aim of the study was to confirm in our patient population the importance of some already recognised prognostic factors that influence survival (age, stage, histology, grade, type of surgery and residuum). We also analyzed the effect of the treatment variables chemotherapy and radiotherapy on survival. The general pattern of prognostic factors appears to be in agreement with reports in the literature. In our experience, residual disease and stage were the main important prognostic factors; grade and histology had a secondary relevance, and age did not seem to be a prognostic factor in our population. New chemotherapy regimens and/or radiotherapy did not appear to improve survival. In fact, comparison of the results obtained from 1975–1979 and from 1980–1985 (when more aggressive surgery and cisplatin-containing regimens were employed) showed no statistically significant difference in survival rate. Our data suggest that patients at an early stage can receive a satisfactory quality of care in a general hospital with oncology facilities, provided the surgeon and the pathologist are experienced in ovarian cancer. Patients at stage III but completely surgically resected can also be adequately treated. Patients with advanced disease, considering the lack of established efficacious treatments, should be referred to specialized centers, where new drugs or experimental strategies can be tested.
Inflammatory Pseudotumor of the Liver: Report of two Cases
Authors: Collina Guido , Baruzzi Giuseppe , Eusebi Vincenzo
Published: April 2018

Inflammatory pseudotumor of the liver is a rare benign lesion which clinically and grossly is often interpreted as a neoplastic condition. It usually arises in children or young adults. Only 11 cases have been described in the literature, and its etiology is still uncertain. Two new cases of inflammatory pseudotumor in adult male patients are reported here. Morphologically, these cases summarize all the features seen in the other cases described previously. They showed fibrous bands delimiting microabscesses made up of granulocytes, mononuclear elements and foamy macrophages. These lesions have in common the symptomatology which is amenable to infectious disease. The purpose of this paper is to draw attention to the existence of a lesion that clinically simulates a neoplastic condition of the liver. This lesion should be histologically recognized to avoid excessive surgical treatment.
Breast Cancer Diagnosis under the Age of Forty Years
Authors: Ciatto Stefano , Smith Andrea Herd , Di Maggio Cosimo , Pescarini Luigi , Lattanzio Enzo , Ancona Antonietta , Punzo Clelia , De Leo Giuseppe , Burke Paolo , Bonomini Mino Giorgio , Melaranci Pietro
Published: April 2018

The authors report on a multicentric consecutive series of 382 cases of primary breast cancer detected before the age of 40 years. Physical examination (PE) was always performed, whereas other diagnostic tests were performed in selected cases, namely mammography (M) in 334, fine needle aspiration cytology (CYT) in 188 and thermography (TH) in 123 cases. Single tests showed a high rate of false-negative/benign cases (PE, 0.23; M, 0.26; CYT, 0.37 and TH, 0.50), especially when the T1 subgroup was considered (PE, 0.34; M, 0.38; CYT, 0.42 and TH, 0.78). The poor results recorded for TH make its current diagnostic use highly questionable. The policy of extensive biopsy of all « dubious » benign lesions on PE allowed for the detection of 41 of 382 cancers and reduced the PE false-negative/benign rate to 0.12 for the total or 0.15 for T1 cancers, although about 80 unnecessary biopsies for each cancer detected were performed in this way. The association of PE to one or more tests resulted in even lower false-negative rates (0.06 for the total, 0.10 for T1 cancers). The authors criticize the aggressive policy of extensive biopsy recommendation based only on a dubious report on PE alone and stress the opportunity of the routine association of M and CYT to PE, since this combination seems to achieve a higher breast cancer detection rate even in this age group.
Chest X-Ray Survey in Breast Cancer Follow-Up – A Contrary View
Authors: Andreoli Claudio , Buranelli Fiamma , Campa Tiziana , Costa Alberto , Magni Andrea , Pizzichetta Maria , Ciatto Stefano
Published: April 2018

The authors report on 83 cases of introthoracic metastases (ITM) observed as isolated first recurrences in a ten-year experience of periodic chest x-ray (CXR) survey of primary breast cancer. In 44 of 83 cases ITM were detected on CXR in absence of subjective symptoms or clinical signs (A) whereas 39 ITM cases were detected as subjectively (S) symptomatic in the interval between two planned CXR controls. Diagnosis was anticipated by CXR survey as the disease-free interval was significantly shorter (30 vs. 43 months, p < 0.04) for A respect to S cases. Nevertheless such a diagnostic anticipation had no prognostic impact as the ten year survival from primary treatment did not differ (0.12 vs. 0.16, p = 0.6) between A and S cases. Multivariate analysis confirmed that no impact on survival from primary treatment is expected whether ITM are detected in an earlier (asymptomatic, preclinical) or in a more advanced (subjectively symptomatic) phase. CXR survey after primary treatment of breast cancer seems thus a very questionable policy.
240 Hepatocellular Carcinomas: Ultrasound Features, Tumor Size, Cytologic and Histologic Patterns, Serum Alpha-Fetoprotein and HBs Ag
Authors: Livraghi Tito , Sangalli Gabriele , Giordano Ferdinando , Ravetto Carlo , Solbiati Luigi , Fornari Fabio , Cavanna Luigi , Matricardi Luigi , Gagliano Elio
Published: April 2018

Two hundred and forty cases of hepatocellular carcinomas (HCC), diagnosed by ultrasonography and fine needle biopsy, were studied. The following parameters were investigated: 1. echo features (240 cases) – hypoechoic, 54; hyperechoic, 56; complex, 112; isoechoic with halo, 18; 2. tumor size (240 cases) – single tumor under 4.5 cm, 30; single tumor over 4.5 cm, 74; multiple masses or diffuse, 136; 3. cytologic pattern (240 cases) – well and medium differentiated, 144; pleomorphic, 43; poorly differentiated, 28; unclassified, 25; 4. histologic pattern (157 cases) – trabecular, 74; solid, 42; acinar, 1; mixed, 2; unclassified, 38; 5. alpha-fetoprotein (AFP) level (185 cases) – under 20 ng/ml, 79; between 20 and 320 ng/ml, 40; over 320 ng/ml, 66; 6. HBs Ag (208 cases) – present in 56 cases; 7. cirrhosis (102 cases) –present in 79 cases. Some of the above parameters were correlated with one another. There was: 1. a highly significant frequency of the hypoechoic feature among small HCC; 2. a percentage of AFP-producing tumors increasing with tumor size; 3. no relationship between AFP production and cytologic or histologic pattern; 4. no relationship between tumor size and cytologic or histologic pattern. However, among the small HCC, all the 9 HCC with a diameter of less than 3 cm showed a trabecular pattern and well-differentiated cells. Cirrhosis was present in every patient with a small HCC. Since the discovery of a small HCC is an incidental ultrasonographic finding in the context of severe liver disease, ultrasonographic monitoring of cirrhotic patients is the best available strategy to screen for small HCC.
An Unusual Case of Primary Hormone-Secreting Germ Cell Tumor of the Retroperitoneum
Authors: Iaffaioli Rosario Vincenzo , Caponigro Francesco , Genua Geppino , Montesarchio Vincenzo , Di Prisco Bartolo , Bianco Angelo Raffaele
Published: April 2018

An unusual case of primary retroperitoneal germ cell tumor is presented. Criteria for considering such a diagnosis in patients with apparent poorly differentiated carcinomas are discussed. An interesting hypothesis is presented to explain the hormonal abnormalities observed.
Conservative Treatment of breast Cancer in Italy. A Survey
Authors: Pacini Paolo , Cappellini Mario
Published: April 2018

The authors evaluated the diffusion of conservative treatment of breast cancer in Italian radiotherapy departments during 1984–1985. T1 and small T2 (less than 3 cm in maximal diameter) cases were particularly considered. Conservative surgery and radiotherapy of breast cancer was adopted in 88.4% of the Italian radiotherapy centers. Quadrantectomy and axillary dissection was the surgical procedure routinely adopted. Large differences emerged in radiation treatment among the different departments, particularly with regard to the irradiation of regional lymph nodes. A total of 1561 T1 and 279 T2 cases were submitted to a conservative treatment in 1984, and respectively 2185 and 334 in 1985. The 1985 versus 1984 increase in cases treated was 40% for T1 and 18% for T2.
Relationship between Progesterone Receptor and Productive Fibrosis as an Index of Tumor Differentiation in Breast Cancer
Authors: Giani Claudio , Pinchera Aldo , Breccia Marina , Campani Daniela , De Negri Ferdinando , Benigni Giuliana , Evangelista Giuseppe , Miccoli Paolo , Savarese M. Rosaria , Incensati Roberto , Masini Isio , Baschieri Lidio , Squartini Francesco
Published: April 2018

We studied the relationship between steroid receptors (SR) and various stromal parameters in 100 breast cancers. Each specimen was submitted to SR determination by the dextran-coated charcoal assay and to histologic examination. No relationship was found between the presence of SR and necrosis or fibroblastic cell content. There was an inverse correlation between SR positivity and the extent of lymphocyte infiltration (p < 0.05). ER + PR + status was strongly correlated with marked productive fibrosis (PF) (p < 0.005). When SR were separately assayed, only the presence of PR was correlated with PF (p < 0.005); similar results were obtained for PR levels (p < 0.01). PF was also associated with a higher nuclear grade (p < 0.001). In conclusion, in this study a strong correlation between PR positivity or concentration and extent of PF was demonstrated in breast cancer. Since PR synthesis is an expression of an intact regulatory pathway, our data suggest that stromal production in breast cancer is related to the degree of differentiation of malignant epithelial cells.
Endocrine and Clinical Effects of an Lhrh Analogue in Pretreated Advanced Breast Cancer
Authors: Lissoni Paolo , Barni Sandro , Crispino Sergio , Cattaneo Giulio , Tancini Gabriele
Published: April 2018

Buserelin represents one of the main LHRH analogues. It appears to be effective in untreated metastatic breast cancer, whereas its activity in pretreated advanced patients remains to be established. To evaluate endocrine and clinical effects of buserelin in pretreated advanced mammary carcinoma, 14 postmenopausal women with metastatic breast cancer, which had been previously treated with hormones and/or chemotherapy, entered the study. Buserelin was subcutaneously injected at a daily dose of 1.5 mg for 7 days, then intranasally at a daily dose of 1.2 mg until progression. Before and after the 7 days of subcutaneous administration of the LHRH analogue, FSH, LH, estradiol, testosterone basal serum levels, and PRL response to TRH were examined. After the 7 days of buserelin subcutaneous injection, a significant decrease in FSH, LH and estradiol values was observed, whereas testosterone was not affected. PRL response to TRH did not change after buserelin subcutaneous treatment in 8 patients, it decreased in one and was completely abolished in the last 5 cases. All patients whose PRL response to TRH did not decrease had a progression within the first month of therapy, whereas only 1 of 6 patients whose PRL response to TRH was reduced or abolished following buserelin administration showed a progression. Among the other 5 cases, 2 minor responses and 3 stable diseases were achieved. These preliminary results suggest that buserelin has only a limited effectiveness in metastatic breast cancer patients who have been previously treated with hormones and/or chemotherapy, and that its activity in the control of tumor growth is associated with a reduction in PRL secretion.
The Use of Lympho-Venous Anastomoses to Prevent Complications from Ilio-Inguinal Dissection
Authors: Orefice Sergio , Conti Alberto Rudy , Grassi Massimo , Salvadori Bruno
Published: April 2018

Lympho-venous anastomoses (LVA) were performed in 30 patients, immediately after the completion of ilio-inguinal dissection for metastatic nodal involvement. This surgical procedure, originally devised to treat post-mastectomy lymphedema from radical mastectomy, was intended in this series of cases to prevent complications from ilio-inguinal nodal dissection. Actually, when compared to another group of 84 patients previously operated on by ilioinguinal nodal dissection without lympho-venous anastomoses, the series showed a lower rate of local-regional complications (38% vs 65.9%). The mean duration of hospital stay was also reduced (18.5 vs 34.7 days). Distant lymphedema of the lower limb was observed in 7 of 23 patients who had received LVA, whereas in the control group, lymphedema was recorded in 39 of 52 patients who were regularly followed-up (30% vs 75%). LVA should be routinely used, as a useful surgical procedure, to prevent or reduce the occurrence of local-regional complications following ilio-inguinal nodal dissections.
Alteration of Opioid Peptide Circadian Rhythm in Cancer Patients
Authors: Barni Sandro , Lissoni Paolo , Rovelli Franco , Crispino Sergio , Paolorossi Franco , Esposti Daniele , Esposti Germana , Fraschini Franco , Tancini Gabriele
Published: April 2018

Endogenous opioid peptides have been seen to play a role in regulating immunity and tumor growth. This study was carried out to investigate opioid activity in human cancer. We evaluated by radioimmunoassay β-endorphin plasma levels on blood samples collected at 9.00 a.m. from 121 cancer patients and 42 healthy subjects. In 22 cancer patients and in 12 controls, β-endorphin circadian rhythm was also investigated. Finally, in 14 cancer patients and in 10 controls GH, PRL, FSH, LH and Cortisol serum levels were measured after the administration of a metenkephalin analogue, FK 33–824 (0.3 mg i.v.). No significant differences were seen in β-endorphin mean levels between cancer patients and normal subjects. Moreover, no differences were found between patients with or without metastases, nor between those with or without chronic pain. β-Endorphin circadian rhythm appeared to be altered in 16/22 cancer patients, and anomalous hormonal responses to FK 33–824 were seen in 13/14 patients. This study shows an altered opioid activity in human neoplasms, whose clinical significance remains to be determined.
Weekly Epirubicin in Advanced Breast Cancer
Authors: Tucci Enrico , Algeri Renato , Guarnieri Alfredo , Pepi Fiorella , Sapio Lidia , Bastreghi Giorgio , Pirtoli Luigi
Published: April 2018

Twenty-nine advanced breast cancer patients, considered unable to tolerate conventional cytotoxic chemotherapy, were treated with a weekly schedule of epirubicin (15 mg/m2 i.v.). All patients were fully evaluable. A remission of 34.5 % was observed (2 CR; 8 PR), with a median duration of response of 9 months (range, 3–24 months). Side effects were mild, and on the whole the toxicity was negligible. This regimen showed a favorable therapeutic ratio in our series and seems active and well tolerated even in elderly and/or poor performance status patients.
Six-Drug Sequential Chemotherapy in Non Small Cell Lung Cancer. A North Milan Group Study
Authors: Cattaneo Maria Teresa , Vago Giuseppe , Piazza Elena , Filipazzi Virginio , Maruzzi Massimiliano , Rho Benedetto , Silvani Aldo , De Marinis Filippo , Cogo Roberto , Calzavara Maria Pia , Scarpazza Giorgio , Piatto Ernesto , Lombardi Franco , Libretti Arnaldo
Published: April 2018

Forty-five patients with inoperable non small cell lung carcinoma were treated according to a sequential polychemotherapeutic regimen with cisplatin-vinblastine (A), cyclophosphamide-etoposide (B), and adriamycin-vincristine (C). Patients were evaluated every two cycles. Ten patients (22.2 %) showed a partial response with a mean duration of 20 weeks, and mean survival of 50.8 weeks. It is remarkable that, among them, 6 patients (13.3 %) lived over 12 months and three (6.6 %) over 18 months. The mean survival for all patients was 35.7 weeks. Toxicity was acceptable and reversible.
Human Papillomavirus (HPV) Cervical Lesions: Results from 300 Italian Women Studied with Dna Hybridization Techniques and Morphology
Authors: Nuzzo Fiorella , Tison Vittorio , Castagnoli Antonella , Tiboni Maurizio , De Villiers Ethel-Michele ,   Cooperative Group of I.O.R., Buzzi Franco , Elegibili Eleonora , Lucchi Ivana , Magni Ettore , Naldoni Carlo , Ravaioli Alberto , Ridolfi Ruggero , Saragoni Ariele , Schincaglia Patrizia
Published: April 2018

Human papillomavirus cervical infection was investigated in a series of 300 unselected women by comparing morphological diagnoses (cytology and histology) with results of DNA hybridization techniques (filter in situ hybridization of DNA from exfoliated cervical cells and Southern blot analysis of HPV-DNA in cervical biopsy specimens). The prevalence of HPV cervical infection diagnosed by PAP smears was 11.6 %. Despite disadvantages, filter in situ hybridization was confirmed to be particularly useful for screening purposes to detect HPV in cervical scrapings. In 3 cases it was the only applicable method for diagnosing « high-risk » HPV infection. Southern blot hybridization of tissue DNA with HPV 16-DNA revealed the presence of this virus in 8 cases, and HPV 31-DNA and HPV 42-DNA in 1 case each.
Nucleolar Organizer Regions in Normal Skeletal Muscle and Benign and Malignant Rhabdomyoblastic Tumors
Authors: Eusebi Vincenzo , Ceccarelli Claudio , Cancellieri Alessandra , Derenzini Massimo
Published: April 2018

The silver staining of interphase nucleolar organizer regions (NORs) has been shown to have an important application in diagnostic histopathology for distinguishing some benign from malignant conditions. In this study, normal fetal and adult skeletal muscles and tissue from fetal and adult rhabdomyomas as well as rhabdomyosarcomas were stained with the silver method for NORs. The morphologic distribution of NORs in rhabdomyosarcomas was found to be very different from that in normal skeletal muscles. In addition, cases of rhabdomyoma were easily differentiated from rhabdomyosarcomas. Statistical analysis of data, from all cases, regarding the diameter of NORs and number per nucleus confirmed these observations.
The Role of Magnetic Resonance Imaging in the Evaluation of Neoplastic Lesions of the Breast
Authors: Petrillo Raffaele , Balzarini Luca , Bargellini Anna , Bartoli Cesare , Ceglia Errico , de Yoldi Gianfranco Coopmans , Greco Marco , Tesoro Tess John David , Musumeci Renato
Published: April 2018

Thirty-seven patients were evaluated for suspected breast cancer by magnetic resonance imaging (MRI) using 0.5- and 1.5-Tesla. We esamined the patterns in breast images and the use of MRI in evaluating neoplasms. At the moment the cost/benefit ratio is unfavorable, mainly because of the availability of alternative methods of high accuracy and low cost, like mammography and ultrasonography. Furthermore fine needle aspiration biopsy is not possible with MRI. The widespread use of MRI for breast pathology seems not to be justified by the results obtained.
« T » Category and Operable Breast Cancer Prognosis
Authors: Ciatto Stefano , Cecchini Silvia , lossa Anna , Grazzini Grazia
Published: April 2018

The authors report on 4,034 consecutively operated breast cancer cases, evaluating the correlation between clinical T category and long term survival. Age and pathologic nodal status were also considered as independent prognostic factors. Univeriate and multivariate (Cox's) analysis confirmed N status as the most powerful single prognostic indicator and did not reveal any prognostic correlation with age. T category was a strong prognostic indicator, independently of N status, the 10 year overall survival of T1, T2 or T3-4 cases being 0.86, 0.76 and 0.73 in N– and 0.73, 0.56 and 0.35 in N+ subgroups respectively. T category should be carefully considered not only in deciding the extent of surgical excision but also in planning adjuvant postoperative treatment.
Pilot Study with Adriamycin and Ifosfamide in Small Cell Lung Cancer
Authors: Bidoli Paolo , Spinazzé Silvia , Santoro Armando , Bedini Amedeo V. , Cataldo Ignazio , Bonadonna Gianni
Published: April 2018

Twenty-one patients with limited (12 cases) or extensive (9 cases) small cell lung cancer entered a pilot study with adriamycin (ADM) plus ifosfamide (IFX) as first line treatment for six planned cycles. ADM was administered at the dose of 60 mg/m2 iv push on day 1 and IFX at 3 g/m2/iv in 1-hour infusion on days 1 and 2. To prevent IFX-induced hemorrhagic cystitis, mercaptoethane sulfonate sodium (Mesna) was given after the admnistration of IFX at the dose of 500 mg/m2 by iv push four times (hour 0, 4, 8, 12) on days 1 and 2. In the absence of disease progression, chemotherapy was repeated every 3 weeks for 6 cycles. All patients were evaluable for analysis of response, toxicity and survival. The overall response rate clinically and radiologically assessed after four treatment cycles was 95.3% (CR 28.6%, PR 66.7%). However, by continuing the same drug treatment up to the sixth cycle, 7 of 14 partial responders showed tumor progression within the intrathoracic region. Therefore, at the end of the planned chemotherapy program the partial remission rate fell to 33.3%, for a total remission rate of 61.9% and a median total survival of 9 months (range 5 to 36+). The regimen was well tolerated with only one case presenting hemorrhagic cystitis. The results achieved with this drug combination appear comparable to those obtained with other conventional regimens. However, the high response rate achieved after four cycles and the low incidence of marrow toxicity suggest the use of this regimen for a short period with increased dose levels.
Yield of Total Body GA-67 Scintigraphy in the Staging of Non-Small Cell Lung Cancer
Authors: Buccheri Gianfranco , Vola Ferruccio , Ferrigno Domenico , Curcio Antonio
Published: April 2018

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.
Sequential versus Alternating Regimens in the Treatment of Advanced Breast Cancer
Authors: Giachella Omar Fernández , Gálvez Carlos , Rufino Carlos , Rufino Adelina , Morera Federico , Jovtis Silvia , Cervellino Juan Carlos , Muro Horacio , Crego Hugo , Marino María Picciola , Blajman César , Iparraguirre Gladis , Castagnari Aldo , Ivulich Carlos , Bianchi Roberto , Pensel Raúl , Breier Simón , Bruno Mario , Dýaz Beatriz , Pasccon Graciela , Larravide Alfredo , Cardoso Carlos , Carlevari Jorge , Chiesa Gerardo , Colombini Enrique , Martínez Justina , Rao Francisco , Chirino Miguel Angel , De Núñez Beatriz , Osuna Alicia , Savulsky Claudio , Longarte Adrián , Graizer Héctor , Fleischer Isaac , Villalba Juan Carlos Blanco , Federico Cristián , Hansen Ernesto Pasini , Levy Daniel , Hannois Adrián
Published: April 2018

With the object of proving whether seqeuntial or alternate forms of chemotherapy would be advantageous one over the other in treating advanced breast cancer and with the purpose of evaluating two different anthracyclines at equimolecular doses in the above-mentioned alternating regimens, 250 patients who had received no prior chemo- or hormonotherapy were entered in a prospective randomized trial. Group A was administered 4-epiadriamycin and cyclophosphamide for 8 courses, followed by 6 cycles of CMF, and medroxyprogesterone acetate (MPA) from the beginning of therapy until progression. In group B, adriamycin + cyclophosphamide were alternated with CMF every two courses until 14 cycles were completed. Group C received 4'-epiadriamycin + cyclophosphamide alternated with CMF for 14 courses. In groups B and C, MPA was administered as in group A. Two hundred and twenty-four patients were evaluated. CR+PR were observed in 55.8 % of group A, 43.4 % of group B, and 46.4 % of group C. Median duration of responses was 16 months (m) in group A, 13 m in group B and 20 m in group C., and median survival (CR + PR) was 16.5 m in group A, 16 m in group B and 24 m in group C. There were no statsitically significant differences among the three groups in terms of response rate, duration of response and survival; furthermore, toxicity was moderate in all groups. At equimolecular doses there were no differences between adriamycin and epirubicin in the alternating schedules.
Gastric Metastases from Breast Cancer: A Case Report
Authors: Cascinu Stefano , Fedeli Stefano Luzi , Fedeli Anna , Catalano Giuseppina
Published: April 2018

We describe a case of a 50 year old woman with a secondary involvement of the stomach from breast carcinoma. She complained of nausea, vomiting and epigastric pain resistant to gastroprotective drugs. Initially symptoms were attributed to the side effects of chemotherapeutic agents. Correct diagnosis led to effective treatment of gastrointestinal symptoms with consequent improvement in her quality of life.
Isolated Central Nervous System Metastasis from Ovarian Carcinoma: A Case Report
Authors: Bonardi Gianmaria , Donadio Michela , Maestroni Franco , Giaccone Giuseppe , Calciati Alessandro
Published: April 2018

Ovarian adenocarcinoma usually disseminates and recurs the abdominal cavity. The detection of central nervous system metastases is rare. In this report we describe a case of intracranial recurrence that developed during a complete local surgical and pathological response and was treated radically with surgery followed by radiation.
Cell Kinetics of Solid Tumors with Time and Its Clinical Implication
Authors: Silvestrini Rosella , Daidone Maria Grazia , Costa Aurora
Published: April 2018

The proliferative rate has been evaluated for several human tumor types as the fraction of cells in S-phase. The methodologies most often used are autoradiographic determination of 3H-thymidine incorporation and flow cytometric evaluation of DNA content. Cell kinetics determined on various solid primary tumors at the time of diagnosis is not related to pathologic stage but it is an indicator of clinical evolution of the disease similar or superior to other biologic and pathologic prognostic factors. In early disease, submitted to loco-regional treatment as a first-line therapy, the rate of cell proliferation provides prognostic information on relapse-free and overall survival. In this clinical situation, a different metastatic potential can be attributed to tumors with different proliferative rates. In more extensive disease, submitted to systemic treatment, proliferation indices generally influence overall survival, eventhough in responsive tumors a fast proliferative activity could be indicative of higher aggressiveness and remarkable chemosensitiveness. Proliferation indices of the metachronous metastatic lesions is increased over those of the primary tumors as a further evidence of the association between proliferative activity and disease progression.
Phase II Trial with Alternating Two Drug Schedules, CAP/MEC', For Advanced (Stage III Mo/Ml) Non-Small-Cell Lung Cancer
Authors: Tummarello Diego , Porfili Emilio , Guidi Francesco , Isidori Pierpaolo , Raspugli Marzio , Biscottini Bruno , Fatati Giuseppe , Cellerino Riccardo
Published: April 2018

Sixty-eight evaluable patients with advanced squamous cell carcinoma (48), large cell carcinoma (2) and adenocarcinoma (18) of the lung were treated with a six-drug regimen delivering two monthly alternated combinations. The combinations were cisplatin, adriamycin and cyclophosphamide (CAP) and methotrexate, etoposide and CCNU (MEC). Following a minimum of two courses, the overall response rate was 22 % (confidence limits, 12% to 32%) (15/68, 2 complete responses and 13 partial responses); 47 % (32/68) had stable disease and 31 % (21/68) had progressive disease. The responses lasted a median of 3 months (range, 1-15 months). The actuarial median survival was 11 months in responsive patients, 10 months in stable disease patients, and 5 months in progressive patients. The overall median survival obtained was 9 months (range, 2-28+ months). Toxicity was minimal, and subjective tolerance of the treatment appeared good. However, this alternating program did not improve response rate or survival.
Grading as a Prognostic Factor: Review of 209 Primary Gastric Cancer Patients
Authors: Secco Giovanni Battista , Fardelli Roberto , Campora Elisabetta , Rovida Salvatore , Lapertosa Gabriella , Motta Giovanni
Published: April 2018

Two hundred and nine cases of primary gastric cancer were treated surgically from January 1968 to December 1983 and analyzed retrospectively. All patients were followed up for a minimum of 5 years. There were 25 SI cases (12 %), 22 SII (10.5%), 55 SIII (26.3%) and 107 SIV (51.2%). Tumor grade according to Broders classification showed 50 cases of G1 lesions (23.9%), 44 G2 (21.1 %) and 115 G3 (55%). Patients with well differentiated G1 lesion, compared to G2-G3 patients, presented a greater incidence of T1-T2 tumors and decreased incidence of T4 tumors (p < 0.05). The lymph node involvement rate significantly increased with variation of T (p < 0.001) but not with tumor grade. Survival results correlated with tumor stage (p < 0.01) but not with tumor grade or histological type.
Serum Bone Gla-Protein in Hypercalcemia of Primary Hyperparathyroidism and Malignancy
Authors: Di Virgilio Roberto , De Lazzari Manuela , Da Rin Giorgio , Legovini Pietro , Foscolo Giancarlo , Roiter Ignazio , Conte Nicola
Published: April 2018

Serum bone GLA-protein, a modem and sensitive marker of bone turnover, was measured in 15 patients with primary hyperparathyroidism, 18 patients with hypercalcemia of malignancy, 41 patients with bone metastasis without hypercalcemia, and 29 healthy subjects. Serum bone GLA-protein was increased in primary hyperparathyroidism (17.6 ± 3.9 ng/ml) and normal in hypercalcemia of malignancy (5.2 ± 2.8 ng/ml; p < 0.001 vs hyperparathyroidism) and in normocalcemic patients with bone metastases. In primary hyperparathyroidism parathyroid hormone correlated positively with urinary calcium excretion (p < 0.05) and with urinary hydroxyproline excretion (p < 0.001). The sensitivity of serum bone GLA-protein measurements in differentiating between primary hyperparathyroidism and hypercalcemia of malignancy was 91 % and the specificity 84 %. Thus this marker appears to be a useful tool for the differential diagnosis of hypercalcemias.
Long-Term Results with the Gn-Rh Analogue, Buserelin, in Metastatic Prostate Cancer
Authors: Maffezzini Massimo , Villa Eugenio , Broglia Luigi , Francesca Francesco , Rigatti Patrizio
Published: April 2018

LH-RH analogues have come into use to suppress the synthesis of testosterone by the testes and to induce palliation in advanced prostate cancer. Twenty-one patients were treated with buserelin (Hoe 766), and 19 were evaluable. Stages of disease were D1-D2. Seventeen patients responded to treatment, 3 patients are still in partial response, and 16 underwent progression. The median time to progression was 12 months (range, 3–36), and the median follow-up time was 10 months (mean, 25.4; range, 5–48).
Neonatal Malignant Solid Tumors
Authors: Cecchetto Giovanni , Previtera Carlo , Messineo Antonio , Longo Maurizio , Guglielmi Maurizio
Published: April 2018

We reviewed the 8 malignant solid tumors in children less than 1 month of age observed at the Pediatric Surgical Department of Padua University from 1968 to 1985. These were 6 neuroblastomas, 1 Wilms' tumor and 1 angiosarcoma; 5/8 are alive without evidence of disease with a median follow-up of 8 years. The importance of combined therapeutic approach and conservative surgery are stressed. The sensitiveness of infants to both chemotherapy and radiotherapy are considered. Surgery remains the treatment of choice when a radical resection is possible.
Cancer Mortality in Italy: An Overview of Age-Specific and Age-Standardised Trends from 1955 TO 1984
Authors: La Vecchia Carlo , Negri Eva , Decarli Adriano , Fasoli Monica , Cislaghi Cesare
Published: April 2018

Number of certified deaths, age-specific and age-standardised rates and percentages of all cancer deaths from 30 cancers or groups of cancers (plus total cancer mortality) for each five-year calendar period between 1955 and 1984 in Italy are presented in tabular form. From these data, three graphs are derived, including trends in age-standardised rates, age-specific rates centered on birth cohorts and maps plotted in different shades of grey to represent the surfaces defined by the matrix of various age-specific rates. These analyses quantified the rises in overall cancer mortality in males (from 137 to 192/100,000 world standard), chiefly due to increases in lung and other tobacco-related neoplasms. Overall cancer mortality was stable in females (around 100/100,000). Appreciable cohort effects were evident for tobacco related neoplasms, but also for other major cancer sites, such as Intestines or breast, whose rates, after earlier rises, are now stable in earlier middle age. Since the early 1970's, cancer mortality rates have been declining in all age groups below 40 in males and below 55 in females. These declines reflect Improvements in therapy for leukemias, lymphomas and germ cell tumors, and general improvements in food availability and storage, hygiene and early diagnosis, which have led to the declines in stomach and cervical cancer. Although moderate in absolute terms and smaller than in other western countries where tobacco-related neoplasms have also been falling in more recent cohorts, these declines are encouraging for the indication they provide on the most likely patterns over the next decades in the same and subsequent generations.
Acute Non Lymphoid Leukemia following CMF Treatment as Adjuvant Therapy in Positive Node Breast Cancer
Authors: Zampa Germano , Andriani Alessandro , Benl Adriano , Patino Nicola , Rinaldi Pierluigi
Published: April 2018

The CMF regimen as an adjuvant therapy for breast cancer with axillary node involvement has become « standard therapy » at least for some subsets of patients (according to the Second Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer). The acute toxicity of such a regimen Is usually mild and well tolerated; the late toxicity is mainly represented by amenorrhea. Here a case of acute non-lym-phoid-leukemia (ANLL) after six CMF cycles is reported.
Practice of Early Diagnosis of Breast and Uterine Cervix Cancer in a Northern Italian Town
Authors: Segnan Nereo , Ronco Guglielmo , Ponti Antonio
Published: April 2018

We studied the practice of screening for breast and uterine cervix cancer in Torino where, currently, no kind of organized program exists and two projects of population screening programs, based on pap smear and mammography, have been developed. Fifty-two percent (95% confidence limits (C.L.): 47%-58%) of women 18-69 years old had had a pap test or colposcopy in the absence of symptoms during their lifetime. Among them 50% had had their last pap test within 18 months of the interview, 77% within 3 and 1/2 years, and only 14% was screened 5 and 1/2 years before or earlier. Thirty percent of never-screened women (95% C.L.: 25-35%) would not accept any of the proposed modalities for screening. Overall, 15% of women had had a mammography for screening purposes. Among women 50 to 59 years old, 23% (95% C.L.: 17-30%) had had at least one mammography for screening purposes in their lifetime, but only 18% (95% C.L.: 13-24%) had had at least 1 screening test at age 50 or after. Half of ever-screened women age 50-69 years had had the last mammography within 2 and 1/2 years. Among all respondents in the same age group this figure was 11% (95% C.L.: 7-15%). Forty-one percent of respondents reported to currently practice BSE (95% C.L.: 36-45%), but this proportion dropped to 10% in the age group 19-39 years and to 4% among women 40-69 years old when only those who had 10-13 examinations each year and judged their performance to be good were considered. Thirty-nine percent (95% C.L.: 34-44%) had had a physical examination of the breast performed by a medical doctor in the absence of symptoms within the last 18 months. Thirty-five percent (95% C.L.: 31-38%) of all women had never had a mammography, did not practice BSE, and had never consulted a physician for control in the absence of symptoms. Analysis by age, birth cohort, education, marital status and place of birth is presented.
Sequential and Synchronous Chemo-Radiotherapy in the Management of Locally Advanced Carcinoma of the Head and Neck
Authors: Antognoni Paolo , Camesasca Giovanna , Bianchi Claudio , Nicoletti Guglielmo , Villa Eugenio
Published: April 2018

Thirty-nine consecutive patients with stage III-IV squamous cell carcinoma of the head and neck entered a pilot study of sequential and synchronous chemo-radiotherapy. The study was planned as follows: two cycles of induction chemotherapy (MTX, BLM, DDP) followed by radical radiotherapy (66 Gy) with synchronous weekly administration of DDP (20 mg/m2) as a radiosensitizer. Out of the 39 patients evaluable for induction chemotherapy 25 (64%) achieved partial or complete response. Two patients underwent radical surgery after induction chemotherapy and 3 patients died of treatment. Out of the remaining 34 patients, 25 were untreated and 9 presented recurrence after primary surgery. Grade 4 mucositis was the major side effect of concurrent chemo-radiotherapy. Local control after synchronous therapy was obtained In 11 (44%) previously untreated patients and only in 1 (11%) patient of the surgically pretreated group. At the time of the analysis 11 patients were alive, 8 of them free from disease (4 after salvage surgery). Actuarial 2-year survival for previously untreated patients was 33% and 24% for all the patients. This survival is not significantly different (log rank test) from that of a similar group of 24 patients treated at the same institution with radiotherapy alone. The important toxicity of the induction chemotherapy regimen and the poor 2-year survival do not show any benefit from such a combined approach in locally advanced head and neck carcinoma. Nevertheless, despite our disappointing results many data in the literature suggest a role for chemotherapy-based treatments of locally advanced head and neck cancer. Further controlled randomized studies are required to better define the place of chemotherapy in the multi-modality management of stage III-IV head and neck cancer.
Prevention of Cisplatin-Induced Vomiting in Patients with Cancer. A Pilot Study with a Multiagent Protocol
Authors: Federico Massimo , Sabbatini Roberto , Piccinini Paolo , Zironi Sandra , Piccinini Lino , Silingardi Vittorio
Published: April 2018

Forty patients receiving a total of 102 courses of cisplatin (CDDP)-based treatment were observed in the present study. The patients received an antiemetic prophylaxis with metoclopramide (6 mg/kg), dexamethasone (12 mg/m2), lorazepam (2.5 mg), promethazine (50 mg), and diazepam (10 mg). Complete protection from acute vomiting was obtained in 77.5% of patients during the first course, and partial protection (1 to 3 episodes of vomiting) was observed in 10.1% additional cases. Complete protection was achieved in 84.6% of males vs 57.1% of females. Patients at their first course of chemotherapy had 80% complete protection compared to 66.7% In those who received prior chemotherapy. No differences in the response rate between patients treated with high versus patients receiving low doses of CDDP were noted. The same pattern of response was observed in subsequent courses of therapy. Side effects were minimal (mild sedation in almost all the cases and hiccups in a few cases). No major extrapyramidal reaction was observed. The regimen used in the study showed good efficacy in preventing acute CDDP-induced nausea and vomiting. Moreover, the very low incidence of major side effects makes this protocol safe and recommendable in patients undergoing CDDP chemotherapy.
Complete Regression of Laryngeal Involvement by Classic Kaposi's Sarcoma with Low-Dose Alpha-2b Interferon
Authors: Gridelli Cesare , Palmieri Giovannella , Airoma Giuseppe , Incoronato Pasquale , Pepe Rosario , Barra Enrica , Bianco Angelo Raffaele
Published: April 2018

We report the case of an 82-year old Italian female with laryngeal involvement of classic Kaposi's sarcoma. We obtained a complete regression of laryngeal lesion with low-dose alpha-2b interferon.
Transfection of Human Breast Epithelial Cells with Foreign Dna Using Different Transfecting Techniques
Authors: Basolo Fulvio , Elliott James , Russo José
Published: April 2018

The introduction of DNA into eukaryotic cells is a powerful technique for the study of gene regulation. This requires both a technique by which genes can efficiently be introduced into cells and a recipient cell representative of the tissue under study. We have utilized a spontaneously immortalized human breast epithelial cell line, CMF-10, which is phenotypically normal for introducing a neomycin-resistant gene contained in the plasmid Homer 6 (pHo6). Three different transfection methods were tested: calcium phosphate, with and without glycerol shock, using as control NIH/3T3 cells, and strontium phosphate and electroporation. In MCF-10 cells the efficiency of calcium phosphate mediated DNA transfection, which was measured as the number of colonies growing in neomycin-containing medium, was 21 and 140 fold higher than in MCF-10 cells transfected by electroporation and strontium phosphate methods, respectively. Glycerol shock enhanced three fold transfection efficiencies. NIH/3T3 transfected cells by calcium phosphate method showed a transfection efficiency similar to that of MCF-10 cells, however, glycerol shock did not improve the efficiency. These studies revealed that calcium phosphate combined with glycerol shock is the most efficient technique for transfection of genomic DNA into human breast epithelial cells.
High-Dose Epirubicin-Cisplatin Chemotherapy for Advanced Soft Tissue Sarcoma
Authors: Jelić Svetislav , Vuletić Labuda , Milanović Nenad , Tomašević Zoran , Kovčin Vladimir
Published: April 2018

A chemotherapy regimen with epirubicin (60 mg/m2, days 1, 2 and 3) and cisplatin (30 mg/m2, days 2, 3, 4 and 5) was started for 35 patients with advanced soft tissue sarcoma (28 males and 7 females; median age, 50 years). All patients were chemotherapy-naive and with an expected survival of more than 2 months. All patients were evaluable for activity and toxicity. The intercycle interval was 4 weeks. Median number of cycles applied was 4 (range, 2-8). The overall response rate was 20/35 (57.1%). A complete response (CR) was achieved in 7/35 patients (20%), lasting for 26+, 26+, 13+, 13+, 9+, 9+ and 5 months; 13/35 patients (37.1%) entered a partial remission (PR), 9/35 patients (25.7%) had stable dis ease (SD), and 6/35 (17.1%) had progressive disease (PD). In non-responders (SD + PD), the median survival was 4 months; the median survival of responders (CR+PR) was 9+ months (the median has not yet been reached). Hematologic toxicity of grade 4 was present at least in one cycle for hemoglobin in 6/35 patients, for leukocytes in 22/35, and for platelets in 13/35. No hemorrhagic syndrome was observed. The leukopenia was usually of short duration (nadir on days 10-12). Febrile episodes were present in 18 patients during the nadir of leukopenia. No other significant toxicity was noted (apart from grade III alopecia in all patients), and specifically, there was neither acute nor cumulative cardiotoxicity.
Chemotherapy in Metastatic Nonanaplastic Thyroid Cancer: Experience at the Institut Gustave-Roussy
Authors: Droz Jean-Pierre , Schlumberger Martin , Rougier Philippe , Ghosn Marwane , Gardet Paule , Parmentier Claude
Published: April 2018

Forty-nine patients with metastatic nonanaplastic thyroid carcinoma were treated over a 10-year period. Five successive chemotherapeutic protocols were used: a combination of doxorubicin, etoposide, 5-fluorouracil and cyclophosphamide; elliptinium acetate; doxorubicin; cispiatin; and the combination of doxorubicin and cispiatin. Results obtained with the different protocols were very disappointing, with only two objective responses (3%). Phase II trials with new chemotherapeutic agents are warranted in selected cases of nonanaplastic metastatic thyroid carcinoma.
Uterine Benign-Appearing Smooth Muscle Tumor « Metastatic » to the Lungs: A Case Report
Authors: Canzonieri Vincenzo , Blandamura Stella , Zanella Alida , Capitanio Giovanni
Published: April 2018

A case of pulmonary fibroleiomyomatosis secondary to a uterine « metastasizing » leiomyoma, with aspects of vascular invasion, is reported. Although we cannot exclude the existence of primitive pulmonary forms, which we do not consider to be of a hamartomatous nature, we believe that a careful examination of the uterus for the presence of angioinvasive leiomyoma is mandatory.