bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Phase Technology Assessment of Nanotechnology in Oncology
Authors: Retèl Valesca P , Hummel Marjan JM , Van Harten Willem H
Published: February 2018

To perform early Technology Assessment (TA) of nanotechnology in oncology. The possibilities of nanotechnology for detection (imaging), diagnosis and treatment of cancer are subject of different research programs where major investments are concerned. As a range of bio- nanotechnologies is expected to enter the oncology field it is relevant to consider the various aspects involved in especially early TA. This article provides two cases of early assessment of (predecessors of) nanotechnologies: Microarray Analysis and Photodynamic Therapy implementation, which methodology can be extrapolated to other nanotechnologies in oncology.

Constructive Technology Assessment (CTA) is used for the introduction of technologies that are still in a dynamic phase of development or in an early stage of diffusion. The selection of studied aspects in CTA is based on: clinical aspects (safety, efficacy, and effectiveness), economic (cost-effectiveness), patient related (QoL, ethical/juridical and psychosocial), organizational aspects (diffusion and adoption) and scenario drafting. The features of the technology and the phase of implementation are decisive for choices and timing of the specific aspects to be studied. A framework was drafted to decide on the relevant aspects. In the first case, early implementation of Microarray Analysis; clinical effectiveness, logistics, patient centeredness and scenario drafting were given priority. Related to the diffusion-phase of Photodynamic Therapy however other aspects were evaluated, such as early cost-effectiveness analysis for possible reimbursement. Often CTA will result in a mixed method design. Especially scenario drafting is a powerful instrument to predict possible developments that can be anticipated upon in the assessment.

CTA is appropriate for the study of early implementation of new technologies in oncology. In early TA small series often necessitate a mix of quantitative and qualitative methods. The features of nanotechnology involved are decisive for the selection of CTA aspects, most likely: safety -especially possible interactions with other technologies-, ethics, cost-effectiveness and patient centeredness.
The Beginning of a Decline in Breast Cancer Incidence in Italy?
Authors: Zanetti Roberto , Ponti Antonio , Rosso Stefano , Ricceri Fulvio , Pitarella Sabina , Segnan Nereo
Published: February 2018

The incidence of invasive breast cancer in Turin, Italy, showed a statistically significant decrease during 1999–2003 overall (estimated annual percent change -2.6; 95% CL -8.52; -0.78) and in women aged over 50, similar to the recently documented trend in American data. This represents the first demonstration of a decline in breast cancer incidence in the early years of this decade outside the United States. In our population, the drop in the usage of hormone replacement therapy which occurred after 2002 is unlikely to be at the origin of this declining incidence trend, which is largely explained by a screening effect. This observation may be relevant to other geographical areas where organized or spontaneous screening reached a plateau after an increase in the preceding years.
Lipid-Rich Carcinoma of the Breast. A Clinicopathological Study of 49 Cases
Authors: Shi Peng , Wang Mingming , Zhang Qinghui , Sun Jingzhong
Published: February 2018

Aims and Background

Lipid-rich carcinoma is a very rare variant of breast cancer with an aggressive clinical course and poor prognosis. The present study aimed to explore its clinicopathologic characters.

Methods and Study Design

We reviewed 3,206 cases treated in two centers in the last 10 years. They all met the criteria of positive oil red O staining, were PAS negative and had the typical histological features included in the study. Their clinical data were collected. The expression of estrogen and progesterone receptors, HER2 and Ki67 was evaluated by immunohistochemistry.

Results

Forty-nine patients were diagnosed with lipid-rich carcinomas. They were all female and ranged in age from 22 to 72 years (mean, 45). The presenting symptoms included a breast mass or lump and nipple discharge. Axillary lymph node metastases were found in 79.2% of the patients at the time of surgery. Respectively 100% and 89.8% were negative for estrogen and progesterone receptors, whereas 71.4% were positive for HER2. All patients received surgery plus chemotherapy with or without radiotherapy. In vitro MTT assay showed taxol- or platinum-based chemotherapy to be the most effective. The 2- and 5-year overall survival rates were 64.6% and 33.2%, respectively.

Conclusions

Lipid-rich carcinoma has a biopathological profile significantly different from other types of breast cancer, with a predominance of unfavorable prognostic parameters. Early diagnosis and active treatment may be helpful to increase its overall survival.
Expression of CD40 in Ovarian Cancer and Adenovirus-Mediated CD40 Ligand Therapy on Ovarian Cancer in Vitro
Authors: Jiang Enli , He Xiang , Chen Xiancheng , Sun Guojuan , Wu Hongbing , Wei Yuquan , Zhao Xia
Published: February 2018

Aims and Background

To test the expression level of CD40 on ovarian cancer tissues and its correlation to clinicopathological features of patients and to evaluate the therapeutic effectiveness of adenovirus-mediated CD40 ligand on ovarian cancer in vitro.

Material and Methods

The expression of CD40 on paraffin-embedded ovarian cancer tissues (n = 58) and normal ovarian tissues (n = 15) was tested by immunohistochemistry, and CD40 expression on ovarian cancer cells derived from fresh surgical specimens was tested by flow cytometry analysis. The apoptosis-inducing effects of adenovirus-mediated CD40 ligand therapy on ovarian cancer cells derived from fresh surgical specimens were analyzed by flow cytometry analysis and TUNEL assay.

Results

CD40 expression was detected in 60.3% (35/58) of paraffin-embedded ovarian cancer tissues and 73.3% (11/15) of fresh ovarian cancer tissues, but not in normal ovarian tissues (n = 15). CD40 expression was significantly correlated with FIGO stage of ovarian cancer. Adenovirus-mediated CD40 ligand therapy induced significant apoptosis effects on ovarian cancer cells derived from fresh surgical specimens in vitro compared to null adenovirus vector and phosphate-buffered saline.

Conclusions

Our results suggested the therapeutic potential of adenovirus-mediated CD40 ligand on ovarian cancer, especially on the late stage of ovarian cancer.
Factors Predictive of Response to Hormone Therapy in Breast Cancer
Authors: Rastelli Francesca , Crispino Sergio
Published: February 2018

Aims and Background

Approximately half of metastatic breast cancers expressing estrogen and/or progesterone receptors responds to endocrine therapy, and postoperative adjuvant endocrine therapy provides about a 50% reduction in the development of recurrent disease. A number of publications have focused on the correlation of biomarkers, in particular estrogen and progesterone receptors and HER-2/neu status as well as different gene profiles, multigene assays and genetic polymorphisms with response to hormone therapy. The purpose of this article is to review the literature to identify biological markers predictive of response to tamoxifen and aromatase inhibitors.

Methods

A computerized literature search through Medline and ASCO abstract databases was performed, applying the words “endocrine therapy” and “predictive markers” and each of the following: early and metastatic breast cancer, estrogen receptors, progesterone receptors, HER2/neu, multigene assays, polymorphisms. The last search was updated in June 2007. In the examined literature, biological markers were retrospectively assayed to establish whether such variables were predictive for endocrine therapy efficacy.

Results

The role of estrogen receptor content as a predictor of response to endocrine treatment was confirmed: benefit from endocrine treatment was directly proportional to estrogen receptor levels. Progesterone receptor status was only a strong time-dependent prognostic value, and it has not yet been validated as a predictive factor of tamoxifen efficacy. Retrospective clinical data from upfront and sequential studies of aromatase inhibitors were discordant regarding the degree of benefit of these drugs over tamoxifen according to progesterone receptor status. HER-2 positivity was associated with a significantly greater risk of endocrine therapy failure in metastatic and neoadjuvant settings. The current generation of genomic assays for tamoxifen sensitivity all contain a combination of prognostic information that it is difficult to integrate into clinical practice.

Conclusions

Available clinical data are inconclusive to support preferential use of aromatase inhibitors over tamoxifen in progesterone-receptor-negative and HER-2-positive tumors, but it was also clear that lower estrogen receptors, lower progesterone receptors, and positive HER-2 are associated with lower responsiveness to any type of endocrine therapy. Tumors overexpressing HER-2 are endocrine resistant and they require the blockage of the HER-2 pathway in addition to estrogen deprivation. Recent molecular studies have shown that endocrine responsiveness is to a large extent influenced by estrogen-receptor-related pathways. In the future, the key to the correct tailoring of hormone therapy will probably be the ability to subtype estrogen-receptor-positive breast cancer.
Histopathological Parameters with Ki-67 and bcl-2 in the Prognosis of Meningiomas According to WHO 2000 Classification
Authors: Üzüm Nüket , Ataoğlu Gülen Akyol Ömür
Published: February 2018

Aims and Background

Meningiomas are classified following the WHO system of 2000 into three grades, benign (grade I), atypical (grade II), and anaplastic (grade III). We investigated the relation between tumor grade and Ki-67 and bcl-2.

Methods

In the present study, 246 cases of meningioma were reclassified according to the WHO 2000 system. The relationship between tumor grade and morphological parameters like pattern, mitotic index, cellularity, pleomorphism, nucleoli, small cell population with high nucleus/cytoplasmic ratio, necrosis and brain invasion was examined. Follow-up data were available for only 80 patients.

Results

A correlation was found between all morphologic parameters except for brain invasion. These parameters were related to a poor prognosis. There was no statistically significant difference in the prognosis between WHO grade I and grade II, whereas these two grades collectively exhibited significantly better survival than WHO grade III. Immunohistochemical staining for Ki-67 and bcl-2 was performed, and correlations between their expressions and other clinicopathological findings were investigated. Ki-67 and bcl-2 expression was correlated with tumor grade, and the higher the tumor grade, the higher the Ki-67 and bcl-2 expression. In conclusion, tumor grade appeared to be the most important parameter for a prognosis of meningiomas.

Conclusions

Ki-67 and bcl-2 expression might participate in carcinogenesis and when used with the grading system could provide additional benefit in assessing the biological behavior of the tumor.
Isolated Splenic Metastasis from Colon Cancer. Report of a Case
Authors: Montemurro Severino , Maselli Enrico , Ruggieri Eustachio , Caliandro Cosimo , Rucci Antonello , Zito Alfredo Francesco , Sciscio Vito
Published: February 2018

Isolated splenic metastasis is an uncommon event, except in the case of secondary involvement by lymphoma. The most common sites of metastases of colorectal cancer are the regional lymph nodes, liver and peritoneum; lung and bone are rarely involved, the spleen exceptionally. In this paper we report a case of metachronous isolated splenic metastasis of transverse colon cancer in an 80-year-old woman who was successfully treated by splenectomy. The peculiar clinical-pathological aspects of this kind of metastasis are discussed on the basis of our clinical observation and a review is presented of similar cases reported in the literature. Only 14 reported cases of isolated splenic metastasis from colorectal cancer were found in Medline.
Correlation between Magnetic Resonance Imaging and Histopathological Tumor Response after Neoadjuvant Chemotherapy in Breast Cancer
Authors: Nicoletto Maria Ornella , Nitti Donato , Pescarini Luigi , Corbetti Francesco , Mencarelli Roberto , Cappetta Alessandro , Galligioni Alessandra , Pogliani Claudia , Marchet Alberto , Bozza Fernando , Ghiotto Cristina , Griggio Luciano , Zavagno Giorgio , Donach Martin Edward , Di Maggio Cosimo
Published: February 2018

Aim

To evaluate the accuracy of magnetic resonance imaging in assessing tumor response following neoadjuvant chemotherapy in patients with locally advanced breast cancer.

Materials and Methods

Twenty-six patients entered a phase II study of neoadjuvant chemotherapy, undergoing bilateral breast magnetic resonance imaging before therapy and before surgery. Tumor response was classified using RECIST criteria, using tumor size at magnetic resonance imaging. The latter was then compared to residue found at histopathological examination.

Results

Magnetic resonance imaging showed 6 (23%) complete responses, 17 (65%) partial responses, 3 (11.5%) disease stabilizations and no disease progressions. Twenty-three tumors (88.5%) were considered responsive and 3 (11.5%) unresponsive. Pathological tumor response was: 6 complete responses (23%), 17 partial responses (65%), 2 stable disease (8%), 1 progression (4%). When results of the preoperative magnetic resonance imaging were compared to pathological tumor response, magnetic resonance imaging overestimated tumor size in 12 cases (46%) and underestimated it in 9 (35%). However, preoperative magnetic resonance imaging failed to detect invasive tumor in 2 false-negative cases (8%), 1 of which was multifocal. Mastectomy was performed in 12 cases: 1 case of disease progression even though the neoplasm appeared smaller at magnetic resonance imaging, 3 cases with stable disease, and 4 cases with T3 or T4 disease. The 9th patient was T2N2 with initial retroareolar disease and negative magnetic resonance imaging after chemotherapy. The 10th patient, affected by lobular cancer, was in partial remission but was T3N1. The 11th patient was 57 years old but was not interested in conservative surgery. The 12th patient requested bilateral prophylactic mastectomy due to her positive family history of breast cancer.

Conclusions

Magnetic resonance imaging of the breast allowed conservative surgery in 54% of the patients. This low value is primarily due to overestimation of tumor size, with a negative predictive value of 67% in our population. However, surgeons were able to choose conservative surgery with relative safety in cases of small residual disease.
Gliosarcomas in the Elderly: Analysis of 7 Cases and Clinico-Pathological Remarks
Authors: Di Norcia Valerio , Piccirilli Manolo , Giangaspero Felice , Salvati Maurizio
Published: February 2018

Aims and Background

Gliosarcomas are rare malignant primary brain tumors that usually affect the fifth or sixth decades of life. The purpose of this study was to describe our experience with such lesions in elderly patients and to establish their prognosis factors.

Methods

Between 1993 and 2001, 7 patients over 60 years of age were treated at our institute for cerebral gliosarcomas. All patients underwent surgery for total or at least sub-total removal of a neoplastic mass.

Results

Owing to poor clinical conditions (Karnofsky performance score = 40), one patient was not treated postoperatively. Remaining patients were treated with whole-brain radiotherapy, whereas concomitant chemotherapy (temozolomide) was administrated only to 4 patients. Histological examination showed the prevalence of sarcomatous aspects in 3 patients; the gliomatous aspect prevailed in 4 patients.

Conclusions

Sarcomatous aspects and multimodality treatment (surgery, radiotherapy and chemotherapy) were associated with a better prognosis and showed in these elderly patients a trend similar to that of young people.
Retroperitoneal Soft Tissue Sarcoma: Prognostic Factors and Therapeutic Approaches
Authors: Pacelli Fabio , Pio Tortorelli Antonio , Rosa Fausto , Papa Valerio , Bossola Maurizio , Sanchez Alejandro Martin , Ferro Alessandra , Menghi Roberta , Covino Marcello , Doglietto Giovanni Battista
Published: February 2018

Aims and Background

Retroperitoneal sarcomas are a rare group of malignant soft tissue tumors with a generally poor prognosis. The aim of the study was to assess clinical, pathological and treatment-related factors affecting prognosis in patients with retroperitoneal sarcomas.

Methods and Study Design

The hospital records of 73 patients who underwent surgical exploration at our unit for primary retroperitoneal sarcomas between 1984 and 2003 were reviewed. Factors influencing overall and disease-free survival were analyzed for all patients and for those who underwent complete surgical resection.

Results

The complete resectability rate was 69.8% (51/73). Operative mortality and morbidity rates were 2.7% and 21.9%, respectively. For patients who underwent complete resection, the 5-year survival rate was 58.3%, whereas it was 0% in cases of incomplete or no resection (P <0.001). Local recurrence rate was 37.2%. Incomplete gross surgical resection and microscopic infiltration of margins were the most important independent predictors of a poor prognosis.

Conclusions

The present study confirmed the importance of an aggressive surgical management for retroperitoneal sarcomas to offer these patients the best chance for long-term survival.
Serum IL-6, IL-8, IL-10 and Beta2-Microglobulin in Association with International Prognostic Index in Diffuse Large B Cell Lymphoma
Authors: Duletić-Načinović Antica , Štifter Sanja , Marijić Blažen , Lučin Ksenija , Valković Toni , Petranović Duška , Jonjić Nives
Published: February 2018

Aims and Background

Diffuse large B-cell lymphoma displays striking heterogeneity at clinical, genetic and molecular levels. The International Prognostic Index is useful to predict the outcome of diffuse large B-cell lymphoma patients. However, patients with identical International Prognostic Index values in clinical practice exhibit marked variability in survival, suggesting the presence of significant residual heterogeneity within each category. Since cytokines such as interleukin-6, -8 and -10 play important roles in the pathogenesis of lymphomas, and plasma level of beta2-microglobulin is associated with the outcome of patients with diffuse large B-cell lymphoma, the aim of the present study was to determine whether these parameters combined with the International Prognostic Index would better stratify these patients to predict their prognosis.

Patients and Methods

The study included 46 untreated diffuse large B-cell lymphoma patients.

Results

All study parameters (International Prognostic Index, Ann Arbor stage, extra-nodal involvement, performance status, lactate dehydrogenase, beta2-microglobulin, interleukin-6 and -10, and response to therapy) except for patient age and serum interleukin-8 level were associated with overall survival. In addition, the International Prognostic Index was strongly correlated with beta2-microglobulin, interleukin-6, -8 and -10, and when combined these parameters significantly better stratified patients according to survival. On multivariate analysis, therapeutic response to the primary treatment, elevated interleukin-6 and -10 levels, and the International Prognostic Index were significant predictors of overall survival.

Conclusions

Our data imply that interleukins and beta2-microglobulin evaluation should be used in association with the International Prognostic Index to define prognostic subgroups in diffuse large B-cell lymphoma patients.
Clinicopathological Significance of Overexpression of TSPAN1, KI67 and CD34 in Gastric Carcinoma
Authors: Chen Li , Li Xinyu , Wang Guei-lan , Wang Yu , Zhu York-Yuan , Zhu Jianwei
Published: February 2018

To investigate the expression of TSPAN1 (Gene ID: 10103), Ki67 and CD34 in gastric carcinomas and the clinicopathological significance, the expression of TSPAN1, Ki67 and CD34 was detected in 86 cases of gastric carcinoma, paraffin-embedded sections using an immunohistochemical method. The rates of overexpression of TSPAN1, Ki67 and CD34 in gastric carcinomas were 56.98%, 74.42%, and 62.79%, respectively. The overexpression of these markers was positively correlated with clinical stage and negatively correlated with survival rates (at 3 and 5 years). The overexpression of TSPAN1 and Ki67 was negatively correlated with carcinoma differentiation, and the overexpression of TSPAN1 and CD34 was positively correlated with infiltration and lymph node status of the tumor. Thus, overexpression of TSPAN1, Ki67 and CD34 in gastric cancer tissues is associated with development of the cancer. The detection of expression of TSPAN1, Ki67 and CD34 in gastric cancer may provide useful prognostic information for patients with the disease.
Tumor Seeding after Open Nephroureterectomy for Ureteral Transitional Cell Carcinoma
Authors: Saredi Giovanni , Di Pietro Corradino , Spasciani Roberta , De Stefani Stefano , Sighinolfi Maria Chiara , Micali Salvatore , Bianchi Giampaolo
Published: February 2018

Skeletal muscle metastases following cancer surgery are rare. Few cases of abdominal wall metastasis have been reported in the literature and attributed to tumor seeding after laparoscopic surgery or percutaneous nephrostomy. We report a case of abdominal tumor seeding after open nephroureterectomy managed by means of a surgical and medical approach.
Laparoscopic Treatment of Simultaneous Splenic Lymphangioma and Non-Hodgkin's Lymphoma: Report of a Case
Authors: Puglisi Francesco , Marino Fabio , Gentile Antonia , Capuano Palma , Martines Gennaro , Lograno Giuseppe , Memeo Riccardo
Published: February 2018

We report, to the best of our knowledge, the first case of simultaneous splenic lymphangioma and non-Hodgkin's B-cell lymphoma with liver and bone marrow involvement arising in a 69-year-old woman suffering from chronic hepatitis C infection treated with laparoscopic splenectomy followed by polychemotherapy. After 22 months from surgical treatment, the patient is alive without signs of residual disease. According to our experience, laparoscopic splenectomy followed by polychemotherapy seems to be an effective treatment for simultaneous splenic lymphangioma and non-Hodgkin's B-cell lymphoma.
Small-Cell Lung Cancer: An Unusual Therapeutic Approach with More than 10-year Overall Survival. Case Report and Review of the Literature
Authors: Samelis Georgios F , Ekmektzoglou Konstantinos A , Xanthos Theodoros , Zografos Georgios C
Published: February 2018

Small-cell lung cancer is the most aggressive lung cancer, with a dismal prognosis. The authors present a case report of a patient with limited-stage small-cell lung cancer who underwent a thoracotomy for diagnostic purposes, with the diagnosis being made after surgical excision. Combination chemotherapy remains the cornerstone of treatment for both limited and extensive disease. Radiotherapy has been established as an adjunct to chemotherapy in limited-stage disease, while in extensive-stage disease it is mostly reserved for the treatment of brain metastases. As for surgery, the potential benefits of resection are predominantly seen in patients who present with a solitary pulmonary nodule. Since small-cell lung cancer becomes highly resistant to chemotherapy, second-line chemotherapeutic schemes are used for disease progression, with topotecan being the highlighted agent. Despite the unusual therapeutic approach, where surgery was preferred over the standard diagnostic and staging procedures, the patient's more than ten years’ survival makes this case presentation a very interesting one.
Cancer Mortality in Italy, 1970–2002
Authors: Malvezzi Matteo , Bosetti Cristina , Negri Eva , La Vecchia Carlo , Decarli Adriano
Published: February 2018

Aims and background

To update previous work on Italian cancer mortality.

Methods

WHO data were used to calculate death rates for 30 cancer sites for 2002. Trends were analyzed with joinpoint regression over the 1970–2002 period.

Results

Total cancer deaths for 2002 in Italy were 163,070 (93,398 men, 69,672 women). Male cancer mortality rose until 1988 and since then has had a 1.4% yearly fall. The first cause of cancer death in males was lung cancer, accounting for 28% of deaths. The decrease in mortality from male lung cancer came about the end of the 1980's (estimated annual percentage change, EAPC, −1.26 from 1989 to 1993 and −2.32 thereafter) and was the main reason for the favorable trends in total male cancer mortality, reflecting the change in smoking prevalence in Italian males. Female total cancer mortality trends have also been favorable, with an overall yearly drop of 1.1% since 1992. The most frequent causes of cancer deaths in females were breast and colorectal cancers, accounting for 16% and 14% of cancer deaths, and both showed declining trends (EAPC, −1.80 since 1992 and −1.51 from 1993 for breast and colorectal cancers, respectively). Female lung cancer has been on the rise (EAPC, 0.82 since 1987) for the last decades due to the rise in cigarette smoking since the 1970's in Italian females.

Discussion

Mortality from the most common cancers in Italy showed a favorable trend over recent years, the maintenance and potential improvement of which would require a strategy focusing on the control of tobacco and alcohol consumption, nutrition and diet. Early diagnosis for selected neoplasms can also have a relevant impact, together with advancements in treatments.
Diet and Melanoma Risk: Effects of Choice of Hospital versus Population Controls
Authors: Malagoli Carlotta , Vinceti Marco , Pellacani Giovanni , Sieri Sabina , Krogh Vittorio , Seidenari Stefania , Bergomi Margherita
Published: February 2018

Aims and background

Hospital-referred subjects are widely used as controls in studies on the relation between diet and cancer risk. However, concern has been raised about the potential for bias of such type of referents, and few studies seem to have examined their reliability in estimating dietary habits of the underlying general population.

Methods

In a northern Italian setting, the differences in dietary patterns between 41 individuals referred for non-neoplastic lesions to hospital surgical outpatient units and age- and sex-matched subjects drawn from the general population were examined. The effects of such differences when carrying out a case-control study on a neoplastic disease, cutaneous melanoma, were also analyzed. Dietary intake was assessed using the EPIC food frequency questionnaire.

Results

Population controls showed higher intakes of energy, animal proteins and animal fats compared with sex- and age-matched hospital controls, whereas intake of carbohydrates and fiber was comparable. An excess melanoma risk associated with intake of animal proteins and fats emerged when hospital controls were used as the referent group, whereas no such relation was detected when cases were compared to population controls.

Conclusions

The results suggest that hospital-referred subjects may not reflect dietary habits of the underlying general population and may be unsuitable for case-control studies concerning the relation between diet and cancer risk.
Liposomal-Encapsulated Doxorubicin (Myocet™; D-99) and Vinorelbine in Previously Treated Metastatic Breast Cancer Patients: A Feasibility Study
Authors: Poletti Paola , Bettini Anna Cecilia , Caremoli Elena Rota , Labianca Roberto , Tondini Carlo
Published: February 2018

Aims and background

We conducted a feasibility study to determine the safety and efficacy of liposome-encapsulated doxorubicin (Myocet) and vinorelbine in previously treated metastatic breast cancer patients.

Patients and methods

Liposome-encapsulated doxorubicin (30 mg/m2) plus vinorelbine (25 mg/m2) on days 1 and 8, every 3 weeks were given until disease progression, sever toxicity or up to 9 cycles. All patients underwent tumor assessment before enrollment. Patients with a life expectancy longer than 3 months and measurable or assessable disease were eligible.

Results

Twenty-one patients were included. Median number of treatment cycles was 5 (range, 3–9). No complete response was obtained. Stable disease and/or partial response was obtained in 9 patients. Fifteen patients experienced grade 3–4 leukopenia. There was no significant decline in cardiac function. Non-hematological toxicity was tolerable (grade 1–2).

Conclusions

The association of doxorubicin and vinorelbine has been shown to be feasible in previously treated advanced breast cancer patients. Its efficacy should be tested as first-line therapy in metastatic patients with cardiac co-morbidities.
p16 Expression in Odontogenic Tumors
Authors: Artese Luciano , Piattelli Adriano , Rubini Corrado , Goteri Gaia , Perrotti Vittoria , Iezzi Giovanna , Piccirilli Marcello , Carinci Francesco
Published: February 2018

Aims and background

The aim of the study was to examine the immunohistochemical expression of a cell-cycle-related factor (p16) in order to elucidate its role in the growth and diffusion of odontogenic tumors.

Study design

Thirty-six odontogenic tumors were divided into two groups according to their clinical behavior: group A and group B composed of tumors at low and high risk of recurrences, respectively. The ANOVA test was used to detect differences between the two groups.

Results

p16 was expressed in both groups, but with different localization. A statistically significant difference was found in p16 expression of peripheral cells, with an increase in the expression in group B compared to group A ( P <0.05). In addition, there was no significant difference in p16 positive expression of the central cells of odontogenic tumors, which was high in both groups.

Conclusions

The present data show a correlation between p16 expression and the biological behavior of odontogenic tumors.
A Guide of the Questionnaires Used in the Measurement of Health-Related Quality of Life in Head and Neck Oncology
Authors: Kanatas Anastasios N , Rogers Simon N
Published: February 2018

Aims and background

There is a plethora of instruments which measure health-related quality of life (HRQOL), although only a fraction of these have been used in surgical studies and palliative care. Clinicians involved in the management of head and neck pathology face the difficult task of selecting the instrument most suited to the aspect of the patients’ perspective that they want to measure. The aim of this article is to guide head and neck trainees in deciding on the use of the appropriate instrument for evaluation of the patient's perspective.

Methods and study design

The two authors independently searched and scrutinized the literature. The ISI search engine with cross-reference using PubMed and Ovid was searched with the terms “quality of life”, “questionnaire” and specific specialty terms. Studies written in the English language were selected and the abstracts searched for evidence of patient self-completed questionnaires and HRQOL outcome.

Results

There are five broad category headings into which quality of life studies in head and neck oncology can be divided. These include: patient performance questionnaires, generic quality of life questionnaires, generic cancer questionnaires, head and neck cancer questionnaires, and head and neck functional questionnaires.

Conclusions

Patient perspective can be assessed using a number of instruments, including open interview, semi-structured interview, and the simple questionnaire. The choice of instrument depends somewhat on personal preference, the outcomes being measured, and available resources.
Disseminated Intravascular Coagulation during Treatment with Thalidomide. A Case Report
Authors: Tassinari Davide , Tombesi Paola , Sartori Sergio
Published: February 2018

The treatment with thalidomide is associated with an increased risk of thromboembolic events, in particular when it is combined with chemotherapy or dexamethasone. However, despite this well-documented prothrombotic effect, to our knowledge disseminated intravascular coagulation has never been reported in hematological or oncological patients treated with thalidomide. We report a case of disseminated intravascular coagulation in a patient treated with thalidomide and dexamethasone for advanced, heavily pretreated hormone-resistant prostate cancer in which a relationship with the treatment appears highly likely.
Radiotherapy for Perianal Paget's Disease: A Case Report
Authors: Velenik Vaneja , Šegedin Barbara , Anderluh Franc , Oblak Irena , Strojan Primož
Published: February 2018

Background

Perianal Paget's disease was first described in 1893. Since then, fewer than 300 cases have been reported in the literature. It might be associated with an underlying malignancy. Most of the patients are treated with surgical excision, which is often mutilating and of variable efficacy. In the present report, we describe the case of an 80-year-old woman with perianal Paget's disease. She was treated at our institution with radiotherapy with curative intent. The pertinent literature is reviewed, and the controversies in diagnosis and management are discussed.

Conclusions

Our single-case experience supports the opinion that radiotherapy is a viable treatment option with curative potential for patients with perianal Paget's disease. For the treatment of in situ disease, hypofractionated regimens to a total dose of 40–44 Gy and orthovoltage X-ray beams are recommended.
Woringer-Kolopp Disease Coexpressing CD4 and CD8 Treated with Radiation Therapy: A Case Report
Authors: Zengin Ahmet Yasar , Topkan Erkan , Cimsit Gülseren , Yildiz Kadriye
Published: February 2018

We present an extremely rare case of Woringer-Kolopp disease with CD4+/CD8+ immunohistochemical features in a 27-year-old male patient, which involved the right gluteal region continuing down to the lower thigh. Although the lesions had been present for 15 years, the disease abruptly changed its indolent clinical behavior in the last 3 months and gained local aggressiveness without features of dissemination. The patient was successfully treated with 6 MeV electron-beam radiotherapy and the radiation portal was determined to be the gross lesion plus 1-cm margins around the lesion. Radiation therapy was administered with a hypofractionated dose schedule of 2.8 Gy per fraction in 13 fractions, 5 days a week, to a total of 36.4 Gy. No radiation-induced toxicity was reported during therapy. The patient's follow-up was ordinary with no recurrence after a follow-up period of 38 months and the cosmetic result was excellent.
Diabetes Insipidus Caused by Pituitary Gland Metastasis Accompanied by Iris Metastasis of Small Cell Lung Cancer: Case Presentation and Review of the Literature
Authors: Alacacioǧlu Ahmet , Öztop İlhan , Fidan Fatma , Akkoçlu Atila , Kargi Aydanur , Osma Emine , Ada Emel , Yilmaz Uǧur
Published: February 2018

Metastasis to the pituitary gland and iris is rarely seen in cancer patients. Breast cancer and lung cancer are the most common tumors that metastasize to these sites. Most lung cancer patients have non-small cell lung cancer and metastasis of small cell lung cancer to the pituitary gland and iris have been very rarely reported in the literature. Here we present a case of iris metastasis and pituitary gland metastasis which caused diabetes insipidus in a patient with small cell lung cancer.
Prevalence of Second-Hand Smoke Exposure After Introduction of the Italian Smoking Ban: The Florence and Belluno Survey
Authors: Gorini Giuseppe , Gasparrini Antonio , Tamang Elizabeth , Nebot Manel , Lopez Maria José , Albertini Marco , Marcolina Daniela , Group Esteve Fernandez, and the ETS EuroSurvey Working ,   the ETS EuroSurvey Working Group, Nebot M , López MJ , Centrich F , Fernández E , Schiaffino A , Moshammer H , Neuberger M , Gorini G , Albertini M , Mulcahy M , Prezwozniak K , Zatonszi W. , Gumkowski J , Chudzikova M , Pilali M , Birkui P
Published: February 2018

Aims and Background

A law banning smoking in enclosed public places was implemented in Italy on January 10, 2005. The aim of this paper is to present a cross-sectional survey on two representative samples of non-smokers of two Italian towns (Florence and Belluno), conducted one year after the introduction of the ban, in order to assess prevalence of second-hand smoke exposure, to record the attitudes towards the ban, and the perception about its compliance in a representative sample of non-smokers.

Methods

Computer-assisted telephone interviews were carried out in March 2006, from a random sample of households from telephone registries. Respondents were 402 non-smokers from Belluno and 1,073 from Florence.

Results

About 12% of Florentines and 7% of Belluno respondents were exposed at home; 39% and 19%, respectively, at work; 10% and 5% in hospitality venues; 20% and 10% in cars. The smoke-free law was almost universally supported (about 98%) even if a smaller proportion of people (about 90%) had the perception that the ban was observed.

Conclusions

Second-hand smoke exposure at home and in hospitality premises has dropped to ≤10%, whereas exposure at work remained higher. These results suggest the need for more controls in workplaces other than hospitality venues.
Treatment of Patients Aged over 50 Years with Non-Osseous Ewing's Sarcoma Family Tumors: Five Cases and Review of Literature
Authors: Bar-Sela Gil , Peer Avivit , Rothschild Shelly , Haim Nissim
Published: February 2018

Background

Most clinical trials on Ewing's sarcoma family of tumors include pediatric and adolescent populations, whereas clinical data on older patients are limited.

Patients and Methods

We report on 5 patients older than 50 years with a tumor of the Ewing's sarcoma family treated recently in our department.

Results

Myelosuppression and infectious complications were the main toxicity encountered. Major dose reductions and/or treatment delays were required in all 5 patients. One patient died of septic shock. Complete remission was achieved in the remaining 4 patients with the addition of different treatment modalities. One patient had lung metastasis 3 years after starting chemotherapy, and 3 patients have remained without evidence of recurrent disease for 1–6 years from the onset of chemotherapy.

Conclusions

There is no definite answer as to whether older age is a poor prognostic factor in patients with a tumor of the Ewing's sarcoma family. In our experience, patients over 50 poorly tolerated the standard chemotherapy protocol used in the pediatric population.
Immunohistochemical Analysis of ER, PR, HER-2, CK 5/6, p63 and EGFR Antigen Expression in Medullary Breast Cancer
Authors: Matkovic Bozica , Juretic Antonio , Separovic Viktor , Novosel Irena , Separovic Robert , Gamulin Marija , Kruslin Bozo
Published: February 2018

Aims and Background

Recent publications of breast cancer classification based on gene expression profile analyses indicate that medullary breast carcinomas (MBC) may be considered part of the basal-like carcinoma spectrum made up of ER-negative, PR-negative and HER-2-negative cells (“triple-negative phenotype”). On the other hand, there are also data showing that a proportion of MBC and atypical MBC (AMBC) is ER, PR and/or HER-2 positive. Therefore, we have decided to immunohistochemically analyze ER, PR, HER-2 and basal/myoepithelial markers CK5/6, p63 and EGFR expression in our archival paraffin-embedded MBC and AMBC samples from 48 patients.

Methods

Immunohistochemical evaluation of samples which were derived from patients operated on at our two hospitals between 1999 and 2005.

Results

Typical MBC was found in 39 patients and AMBC in 9 patients. The patients ranged in age from 32 to 84 years (median 55). Modified radical mastectomy with axillary dissection was performed in 30/48 patients (63%) while breast segmentectomy with axillary dissection was performed in 18/48 patients (37%). Metastases in axillary lymph nodes were observed in 15/48 patients (31%). ER positivity was present in 3/48 patients (6%), PR positivity in 8/48 (17%), and a positive HER-2 reaction was present in 14/48 patients (29%). CK 5/6 was positive in 20/48, p63 in 24/48 and EGFR in 8/48 patients. Adjuvant therapy was applied in all but 2 patients. Alive were 45/48 (94%) of patients. With the exception of PR expression, 39 patients with typical MBC and 9 patients with AMBC were comparable in the analyzed parameters. Positive HER-2 antigen expression in the analyzed sample was not found to be associated to a statistically significant degree with the MBC or AMBC histological tumor type, tumor size, axillary lymph node metastases, ER and PR status nor with patient survival.

Conclusions

The data from our study seem to be generally comparable with the relatively scarce published data on clinicopathological parameters of MBC and AMBC.
Erlotinib in Advanced Well-Differentiated Thymic Carcinoma with Overexpression of EGFR: A Case Report
Authors: Pedersini Rebecca , Vattemi Emanuela , Lusso Maria Rita , Mazzoleni Guido , Ebner Heinrich , Graiff Claudio
Published: February 2018

Aims and Background

Advanced chemorefractory epithelial thymic tumors are still a challenge in clinical oncology. A therapeutic approach targeting a key molecular pathway could be the ideal solution in a neoplasm that can overexpress epidermal growth factor receptor (EGFR) in the epithelial component.

Methods

A patient with metastatic heavily pretreated thymic carcinoma was evaluated for EGFR expression in the primary tumor.

Results

Strong EGFR expression was revealed by immunohistochemistry. The patient received erlotinib therapy but had obtained no response after four months of treatment.

Conclusion

This preliminary experience suggests that erlotinib may not be a useful therapeutic choice in advanced pretreated thymic carcinomas.
Chondrosarcoma of the Larynx: Presentation of a Case and Review of the Literature
Authors: Rizzo Santino , Strinati Francesco , Longari Fabrizio , Bizzotti Cristina , Altissimi Guido , Frenguelli Antonio
Published: February 2018

Chondrosarcoma of the larynx is a rare tumor of the upper respiratory tract that originates from cartilaginous tissue. The cricoid cartilage is the most frequent site of onset at the larynx. The diagnosis is not always easy, given the tumor's slow growth rate, the aspecificity of the symptoms, and the low degree of malignancy with which most cases present and which often causes it to be mistaken for a chondroma. A case is presented of a 61-year-old woman with a chondrosarcoma of the larynx, grade 2, originating from the cricoid cartilage and measuring about 3 cm in diameter. The patient underwent extirpation of the tumor together with the cricoid cartilage, with a successive thyrotracheal anastomosis because she refused a total laryngectomy, which would have been the indicated intervention on the basis of the extent and grade of the neoplasm. At 6 years from surgery, the patient is in a good state of health with good laryngeal function and without recurrence of the disease. This fact confirms that the surgical approach to chondrosarcoma of the larynx can in most cases be conservative, reserving demolitive surgery for the more aggressive forms, for tumors of greater extent, and for recurrences. In fact, good laryngeal function and therefore a good quality of life can be maintained even for long periods of time.
Primary Cardiac Angiosarcoma: A Case Report
Authors: Erpolat Ozge Petek , Icli Fikri , Dogan Orhan Veli , Gokaslan Gokhan , Akmansu Muge , Erekul Selim , Yucel Ertan
Published: February 2018

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. We describe a 29-year-old man with primary cardiac angiosarcoma with multiple site metastases. The therapeutic approach includes surgery, chemotherapy and radiotherapy alone or in combination. New techniques of radiotherapy and combined chemotherapeutic agents may relieve symptoms and prolong a patient's life. We discuss the diagnosis and treatment of cardiac angiosarcoma in the light of a case report.
Estimates of the Incidence and Prevalence of Hepatocellular Carcinoma in Italy in 2002 and Projections for the Years 2007 and 2012
Authors: Bosetti Cristina , Bianchi Cosetta , Negri Eva , Colombo Massimo , La Vecchia Carlo
Published: February 2018

Aims and background

Data on liver cancer incidence and prevalence in Italy are not available on a national and regional level.

Methods

We provided estimates of the number of incident and prevalent cases for hepatocellular carcinoma in Italy overall and in various regions in 2002 and gave projections for the years 2007 and 2012. We obtained annual numbers of incident cases of hepatocellular carcinoma by combining mortality data provided by the World Health Organization and information on survival for liver cancer, and subsequently derived five-year prevalence for hepatocellular carcinoma by combining incidence with information on survival.

Results

In 2002, there were about 5800 incident cases and 4300 prevalent cases of hepatocellular carcinoma in Italy. The most reliable estimate of hepatocellular carcinoma incident cases in Italy in 2007 is between 5500 and 6000, and this figure is likely to decline to 5000–5500 in 2012. The best estimate of prevalence is about 4000 cases in 2007, which is likely to decline to 3700 in 2012.

Conclusions

Incidence and prevalence of hepatocellular carcinoma are likely to remain approximately stable between 2002 and 2007 and slightly decrease in the subsequent quinquennia. These projections are, however, subject to large uncertainties because of the problems in diagnosis and death certification for this neoplasm, particularly for the elderly.
Atypical Lobular Hyperplasia and Lobular Carcinoma in Situ without other High-Risk Lesions Diagnosed on Vacuum-Assisted Core Needle Biopsy. The Problem of Excisional Biopsy
Authors: Polom Karol , Murawa Dawid , Pawelska Anna , Murawa Pawel
Published: February 2018

ims

Verification of clinical procedure in patients with primary diagnosis of lobular carcinoma in situ and atypical lobular hyperplasia found on the basis of 11-gauge mammotomic biopsy.

Material and methods

A retrospective evaluation of 4326 mammotomic biopsies carried out in one clinic by three oncological surgeons in view of the diagnosed lobular carcinoma in situ or atypical lobular hyperplasia without concomitant invasive lesions. Biopsies showed that lobular carcinoma in situ or atypical lobular hyperplasia were concomitant lesions with benign changes of the mammary gland.

Results

Of 16 cases of lobular carcinoma in situ, invasive ductal cancer was observed in 2 patients, invasive lobular cancer in 2 patients, and ductal carcinoma in situ in 1 case. Seven patients did not undergo surgery but were kept under intensive oncological supervision. Of 17 cases of atypical lobular hyperplasia, after surgery it turned out that there were 4 cases of invasive ductal cancer and 1 case of ductal carcinoma in situ. Five patients did not undergo surgery but were kept under intensive oncological supervision.

Conclusions

After initial mammotomic diagnosis of lobular carcinoma in situ, invasive carcinoma or ductal carcinoma in situ was found in 31.25% of the cases and atypical lobular hyperplasia in 29.4%. This suggests that lobular neoplasia on core needle biopsy should prompt surgery. The open question is what factors are associated with the lower probability of concomitant invasive cancer. It seems that for isolated microcalcifications, which are totally removed in core biopsy, we can offer a close follow-up. We will have to wait for a follow-up longer than 2 years to be sure that surveillance is recommended for totally removed isolated microcalcifications.